The characteristics of high functioning anxiety

Author and Medical Reviewer
Dr. Jose Toledo

The characteristics of high functioning anxiety

Anxiety disorders are the most common mental health condition in the United States. They affect approximately 40 million adults throughout the country.

There are many different types of anxiety disorders, but they’re not always easy to spot. This is especially true for those who struggle with high-functioning anxiety.

Do you suspect that you struggle with this particular kind? If so, keep reading to learn more about high-functioning anxiety. You’ll also find out what it looks like, its causes, and the potential treatment options available.

What Is High-Functioning Anxiety?

High-functioning anxiety is, technically, not an official medical diagnosis. However, it’s a common type of anxiety, especially among high-performing professionals.

People who have high-functioning anxiety struggle with an anxiety disorder, but they’ve also learned how to cope with their symptoms (sometimes in unhealthy ways) or push them aside so that they can continue to do what they need to do.

High-Functioning Anxiety on the Outside

What does someone with high-functioning anxiety look like?

On the outside, a person with high-functioning anxiety looks like they’ve got it all together. They show up to work early, they’re always dressed for success, their hair and makeup look perfect, etc.

People with high-functioning anxiety also perform at a high level. They don’t miss deadlines, they also go the extra mile, and they’re always willing to step in and help their colleagues. Basically, they’re every boss’s dream employee.

High-Functioning Anxiety on the Inside

On the outside, everything looks great. On the inside, though, you might be struggling quite a bit. You might feel paranoid about slipping up or failing. You might go above and beyond because you’re afraid of being seen as less-than or disappointing someone else.

People with high-functioning anxiety might even sacrifice their physical and mental health because they’re so focused on doing things perfectly and putting up a good front.

They might not take time off work, even when they’re feeling under the weather, because they’re afraid of calling in sick, for example. They might also sacrifice their sleep so that they can stay up late and get more work done.

Characteristics of High-Functioning Anxiety

Does the above description resonate with you? Can you relate to putting immense pressure on yourself to try and quiet the feelings of anxiety that are bubbling up inside you?

If you said “yes” to those questions, you may be dealing with high-functioning anxiety.

Are you still unsure if this is what you’re experiencing? If so, consider whether or not you possess any of the following characteristics:

Positive Characteristics

There are certain traits of high-functioning anxiety that many people consider to be positive, at least on the surface, such as these:

  • Outgoing personality
  • Punctuality
  • Proactive
  • Organized
  • High-achieving
  • Detail-oriented
  • Outwardly calm and collected
  • Extreme loyalty in relationships

Negative Characteristics

While these outer characteristics might seem positive and aren’t cause for concern, these negative characteristics could be taking place without anyone noticing:

  • Being a “people pleaser”
  • Nervous habits like cracking your knuckles or biting the inside of your cheek
  • Repetitive behaviors (counting, tapping, rocking, etc.)
  • Overthinking
  • Needing constant reassurance
  • Procrastinating and then spending long periods catching up or getting ahead
  • Rumination and excessive “What if?” thoughts
  • Being unable to say “No”
  • Insomnia
  • Racing mind
  • Limited social life
  • Being unable to “enjoy the moment”
  • Frequently comparing oneself to others
  • Severe mental and physical fatigue
  • Use of unhealthy coping and stress management mechanisms, such as drugs or alcohol

Causes of High-Functioning Anxiety

Causes of High-Functioning Anxiety

There are plenty of reasons why someone might develop the characteristics of high-functioning anxiety. The following are some possible causes:

Genetic Predisposition

Those who have family members with anxiety disorders might be more prone to anxiety and high-functioning anxiety, in particular. Some research shows that anxiety has a heritability of approximately 30 percent.

Genetics, alone, may not cause an anxiety disorder, but they can increase one’s chances of developing one. This is especially true if they’re under a lot of pressure or dealing with major life changes.

Altered Brain Chemistry

Similar to other mental health conditions, such as depression, people with anxiety disorders might experience alterations in their brain chemistry. They may have imbalances in neurotransmitters like serotonin, dopamine, norepinephrine, and oxytocin.

