High Functioning Anxiety

The vast majority of people who experience anxiety have what might best be called “high functioning anxiety.” But what does that even mean?

There are two parts to it of course: the anxiety part and the high functioning part. Let’s start by breaking those two things apart, beginning with anxiety. Anxiety has become so ubiquitous in recent years that we hear about it almost every day. Our friends talk about anxiety, the news is anxiety-inducing, and, in therapy, anxiety is one of the most common reasons people show up. But what, precisely, are we talking about?

The truth is that anxiety is, first of all, just a completely normal part of being a living creature. If you’ve ever been on a roller coaster, imagine that moment when it creeps upward, straining and groaning, moving inevitably towards the big drop. We anticipate the fear and thrill and gut wrenching surprise of the moment which looms ahead, our guts churn in a state of suspense and yes, anxiety. The fact that this moment can be manufactured for all of us to feel tells us some important things about the nature of anxiety: it is predictable, and universal. It would be weird NOT to feel anxiety sometimes.

Rollercoaster

But that’s not really what people mean when they say I HAVE anxiety. They’re saying that they experience a kind of chronic anxiety about situations which, apparently, other people DON’T feel anxious. There’s a couple things worth unpacking there too though. First, peoples perceptions of the anxiety of other people is often incorrect, because we downplay these everyday social anxieties and push on through making them invisible to others. Secondly, peoples sense of when it is appropriate and when it is pathological to experience anxiety is often defined by incorrect gatekeeping we learned when we were young. Truth is, it makes a lot of sense to have a bit of social anxiety in, say, a new workplace, because life is going to be a lot better if it goes well! So, we ought to be feeling a little apprehensive amidst the uncertainty.

So, really, what is anxiety then? It’s just a state of being – with a set of cognitions, emotions, and bodily sensations — which accompany those moments when we anticipate something strong in the near future – it could be a bad thing, an intense thing, or just a very uncertain thing. And this “self state” is there to get us ready to respond to whatever it may be — but in the leadup, that persistent state of anxiety can feel uncomfortable.

But this brings us to part two, the idea of high functioning. High functioning contrasts with disabling. The idea is that the person who is a high functioning sufferer is getting on with things as if they were normal, but they are especially and invisibly challenged by the discomfort of that anxiety in their mind/brain/body.

And it sucks.

It sucks in part because its invisible. People don’t know the “battle you fight”. People don’t see the discomfort you feel. And people don’t acknowledge with pride and graciousness the successful overcoming that you do everyday. So while being high functioning means you get a lot more done that if you’d become disabled by symptoms, there is a special burden to it.

So what can you do?

Deal with the root cause – this often means addressing the underlying anxiety first of all. If it weren’t for those symptoms in the first place, this wouldn’t be such a big deal. What helps most of all is recognizing that very few people truly experience “generalized anxiety”, even if that label has been applied to them. Most often, anxiety is attached to very specific fears – but it takes work to find out what those are. When we start to identify the particulars of our anxiety, and then understand and normalize why our body gets “activated” into those anxious states) it becomes a very different, far less chaotic experience.

Deal with the striving – High achievers are often working so hard for some sort of reason. Of course, there are obvious reasons: expectations of others, money, status… the usual suspects. But it’s worth asking, when someone is pushing through significant discomfort in the name of “high function”, just what the motivations are, where the choices are coming from.

Deal with the isolation – Because high functioning sufferers are so successful on the surface, they make it impossible for others to see just what is really going on. This has a two-fold consequence – the first is that people don’t adjust their expectations of us if they don’t see a reason to, and the second is that by suffering invisibly we can feel a variety of strong negative emotions, from loneliness to resentment.

Ultimately, self understanding and the courage to be vulnerable are keys to better navigating high functioning anxiety.