The Characteristics of High Functioning Anxiety

By Olivia Guy-Evans, published May 09, 2022 | Fact Checked by Saul Mcleod, PhD


Although it is not recognised as a mental health disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), high functioning anxiety is a condition characterised by symptoms of anxiety which do not prevent someone from being successful in their lives.

 High Functioning Anxiety

It is thought of as a general term that refers to people who live with anxiety but identify as functioning reasonably well in different aspects of their lives.

On the outside, someone with high functioning anxiety appears to manage well, they may be highly successful in their careers, academically, and have a full social life.

However, they experience internal struggles of anxiety such as excessively worrying, being restless, having racing thoughts, and feeling as if something bad is going to happen.

Often, people with high functioning anxiety find that their anxiety propels them to be overachievers rather than hindering them.

Signs of High Functioning Anxiety

The portrayal of high functioning anxiety is not the typical idea one has when imagining someone with anxiety who is withdrawn, isolated from society, and visibly distressed.

Many people, including the person with high functioning anxiety, may not realise they have anxiety for these reasons.

Below are some signs which may indicate that someone has high functioning anxiety:

  • Always looking busy, having a full schedule Not having a lot of downtime to relax
  • A strong desire to work on something until it is completed
  • High achieving, often going beyond what is expected
  • Always early for work or working late
  • A need to always be in control
  • Traits of a perfectionist
  • A fear of failure
  • Spend a lot of time planning and preparing
  • Always wanting the best possible outcome
  • May be very talkative and sociable
  • Often agrees to help others out

High functioning Anxiety vs Low Functioning Anxiety

The symptoms of both high functioning and low functioning anxiety are the same in the sense that they are both characterised by extreme worry and fear which can lead to physical symptoms such as increased heart rate, sweating, and trouble sleeping. The differences lie in the ability to function in everyday life. 

A common characteristic of low functioning anxiety is a disruption of daily functioning. This can depend on what type of anxiety disorder a person has.

Someone with social anxiety disorder may struggle to talk to others or with going anywhere where they will have to socialise with others; someone with a phobia such as agoraphobia will fear leaving their home which can negatively impact on their work and social life. 

In contrast, someone with high functioning anxiety will find they are still able to function well and can even strive in their work, school, or social life despite feeling the internal struggle of their anxiety. 

Many of the positive characteristics of high functioning anxiety can be seen in the outcomes and outward actions that other people observe. Some of these observable characteristics include:

Appearing successful

On the outside, people with high functioning anxiety appear driven in their work, rarely miss deadlines, arrive to work early, or stay late to complete projects, and seem to be working hard in general.

They may be more likely to be considered for promotions, achieve high grades, and work in higher paid jobs for their strong work ethic.

Having good relationships

Someone with high functioning anxiety may have a full social life and will likely agree to as many social events as they can manage.

They are usually always willing to help others when asked or will offer help without being asked. Because of this, they may have a lot of strong friendships as people value how helpful and loyal they are.

Having a positive personality

Someone with high functioning anxiety may have a calm exterior which they present to the world. They may have an outgoing personality such as being chatty, always happy, smiling, and laughing.

Friends and co-workers may often enjoy spending time with this type of individual if they are very positive to be around.

Being detail-oriented

Having high functioning anxiety may mean that someone is very organised, has lots of plans put in place, and is generally tidy. They may notice small details that others do not and may follow and stick to their schedules.

They may be the person that makes all the plans since this is something they are good at, and they plan for all possibilities, so they are prepared for almost anything.

Being productive

Someone with high functioning anxiety may be very good at making things happen due to their apparently high levels of productivity.

They can usually be relied on to get a lot of productive tasks completed and are the go-to person for many tasks. They can excel at staying on top of tasks and remember what needs to be done.

Anxiety propels them

People with high functioning anxiety may see their symptoms as something which pushes them to be motivated and driven to perform at high levels.

They may believe that without their anxiety, they would not be able to accomplish their goals.

