Eight subtle signs you’re suffering from high-functioning anxiety – and how to alleviate it

Those you consider “perfectionists” may actually be wracked with anxiety, driven by their desire to show that they have it all together.

Although not a formal diagnosis in itself, high-functioning anxiety describes a person who overworks themselves to cope with persistent feelings of stress, self-doubt, and the fear of not measuring up.

Nearly seven million Americans have been diagnosed with generalized anxiety disorder, of which high-functioning anxiety is a subset.

However, the actual number is likely much higher as not everyone has access to professional help.

People with high-functioning anxiety are often high achievers and have successful careers, but at the same time struggle with near-constant self-criticism. No amount of positive feedback or rewards can fix this.

Dr. Neha Chaudhary, a child, adolescent and adult psychiatrist at Massachusetts General Hospital and Harvard Medical School, told Fortune: ‘They can still excel in their careers, have many friends and have strong relationships.

‘But inside they may be struggling with general symptoms of anxiety, such as restlessness, excessive worrying, sleep problems or fatigue.’

High-functioning anxiety can manifest itself in different ways. Individuals can overexert themselves and feel reluctant to take breaks, often finding it difficult to slow down or take time off.

People with high-functioning anxiety often perform well and have successful careers, but struggle with constant self-criticism. Despite receiving positive feedback or rewards, they find it difficult to overcome these feelings

They may experience intense feelings of guilt or shame over minor failures or setbacks and resist delegating tasks to others because they believe they must handle everything themselves.

This can lead to irritability, frustration and constant negative self-talk. Micromanaging becomes common as they strive for perfection in every detail.

Additionally, trouble sleeping is another sign, as their anxious thoughts often keep them from fully relaxing.

Dr. Michael Louwers, associate professor at the Reset Medical and Wellness Center, said: ‘The same personality traits that drive individuals to perform at their highest levels often fuel the symptoms of anxiety.

‘It often starts with good intentions, such as setting goals and rigorous planning. However, those who experience this type of anxiety usually set incredibly high and unrealistic goals, resulting in procrastination or constant worry.”

People with this form of anxiety can often also experience physical symptoms, such as sweating, muscle tension, dizziness, migraines, heart palpitations, and numbness in the toes and fingers.

It can affect anyone of any age or gender, but women are twice as likely as men to suffer from generalized anxiety disorder in their lifetime.

It is essential to pay attention to signs of high-functioning anxiety. Ignoring it is a recipe for overwork and burnout, as well as worsening anxiety in other parts of life and depression.

Dr. Judith Joseph, psychiatrist and author of the book High Functioning: ‘People with high-functioning anxiety and depression will have the symptoms, but may overwork themselves to appear functioning.

“If we wait until these people can no longer function, we may be too late. “Many of them become burned out, develop clinical depression or anxiety, abuse substances, or develop medical problems if left untreated and unsupported.”

To combat high-functioning anxiety, it’s important to give yourself some grace and accept that not everything will get done every day.

Recognizing when anxiety is increasing and taking breaks, whether from work or social obligations, can help manage stress.

It can also be helpful to incorporate deep diaphragmatic breathing into your routine, where you inhale for four seconds, hold for four seconds, and exhale for four seconds.

Feeding your brain with foods rich in omega-3 fatty acids, B12, vitamin D, and magnesium-like berries, nuts, and fish can also help reduce inflammation and improve your mood by sustaining energy.

Experts recommend setting aside at least 30 minutes for yourself every day, whether you’re going for a walk, listening to music, or talking to a friend, to calm your nervous system and interrupt the cycle of anxious thoughts.

Finally, learning to delegate tasks and say no when necessary will allow you more time to take care of yourself and engage in activities that bring you joy.

Therapy is a crucial tool for overcoming anxiety, often in particular talk therapy, which helps people reframe their unhelpful thoughts about life and transform their coping mechanisms and behaviors that can fuel their anxiety.

Often in therapy, people are taught not to view anxiety as a negative emotion, but rather as an “unhelpful” emotion that needs to be acknowledged but not dwelled on.

A licensed therapist can encourage someone to say, “I have anxiety, and that’s okay. It doesn’t make me a bad or innately flawed person.”

Instead of being self-critical and looking for what could go wrong, a person dealing with a well-functioning society is taught to look for solutions that alleviate their symptoms and fulfill their obligations with less self-doubt.

Mindfulness exercises, including guided meditations and breathing exercises, are common tools to quell people’s worries about the future and the unknown, known as “future tripping.”

Focusing on one thing or moment can increase feelings of calm and peace.

Deep and measured breathing also regulates the parasympathetic nervous system, which is responsible for the ‘rest and digest’ response – the opposite of the anxiety-inducing ‘fight or flight’ response caused by the sympathetic nervous system.

However, there are benefits to anxiety. Many people with anxiety are empathetic and natural peacemakers and rule followers. They often have a strong desire to overcome obstacles and prove unbelievers wrong.