What is High-Functioning Anxiety?

“I am an old man and have known a great many troubles – but most of them never happened.” – Mark Twain

High-functioning anxiety isn’t actually considered a clinical health diagnosis in the way that other forms of anxiety disorders are such as: general anxiety disorder, obsessive compulsive disorder, post-traumatic stress disorder and others[1]. High-functioning anxiety has not (yet) been included in the Diagnostic and Statistical Manual of Mental Disorders (DSM–5).

High-functioning anxiety is often a stress-related condition that develops over time. To the outside world you appear to be not only “just fine,” but super responsible and often a high achiever. High-performing anxiety, as the name suggests, implies that your responsibilities are being met and exceeded, but at a high cost to your physical and emotional well-being.

Anxiety is a normal reaction to stress and can serve us in challenging situations, and serves as a “red flag” that something is amiss. It can alert us to dangers and help us prepare and pay attention. When this early warning system remains on high alert throughout the day High-functioning anxiety can be exhausting- impact your health and well-being. Anxiety is a bodily natural response to stress. When you don’t know what to expect, your anxiety can be triggered.

Do You Think You Might Have High-Functioning Anxiety?

  • Your career is on track, but your personal life is a struggle
  • You appear highly responsible and ambitious, but it’s anxiety that’s driving the show
  • To the outside world you have it together, but getting through every day is very difficult
  • Unexpected changes in your routine cause you to be upset
  • Your mind never stops, and you feel exhausted
  • You internally react to things that others aren’t phased by
  • You often cancel plans with friends, because you are too exhausted to “put on a smile”
  • Days off are often an opportunity to collapse rather than have fun and recharge

Who is Affected by High-Functioning Anxiety?

According to the National Institute of Mental Health (NIMH) approximately 40 million people suffer from an anxiety disorder at any given time and some fall into this category of “high functioning”—a silent anxiety masked by a smile. Some sources report that women are twice as likely as men to suffer from anxiety.

People with high-functioning anxiety appear to be in total control at work and social situations, however, under the surface they are experiencing the same symptoms of anxiety disorders. These include feelings of unrelenting worry, dread, fear, heart fluttering, gut issues, and quiet despair. Anxiety propels people with this condition to achieve more, while other forms of anxiety may cause a person to be frozen with fear.

Regardless of their outstanding accomplishments, there is an impending sense of “the other shoe dropping” or something going horribly wrong. The negative mind takes over by scrutinizing and criticizing even the best jobs that were well done. The “what if” scenarios get replayed in their mind over and over.

What Are the Symptoms of High-Functioning Anxiety?

  • The need to have everything under control in order to feel at ease
  • Getting things done is a higher priority than your health
  • Saying yes to non-essential requests, when you are already overwhelmed
  • Feeling distressed yet you continue to operate in your day-to-day life while no one around you really knows what’s happening with you internally
  • Sleep problems caused by incessant worry
  • Wearing a mask to hide your emotions, not showing up as your authentic self
  • Negative self-talk is relentless
  • Destructive self-soothing behaviors such as smoking, drinking, drugging, shopping
  • Excessive ruminating
  • Reliance of the approval and opinion of others, rather than tapping into their own internal reference point

How Do I Relieve High-Functioning Anxiety, Naturally?

Many people are opting for non-pharmaceutical solutions to stress, anxiety, and depression management. Breaking the grip of the anxious mind requires help from many fronts. In yogic terms, the anxious mind is referred to as the “negative mind.” If left unchecked, it obsesses about the “what if’s” of a situation to an unnecessary, and sometimes debilitating, degree. The job of the negative mind is to raise cautions and considerations about the situation at hand.

There is value in the negative mind’s contributions to a situation, however when it hijacks the problem, especially minor details, and runs down the field like a quarterback then problems arise. The negative mind[2] needs to be trained to do its part, then yield to the “neutral mind,” the deep reservoir of inner heart wisdom, discerns the correct course of action.

7 Keys to Healing from High-Functioning Anxiety

  1. Begin a daily gratitude practice (use gratitude to turn off fear)
  2. Shift to an inner reference point of control rather than seeking outside validation
  3. Give yourself safety cues by using a mantra (example: “May I be happy. May I be well. May I be safe. May I be peaceful and at ease”)
  4. Learn self-regulation strategies that quell anxiety (i.e. heart rhythm biofeedback)
  5. Learn to become the observer and witness your emotional responses
  6. “Rewire” your neurocircuitries and establish new patterns
  7. Evaluate gut health and nutrition (gut health and anxiety are closely linked!)

There are many options available today for quelling High-Performing Anxiety. In fact, it can be downright overwhelming. It is not enough to read and educate yourself on High-Performing Anxiety, you must make changes in lifestyle and thought patterns. Effective strategies for managing High-Performing Anxiety should include (at a minimum):

  • Moving beyond talk therapy
  • Getting the body in act
  • Shifting your internal compass from ego to heart
  • Optimize your gut and brain bacteria

Want Help Developing a Strategy, There Is Another Way

When you want help with an actionable and personalized plan to relieve High-Performing Anxiety naturally, then let’s meet over a coffee in my Zoom office (virtual) and see if working together may be a viable option for you.

“Together, we work on healing your autonomic nervous system through mind-body principles.”

Schedule free consultation with Dr. Anne Taylor now.



[1] It is important to check in with your healthcare provider to understand what you are dealing with and what treatment options are available.

[2] The counterpart to the negative mind is the positive mind. The saying “fools rush in where angels fear to tread” encapsulates the positive mind, because it only sees the positive side of a situation. The positive mind does not consider anything that could possibly go wrong. The two minds, negative and positive, are trained in yoga to yield to the neutral mind–the wise discriminator who “listens” to both sides and discerns accordingly.

Leave a Comment