Yerkes Dodson Curve and Task Performance

According to Yerkes-Dodson Law, some levels of anxiety are positively correlated to increased performance at work, school, or home. This means that some anxiety is necessary to reach goals that an individual cares about.

Despite their outward appearance of being a well-rounded, successful person, a person with high functioning anxiety has a lot of internal struggles. A lot of their observably positive behaviours are often driven by anxious thoughts. Some of the negative characteristics of high functioning anxiety include:

Overthinking

Those with high functioning anxiety are prone to racing thoughts. They may overthink situations and over analyse people.

They may ruminate on things which happened in the past and feel distressed and unable to control their thoughts. Due to overthinking and being unable to switch off, they may find they have difficulties going to sleep.

People pleasing 

While someone with high functioning anxiety may come across as outgoing and helpful, this is often because they are anxious about being seen in a negative way.

They may always agree to help other people out due to fears of feeling like they have let people down. They never want to say no to people even if they are burnt out or it inconveniences them.

Likewise, they may be too scared to call in sick for work for fear of disappointing others. 

Not being able to relax

Someone with high functioning anxiety may find that they cannot relax or enjoy an activity that they do not consider ‘productive’.

They might not be able to sit and do nothing without feeling guilty that they are not working or increasing their skills such as learning a new language or reading an informative book.

They may always be pressuring themselves to do something which they consider to be worthwhile and valuable.

They may also have a lot of nervous habits which stops them from relaxing, such as biting their nails, tapping their fingers, pacing, and rocking back and forth.

Having high expectations

Since a lot of people with high functioning anxiety are high achievers, they may have a lot of pressure put on them to constantly be achieving more.

This pressure can come from others, such as parents, teachers, and employers, or they can come from within the individual. They may have a strong fear of failure, and this is why they keep agreeing to do more and more tasks.

Their expectations can be so high that they feel as if they can never do enough to meet them.

Challenges of those with high functioning anxiety

Needing to achieve

As they are often seen as high achievers, people with high functioning anxiety may feel immense pressure to always achieve high levels of success.

While they may be viewed as highly successful, outsiders may not have any clue as to the struggle that was required to achieve that level of success or the reasons why they are high achievers. 

False persona

Someone with high functioning anxiety may be very skilled at portraying themselves as a calm, happy person who is always in control even if they do not feel this way.

They may often keep all their true feelings bottled up so as not to disappoint others.

They probably have a false persona that is presented to the world which they have been so skilled at keeping up that they may have lost sight of who they are. 

Low self-esteem 

People with high functioning anxiety may feel as if they are not a worthy person without all their achievements.

They find it hard to see their value in other areas of life and may believe that other people will not want to be around them if they weren’t successful. They may think that if they decline to help someone out, then that person will not like them anymore.

They may feel as if their life has little value if they are not constantly on the go and striving to achieve more.

Being held back

Others may not realise that people with high functioning anxiety struggle with their anxiety every day. Anxiety often holds people back from doing things which are outside of their comfort zone.

Someone may put all of their focus on achieving success academically or at work, that they miss out on other opportunities in life due to feeling too anxious to do anything other than what they know. 

Unhelpful coping strategies

As is the case for many people who struggle with anxiety, those with high functioning anxiety may turn to unhelpful coping strategies to help them manage their anxious feelings.

They may become dependent on alcohol or drugs as a way of coping, which can ultimately result in substance-use disorders. 

A lot of people with high functioning anxiety may not want to seek treatment as they find they may rely on their anxiety to propel them towards achieving their goals. However, treatment should be considered if someone is experiencing any of the following:

  • If their regular symptoms of anxiety are causing significant distress 

  • They find they cannot control their anxiety 

  • The anxiety is affecting their relationships, health, or occupation

  • The anxiety is impacting on their self-worth and confidence 

  • They are using substances as a way to manage their symptoms 

  • They are developing symptoms of mental health issues such as depression

Treatments for anxiety usually involve psychotherapies and medications, or a combination of both. Likewise, there are some ways in which an individual can manage their anxiety through lifestyle changes.

Therapy 

Psychotherapies are often an effective treatment for anxiety as they often delve into the root cause of someone’s distress and help to change negative thoughts and behaviours. 

