Five effective therapy treatments for high-functioning anxiety

Author and Medical Reviewer
Dr. Jose Toledo

Five effective therapy treatments for high-functioning anxiety

Anxiety comes in many forms. The way that anxiety disorders present themselves in terms of symptoms and how they interfere with a person’s daily life is just as unique.

Those with high-functioning anxiety are usually successful, high achievers with great careers and the social life to match.

Anxiety disorder at a glance

People with high functioning anxiety tend to suffer intensely; they also tend to suffer alone. 

All this is because of the unique ways that social anxiety differs from other anxiety disorders such as:

  • Obsessive-Compulsive Disorder
  • Post Traumatic Stress Disorder
  • Panic Disorder
  • Generalized Anxiety Disorder
  • Social Anxiety Disorder

What is high functioning anxiety?

Clinical psychologist, Maria Shifrin explains that:

”High functioning anxiety is a chronic mental health issue that affects a person’s relationships, health and self-esteem. 

Most people assume that those impacted by the disorder are just stressed out, or in need of a holiday, they may even suggest the person is suffering from other mental health problems when in reality they are suffering from high functioning anxiety.”

On the flip side

Many people report feeling anxious at work, in social settings and public speaking events. Every one of us experiences anxiety at some stage of our lives.

All this is part of the human experience and can even be a positive thing. 

If, for example, someone is preparing for a public speech, they may experience symptoms of anxiety such as:

  • Sweating
  • Shaking
  • Dry throat
  • A general feeling of nervousness and anticipation

These symptoms usually subside once they begin their speech, or soon after they have finished the presentation. 

In this case, anxiety is purposeful – these anxiety symptoms (although unpleasant) may even be the catalyst for better performance.

All this suggests that healthy amounts of anxiety can be a positive thing.


According to the National Institute of Mental Health, anxiety is a prevalent mental health condition that affects around 19 percent of people living in the United States every year.

There is a wide range of mental health disorders such as the ones mentioned earlier, (including anxiety disorder) that significantly impact someone’s quality of life.

An invisible illness

Since people with high functioning anxiety appear to be doing fine, their symptoms often get overlooked.

As with some physical conditions, functioning anxiety tends to be an invisible illness due to its nature – people with the disease can perform, and are usually successful types that appear to be doing well in life.

In reality, all this is part of the illness – which features several components:

  • The desire to over-achieve
  • The need for perfectionism
  • The tendency to worry about their performance, fearing that they might mess things up in the future
  • The need to be busy all the time to cope with feelings of anxiety

What are the symptoms of high functioning anxiety?

There is a range of symptoms that set functioning anxiety apart from other anxiety disorders.

People report various symptoms and mental health professionals must be thorough when examining some of the negative and positive traits of this mental disorder.


Some of the signs and symptoms include:

  • Irritability or the propensity to become enraged at perceived failures or setbacks
  • Insomnia or other sleep disturbances
  • Frequent anticipatory anxiety before an event or series of events
  • Feelings of discomfort when it comes to expressing emotions and an unwillingness to discuss feelings
  • Feelings of worry and anxiety even when things are going well
  • Perfectionism and continuously putting yourself and your performance down
  • Fear or Feelings of worry that others are judging you
  • Displaying a false, cheerful disposition, which masks feelings of pessimism
  • Nervous habits such as biting nails, cracking the knuckles and chewing the lips due to pent up nervous energy
  • Difficulty saying no to unreasonable demands or requests
  • Racing thoughts

Is it possible to develop other mental illnesses along with functioning anxiety?

Research shows that several co-occurring mental illnesses accompany conditions that are high in anxiety. These conditions include:

  • Eating disorders
  • Chronic physical health conditions (usually brought on or worsened by anxiety)
  • Substance misuse disorders – reports show that men with concerns are two to three times more likely to develop a substance misuse disorder compared to women
  • Depression – this occurs in over half the cases and is common for people suffering from some form of an anxiety disorder (such as functioning anxiety)

Those with a substance use disorder, such as alcoholism (or any other disorder) must seek help and support from a health professional to help them face and overcome their problems.

What are the most effective treatments for high functioning anxiety?

High functioning anxiety may cause many issues for a person – they may find that others misunderstand them, which results in the sufferer not feeling seen or heard.

The stress of this alone makes reaching out for support a bit more of a challenge whilst others may well get the help they need; and have an entirely different experience.

Informed diagnosis

Getting an accurate diagnosis from a doctor or mental health professional sets people on the path to recovery and is incredibly soothing for people with anxiety.

Living with anxiety

Living with high functioning anxiety presents many challenges. Still, with the right treatment -it also creates a space for self-understanding, the ability to experience a fuller life, and allowing a person to adopt more positive traits and healthier coping ways.

As many of us know, anxiety causes many unpleasant symptoms – but these symptoms do not have to be a way of life. 

Crucially, effective treatment programs often help people living with anxiety disorders to blossom and self-actualize.

Since the nature of high functioning anxiety may help a person excel and over-achieve – if done healthily – this often creates a platform for them to manage their symptoms, while (constructively) working towards their goals and aspirations.

Therapy for functioning anxiety

Therapy for functioning anxiety gets centred around psychotherapy. All this gets offered to patients in clinical settings such as residential treatment.

High functioning anxiety may be an invisible illness to most people, but mental health professionals who specialize in treating anxiety disorders, will know that psychotherapy based treatments are beneficial.

Treatment options

Treatment options available to those suffering from high functioning anxiety include:

  • Cognitive Behavioral Therapy – This therapy targets any maladaptive thoughts, emotions and beliefs that may lead to self-destructive behaviours such as addiction. Through treatment, the person learns to explore and resolve any limiting actions that may prevent their potential, allowing them to adopt healthier coping methods.
  • Psychotherapy – sometimes referred to as ‘talk therapy’ is very useful for high functioning anxiety people. This type of therapy challenges any unhelpful thoughts and beliefs that often lead to stress and self- destructive behaviours.
  • Practising mindfulness and meditation – high functioning anxiety also gets treated through learning the art of relaxation and meditation. Since catastrophic thinking is at the heart of functioning anxiety, people must seek ways to break the thought patterns leading to stress. Practising specific breathing techniques helps lower anxiety levels in the body, thus breaking the cycle of negative thinking.
  • Medication – When used in combination with other therapies, medication such as anti-anxiety medication and antidepressants are often very helpful in controlling anxiety symptoms.
  • Creating a support network – a support network may involve getting support from a close loved one, friend, relative or co-worker. Having someone close by that understands you often help with the everyday feelings associated with high functioning anxiety.

Reaching out

It’s not always easy for people with anxiety to reach out for support – particularly with high functioning anxiety as often the sufferers themselves may not know they have a problem.

People must take the time to seek help and support as this will help them feel more at ease when it comes down to what it feels like for themselves (and other’s) living with high functioning anxiety.

Treatment at Tikvah Lake Recovery

At Tikvah Lake Recovery – we specialize in treating a range of mental health conditions, including anxiety, depression and addiction disorders.

If you feel as though you could be experiencing any of the signs or symptoms mentioned above – there’s a chance you may well have a form of functioning anxiety.

If you would like to discuss any concerns or worries you may have regarding your mental health – feel free to get in touch with one of our recovery specialists today and find out how we can help you.

About Adam Nesenoff

Adam Nesenoff has been working in recovery for over ten years.

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