Tell-tale signs you may have high functioning anxiety

Upset depressed teenager covering face with hands and crying
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Individuals living with high functioning anxiety often cover their symptoms and strive to maintain as normal a functionality as possible.

While not an official term 'high functioning' is associated to generalized anxiety disorder (GAD). People with GAD can often relate to being high functioning.

High functioning anxiety sufferers may appear successfully composed to outsiders, yet internally are wrestling with feelings of worry, stress or obsessive thoughts. Symptoms of anxiety might present alongside other behaviours, such as establishing stringent routines and habits to exert control over their lives.

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Lynne Siqueland, of the Children's and Adult Center for OCD and Anxiety, explained: "As therapists, we talk about a lot of people even with diagnosed anxiety disorders as 'high functioning,' and many of them are. They are doing really well in their jobs, in relationships and raising kids, despite having significant anxiety."

Research suggests those grappling with GAD perceive the world differently to others. People living with the condition typically feel consumed by angst and unease, they will usually see negative outcomes even in situations that don't give any concrete reasons to worry.

Continually battling against these irrational fears often results in persistent mental exhaustion. The extensive effort required to suppress negative thinking related to potential disasters, previous failings, and future uncertainties can significantly drain on those living with anxiety, reports Wales Online.

Despite their confident demeanour and active involvement in daily activities, individuals with high functioning anxiety often face an internal struggle to get through each day. Siqueland adds: "Much of anxiety is internal-uncontrolled worry or social evaluation, and no one would know unless the person has a lot of physical symptoms of avoidance.

"Many people with mild to severe anxiety will do the essential tasks but limit other experiences or opportunities, and this is what sometimes leads them to treatment."

What is anxiety?

Anxiety is a feeling of unease, such as worry or fear, that can be mild or severe. It's common for everyone to experience feelings of anxiety at certain times in their lives.

For instance, you might feel worried and anxious about sitting an exam, having a medical test, or going for a job interview. In these situations, it's completely normal to feel anxious.

However, some people find it hard to control their worries. Their feelings of anxiety are more constant and can often affect their daily lives.

What does 'high functioning' anxiety look like?

On the outside, they may seem:

  • highly organised

  • detail oriented

  • proactive

  • and a high achiever

But inside, they are:

  • scared of letting people down

  • over-planning

  • excessively worry about the future

  • have a constant need for reassurance

  • have poor boundaries

  • and impossibly high standards

People may show subtle signs and symptoms of anxiety paired with unique behaviours such as:

  • controlling behaviour with strict routines and habits

  • seeming busy all the time with a to-do list that never ends

  • striving for perfection in every area of life

  • often being hard to read and relate to

  • worrying about things ahead of time to extremes

  • working long hours and always going above and beyond to make sure you don’t make an error

  • an intense fear of letting people down

  • impossibly high standards that even when reached, don’t leave you feeling satisfied

  • feeling safe and stable when you focus on small details

  • certain habits like nervous chatter, fiddling with your hair, or cracking your knuckles

GAD can also have a number of physical symptoms, including: dizziness, tiredness, a noticeably strong, fast or irregular heartbeat (palpitations), muscle aches and tension, trembling or shaking, dry mouth, excessive sweating, shortness of breath, stomach ache, feeling sick, headache, pins and needles and difficulty falling or staying asleep (insomnia).

It is important to note that only a clinician can accurately diagnose anxiety.

How to deal with high functioning anxiety

If you have received a diagnosis of anxiety, there are various treatment options to consider. Medication, cognitive behavioural therapy, and mindfulness training are all tools that could be beneficial.

NHS has issued a self-help guide for dealing with generalised anxiety disorder Other tips you can try on your own to reduce anxiety include:

  • Look at lifestyle changes, such as limiting caffeine, nicotine, alcohol, and other drugs, eating a balanced diet and exercising regularly.

  • Consider alternative therapies such as yoga, meditation and acupuncture.

  • Try to dedicate 10 minutes each day to work on your mental wellbeing.

  • Reflect on your thought patterns when the anxiety kicks in. Try challenging them with more helpful thoughts.

  • When it comes to managing anxiety, sleep is often underrated. Sticking to a regular bedtime and getting up early to do something you enjoy are great places to start.

  • When you feel nervous, find coping strategies such as deep breathing, muscle relaxation, meditation, acupuncture, and yoga.

How you can get help:

Anxiety Care UK: Helps people with anxiety disorders - anxietycare.org.uk

Anxiety UK: Advice and support for people living with anxiety - 03444 775 774 (helpline), 07537 416 905 (text) or anxietyuk.org.uk.

British Association for Counselling and Psychotherapy (BACP): Professional body for talking therapy and counselling. Provides information and a list of accredited therapists - bacp.co.uk

Hub of Hope: UK-wide mental health service database - hubofhope.co.uk

Mind: Mind's helplines provide information and support by phone and email and Side by Side is a supportive online community for anyone experiencing a mental health problem.

NHS Services Finder: Searchable database of NHS services - nhs.uk/service-search (England) and 111.wales.nhs.uk/localservices (Wales)

NHS talking therapies self-referral: Information about local NHS therapy services for certain mental health problems - nhs.uk/service-search/mental-health/find-an-nhs-talking-therapies-service

No More Panic: Provides information, support and advice for those with panic disorder, anxiety, phobias or OCD, including a forum and chat room - nomorepanic.co.uk

No Panic: Provides a helpline, step-by-step programmes, and support for people with anxiety disorders - nopanic.org.uk

Samaritans: Samaritans are open 24/7 for anyone who needs to talk - samaritans.org

Triumph Over Phobia (TOP UK): Provides self-help therapy groups and support for those with OCD, phobias and related anxiety disorders - topuk.org

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