DEAR MAYO CLINIC: I've always been a high achiever, both personally and professionally. But I struggle with a whirlwind of worries and thoughts, constantly second-guessing myself and pushing for perfection. I've heard the term "high-functioning anxiety," and I feel like it is what I'm experiencing. How can I navigate and cope with this?
ANSWER: It's normal to feel anxious sometimes, especially in stressful situations. However, for some people, excessive and ongoing anxiety can be a challenge to control and interferes with daily activities.
There are several types of anxiety disorders. The term "high-functioning anxiety" represents people with anxiety symptoms while maintaining a high level of functionality in various aspects of their lives. Often, they are successful in their careers or other roles, yet internally struggle with persistent feelings of stress, self-doubt, and the fear of not measuring up. They feel extremely uncomfortable inside and struggle with significant self-criticism.
High-functioning anxiety isn't recognized in the Diagnostic and Statistical Manual of Mental Disorders but instead is a subset of generalized anxiety. Many emotional and physical symptoms are associated with generalized anxiety disorder. The symptoms of high-functioning anxiety mirror many of these, but some may be more prominent.
Some symptoms of generalized anxiety disorder include overall general nervousness and worry. Other symptoms that may lead you towards high-functioning anxiety include internal struggles with:
It's important that you meet with a mental health professional to talk about your symptoms and obtain an accurate diagnosis. Then, if it is determined that you have high-functioning anxiety, you can develop a care plan for having the best quality of life.
Counseling and therapy play crucial roles in helping people with high-functioning anxiety manage their symptoms effectively. Cognitive behavioral therapy can help you learn to reframe your thoughts about life and transform behaviors that may feed your anxiety. Instead of being self-critical and looking for what could go wrong, you can be taught to manage your thoughts, seek solutions and guide yourself through anxious feelings.
In addition to therapy, other coping strategies to ease symptoms include:
Medications can help some people with high-functioning anxiety, but should only be used in conjunction with other coping strategies and under the care of a healthcare professional.
Talk with your healthcare team about how you are feeling. They can connect you to a skilled mental health counselor or therapist, if needed, and assist you with coping strategies to manage your anxiety and lead a fulfilling life. — Linda Hubbard, Psychotherapy, Mayo Clinic Health System, Eau Claire, Wisconsin