  • Cognitive behavioural therapy (CBT) – a common type of psychotherapy which involves working with the therapist to identify unhelpful thought patterns and behaviours and replace them with healthy, positive ones.

  • Dialectical behaviour therapy (DBT) – a type of CBT that teaches behavioural skills to help someone to manage their stress, manage their emotions, teach acceptance, and improve relationships with others.

  • Acceptance and commitment therapy (ACT) – a therapy that is focused on helping people live in the moment and accept the present without judgement, as a way to cope with discomfort. 

  • Eye movement desensitisation reprocessing (EMDR) – a way to reduce the distressing thoughts that are commonly linked to anxiety through the use of bilateral stimulation. 

Medication 

Below are some of the most common medications that can be prescribed for someone who is struggling with the symptoms of anxiety:

  • Some antidepressants such as selective serotonin reuptake inhibitors (SSRIs)

  • Buspirone, which is an anti-anxiety drug

  • Benzodiazepines, which is often prescribed for short-term relief of anxiety

How to manage your high functioning anxiety

Below are some ways in which high functioning anxiety can be managed in your everyday life:

  • Spend some time every day dedicated to your mental health – this can involve journaling, using a mood diary, or completing a short, guided meditation session.

  • Limit your caffeine intake as this is known to increase anxious symptoms. 

  • Eat a healthy, balanced diet.

  • Engage in regular exercise, especially aerobic exercises.

  • Try progressive muscle relaxation exercises. 

  • Stick to a regular bedtime routine – if you find that you cannot sleep because your mind is racing, get up and do something else until you feel tired. 

  • Try to identify negative thought patterns when they occur so you are made aware of what you are thinking. Ask yourself why you are having these thoughts and try countering it with something more realistic or helpful.

    For instance, if you find you have a thought such as ‘I must not make any mistakes’, counter this with ‘If I do make a mistake then it will not be the end of the world.’

  • Try to identify why you hold onto your anxiety. For example, do you worry that you will not be able to succeed as well if you were not anxious? Once you can address what your reasons are, this can help you to identify what needs changing. 

Is high functioning anxiety the same as ADHD?

Oftentimes, anxiety can be mistaken for attention deficit hyperactivity disorder (ADHD) and vice versa. There are some traits which overlap between ADHD and high functioning anxiety, including:

  • The inability to relax, feelings of restlessness

  • Difficulty concentrating or sustaining attention 

  • Having racing and scattered thoughts 

However, they are not the same disorders. The reasons for their shared symptoms are where they differ.

Someone with high functioning anxiety may not be able to relax because they have given themselves such a busy schedule that they cannot fit relaxing into it.

Whereas someone with ADHD may be feeling restless because they feel as if they are driven by a motor and need a lot of stimulation.

A person with high functioning anxiety may have difficulty with concentrating or sustaining attention because they have a lot of racing anxious thoughts, whilst a main trait with ADHD is that they have dysregulated attention and can find it hard to focus on one thing at a time. 

Can high functioning anxiety be linked to depression?

Whilst they are different conditions, there may be a link between high functioning anxiety and depression.

The National Alliance for Mental Illness (NAMI) indicates that around 60% of people with anxiety will also have symptoms of depression.  

It is often seen that anxiety and depression go together and having one condition may put someone at a higher risk of developing the other.

Likewise, if people do not seek treatment for anxiety, they may be at more of a risk of developing depression.

Those with high functioning anxiety may be less likely to seek treatment than those who outwardly appear to be struggling such as those with generalised or social anxiety.

This could in part because some people with high functioning anxiety find their anxiety helpful to motivate them to succeed. Overtime, not managing their anxiety could worsen their symptoms and it may develop into depression. 

What causes high functioning anxiety?

While there is often not one known cause for why someone may develop anxiety, it is thought that in most cases, a combination of genetic and environmental factors can play a part. 

Genetics

Someone may have a strong biological disposition to developing high functioning anxiety, especially if they have an immediate relative such as a parent who also has anxiety or another mental health disorder. 