Personality Types

People with certain personality types can be more prone to high-functioning anxiety, too. Those who have Type A personalities (high-achieving, competitive, always on the go, etc.), for instance, often exhibit more characteristics of high-functioning anxiety.

Relationship Issues

If a person feels that they’re struggling in one area of their life, they might try to compensate and over-perform in others to make up for it. If they’re having problems in their relationship (with a spouse, a child, a parent, etc.), they might go above and beyond at work as a way to cope with the negative feelings and anxiety produced by those relationship difficulties.

Financial Trouble

Financial problems can also contribute to anxiety disorders and high-functioning anxiety. If someone is constantly worried about having enough money to pay their bills, they might pull more than their own weight at work to show their value and protect themselves from a potential firing or lay-off, which would worsen their financial situation.

Job Insecurity

In the same vein, job insecurity can lead to high-functioning anxiety in the workplace, too. When a person’s job is constantly being threatened, either directly or indirectly, they may over-perform and sacrifice their own physical and mental well-being to make sure they maintain employment.

Post-Traumatic Stress Disorder

People with Post-Traumatic Stress Disorder (or PTSD) may be more prone to high-functioning anxiety than those with other types of anxiety.

If they have unprocessed trauma from exposure to extreme stress as a child (abuse, living in a dangerous area, etc.), they might find themselves overcompensating to avoid situations that would cause them to have to relive that trauma (such as being lectured or yelled at by a boss).

Consequences of Untreated High-Functioning Anxiety

Consequences of Untreated High-Functioning Anxiety

If left unaddressed, high-functioning anxiety can lead to some serious consequences, including these:

Obsessive-Compulsive Disorder

When anxiety isn’t managed, especially in a person who considers themselves to be a perfectionist, obsessive-compulsive inclinations might arise. They might try to gain more control over their lives by increasing their obsessive behaviors.


Unmanaged symptoms of anxiety might eventually result in feelings of depression. The person with high-functioning anxiety might start to feel hopeless or sad, especially if it seems like all of their efforts aren’t paying off.


In those who are using unhealthy coping mechanisms (such as drugs and alcohol) to manage their high-functioning anxiety, there is a risk of addiction.

In addition to addiction to drugs or alcohol, a person with high-functioning anxiety might also take up other unhealthy habits. They might develop an eating disorder, for example, or start spending an excessive amount of money on gambling.

High-Functioning Anxiety Treatment Options

If you struggle with high-functioning anxiety, there are plenty of treatment options available. It’s important to seek help early before your symptoms spiral out of control and increase your chances of experiencing serious consequences like those mentioned above.

Here are some potential treatment options you might want to consider:


Some people with high-functioning anxiety find relief when they start taking medication. Anti-anxiety medications can help them to feel more in control and relieve some of the stress they feel.

The following are some medications your physician might prescribe:

  • Benzodiazepines
  • Antidepressants
  • Buspirone

Some doctors also prescribe beta-blockers. These are drugs that lower blood pressure and help you to remain calm in difficult situations.


Anti-anxiety drugs often work better when they’re combined with other treatment modalities, such as therapy. Sitting down with a therapist to talk about the causes of your high-functioning anxiety, as well as the specific symptoms you’re experiencing, can help you get to the root of your struggles and learn to manage them in healthier ways.

Lifestyle Changes

Some people also find relief from high-functioning anxiety when they make changes to their lifestyle.

For example, taking up exercise or spending time in nature can be a great stress reliever. It helps to balance neurotransmitters and gives you a chance to take a break from the hustle and bustle of your job.

Other practices like mediation, yoga, and journaling can be beneficial as well.

Residential Treatment

Finally, it may help to get away from the stress of work or family life for a while and spend some time in a residential treatment or rehab facility.

These kinds of treatment centers give you a chance to rest, separate yourself from the environment that’s causing or worsening your anxiety, and work with a qualified therapist. You’ll also have a chance to learn some effective coping mechanisms to manage symptoms that arise in the future.

Get Help Today

If you’re struggling with symptoms of high-functioning anxiety, it’s time to seek help. Keep the treatment methods mentioned above in mind so you can find the option that works best for you.

Do you think you could benefit from a residential treatment facility? If so, we’re here for you. Contact us today to learn more about our services.


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