“The difference between the driven person that does not have high-functioning anxiety and the driven person that does is the symptoms of anxiety,” therapist and coach Aisha Shabazz, L.C.S.W., tells SELF. “Do you have restlessness during the day? Are you able to have an even balance and a natural pattern of sleep? Do you have any GI symptoms as it relates to being nervous, overwhelmed, anxious, stressed?” Essentially, if you’re experiencing mental or physical symptoms of anxiety, that’s something worth paying attention to.
“The way in which I conceptualise high-functioning anxiety is that you can take on more than most people. But just because you can lift a heavy boulder doesn’t mean it’s not heavy,” Shabazz says.
Still, most people — whether they realise it or not — seem to be adhering to the criteria laid out in the DSM: They’re not seeking help until their symptoms lead to real consequences in their daily lives, like missing deadlines or special events. In fact, many high-achieving people may not address their symptoms until they notice a dip in their performance or productivity, even if those symptoms include intense dread, constant worry, and the unavoidable physiological signs of stress.
“If the problem is not showing up behaviourally, then some people would say, ‘I don’t have a problem,’” Dr. Spitalnick, who notes that very few adults come into his practice with high-functioning anxiety, says; instead, he tends to see them once that functioning takes a hit. On the other hand, he does see a lot of kids, teenagers, and college students whose parents are worried that their stressed-out child is headed for burnout — despite their perfect attendance and exam results.
Burnout is another term you often hear associated with high-functioning anxiety — both hinting at our culture’s desire to describe an emotionally and physically fraught experience in a way that’s more relatable and less pathological than what you might find in the DSM.
“I think burnout became much more discussed because it’s essentially a manifestation of emotional and wellness issues, but it’s in relation to work,” Dr. Hodge says. “Since we’re very focused in our society on work and productivity, it kind of became a catch-all term for: This is not sustainable, this pace is ridiculous, and I can’t function like this.”
But high-functioning anxiety doesn’t only thrive in professional settings, notes Shabazz. It can also be fuelled by societal expectations thrust upon people based on their gender, race, culture, parenting status, and other factors.
What is the treatment for high-functioning anxiety?
If high-functioning anxiety is essentially anxiety that hasn’t yet led to real consequences in your daily life, why not address the symptoms before they have a chance to impact your functioning? While this might include therapy and/or medication, Dr. Spitalnick notes that not everyone who identifies with high-functioning anxiety necessarily needs that type of intervention.
For some people, addressing the symptoms of anxiety — especially the worry, the rumination, and the restlessness — can happen through mindfulness and meditation practices. “Anxiety is happening in the future — it’s the what ifs, it’s the hypothetical, things that have not happened yet,” Shabazz says. “[One] way in which we can combat anxiety is to bring us back to the present moment because it’s nearly impossible to exist in the present moment and to be in the future.” (I took Shabazz’s advice and tried to practice mindfulness in the shower — rather than my usual routine of cycling through all of my existential worries one by one — and honestly it worked. 10/10 would recommend this tip.)