Personality 

The temperament of someone may make them more prone to developing high functioning anxiety.

Those who were shy or timid as a child, are more socially withdrawn, or are less likely to take risks may be more likely to develop anxiety. 

Substance misuse

Sometimes anxiety can be caused by substance misuse, especially stimulants since these can often create higher levels of anxiety in individuals. 

Negative childhood experiences 

Exposure to adversity in childhood such as trauma, abuse, neglect, and family chaos could put someone at risk of developing anxiety.

Moreover, if a child is brought up around close family members who struggle with their mental health, they may have experienced a more unstable home life which could result in them developing high functioning anxiety.

Being a high achieving child

In a lot of cases, there may not be a genetic predisposition or any negative life stressors that have caused someone to develop anxiety. It could be that someone was very gifted as a child and achieved a lot in a short amount of time.

Consequently, they may have received pressure from family, teachers, or themselves to keep achieving above and beyond what is typically expected.

The pressure may not intend to have caused any distress, but it can still cause someone to have unattainable expectations. 

About the Author

Olivia Guy-Evans obtained her undergraduate degree in Educational Psychology at Edge Hill University in 2015. She then received her master’s degree in Psychology of Education from the University of Bristol in 2019. Olivia has been working as a support worker for adults with learning disabilities in Bristol for the last four years.

Fact Checking

Content is rigorously reviewed by a team of qualified and experienced fact checkers. Fact checkers review articles for factual accuracy, relevance, and timeliness. We rely on the most current and reputable sources, which are cited in the text and listed at the bottom of each article. Content is fact checked after it has been edited and before publication.

This article has been fact checked by Saul Mcleod, PhD, a qualified psychology teacher with over 17 years' experience of working in further and higher education. He has been published in psychology journals including Clinical Psychology, Social and Personal Relationships, and Social Psychology.

Cite this Article (APA Style)

Guy-Evans, O. (2022, May 09). The Characteristics of High Functioning Anxiety. Simply Psychology. www.simplypsychology.org/what-is-high-functioning-anxiety.html

APA Style References

Ayano, G., Betts, K., Maravilla, J. C., & Alati, R. (2021). A systematic review and meta-analysis of the risk of disruptive behavioral disorders in the offspring of parents with severe psychiatric disorders. Child Psychiatry & Human Development, 52(1), 77-95.

Christiansen, D. M. (2015). Examining sex and gender differences in anxiety disorders. A fresh look at anxiety disorders, 17-49. 

Mayo Clinic Staff. (2016, March 17). Psychotherapy. Mayo Clinic. https://www.mayoclinic.org/tests-procedures/psychotherapy/about/pac-20384616

The Healthline Editorial Team. (2017, July 25). Anxiety Diagnosis. Healthline. https://www.healthline.com/health/anxiety-diagnosis 

The Healthline Editorial Team. (2021, October 11). What causes anxiety disorders and anxiety? Healthline. https://www.healthline.com/health/anxiety-diagnosis

Mayo Clinic Staff. (2018, May 4). Anxiety disorders. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/anxiety/symptoms-causes/syc-20350961

Government of Western Australia. (n.d.). The Vicious Cycle of Anxiety. Centre for Clinical Interventions. Retrieved 2021, November 19, from: https://www.cci.health.wa.gov.au/~/media/CCI/Mental-Health-Professionals/Panic/Panic---Information-Sheets/Panic-Information-Sheet---03---The-Vicious-Cycle-of-Anxiety.pdf 

Nikčević, A. V., Marino, C., Kolubinski, D. C., Leach, D., & Spada, M. M. (2021). Modelling the contribution of the Big Five personality traits, health anxiety, and COVID-19 psychological distress to generalised anxiety and depressive symptoms during the COVID-19 pandemic. Journal of Affective Disorders, 279, 578-584.

Zhang, F., Baranova, A., Zhou, C., Cao, H., Chen, J., Zhang, X., & Xu, M. (2021). Causal influences of neuroticism on mental health and cardiovascular disease. Human Genetics, 1-15.