Supporting Clients with High Functioning Anxiety: Helping Our O…

Ellie is a 32-year-old woman who is a successful social media manager at a tech firm. She is known for her ability to multitask, handle pressure, and “make things happen.” She’s often admired by her coworkers for keeping her cool under pressure, coaching her team through challenges, and producing high-quality work.

What most people don’t see is her struggle. She feels her work is not good enough, feels “tired but wired,” and has a constant fear of being fired for underperforming. She suffers from physical symptoms such as headaches, fatigue, and muscle tension. She also has difficulty relaxing.

Ellie has high-functioning anxiety, which causes symptoms of physical and emotional stress that people around her don’t recognize.

High-functioning anxiety affects many people but can often go unnoticed. It does not impact daily functioning or fit the criteria of an anxiety disorder but impacts a person's mental health and stress response.

You may have come across this term before on social media; #highfunctioninganxiety has over 100 million views on TikTok.

“Anxiety disorders exist on a spectrum and affect people in various ways,” Medical News Today reports.

According to the article, “Doctors do not recognize high functioning anxiety as a distinct anxiety condition, and there is a distinct lack of research in the area.”

It’s important to note that even though the condition is not listed as an official diagnosis, it impacts many individuals’ lives.

Symptoms may vary depending on the person, their environment, and their current stressors.

Signs and symptoms may include:

Difficult winding down or relaxing because of guilt

Tendency toward perfectionism

Difficulty deciding, second-guessing oneself

Constant feelings of worry & fear

Physical symptoms such as headaches, exhaustion, and/or muscle tension

High-functioning anxiety can have different causes and factors, including genetic predisposition to anxiety, chronic stress, and sociocultural factors.

Therapists can help their clients manage high-functioning anxiety by encouraging mindfulness and relaxation, building awareness of their triggering situations, practicing work-life balance, and prioritizing sleep, exercise, and nutrition.

Learning to set boundaries and clear communication can help clients learn to say no to unnecessary commitments.

High-functioning anxiety can go unnoticed by family and friends but has a large impact on the individual’s daily mood. It is characterized by anxiety levels that are not high enough to interfere with life activities (e.g., work and family relationships) but still impact physical health and well-being.

With treatment from a mental health professional and the right self-care, people with high-functioning anxiety can learn to manage their symptoms and improve their overall quality of life.

Learn more about High-Functioning Anxiety with the Continued course Working with High Functioning Anxiety: Supporting Our Overachievers by Jenny Maenpaa, MSW, EdM LCSW. The course teaches social workers how to identify high-functioning anxiety and reviews tools they need to support their clients.