High-functioning anxiety

What is high-functioning anxiety?

Experiencing occasional anxiety or fear is a normal part of life. But anxiety disorders usually manifest as intense, excessive, and persistent worry or fear about everyday situations and the future. 

Anxiety disorders are prevalent in the UK, and the number of people suffering from anxiety more than doubled in the past 10 years, particularly during and after the COVID-19 pandemic. This number grew from 8.2 million cases in 2013 to 19 million in 2020.

High-functioning anxiety doesn’t affect your work performance or social life, making it more challenging to recognise and diagnose. But anxiety symptoms can still affect your health, wellbeing, and quality of life. 

Women are also more likely to experience mild, moderate, or severe anxiety symptoms than men.

What are high-functioning anxiety symptoms? 

There are many symptoms of high-functioning anxiety that can affect your mental and physical health.

Mental symptoms of high-functioning anxiety include:

• fear of losing control
• fear of physical injury or death
• feeling unstable
• fearing what others think
• poor concentration, confusion, or distraction
• frightening thoughts, mental images, or memories

Physical symptoms include:

• increased heart rate
• heart palpitations — this might feel like fluttering in your chest
• shortness of breath or rapid breathing
• pain or pressure in your chest
• dizziness or lightheadedness
• sweating or hot flashes
• nausea, upset stomach, or diarrhoea
• tingling or numbness in your arms and legs
• a dry mouth

High-functioning anxiety might also affect your behaviour, like: 

• feeling restless or agitated
• pacing, feeling frozen, or the need to escape
• difficulty speaking

 Emotional (affective) symptoms include:

• feeling nervous, tense, or wound up 
• feeling frightened or fearful 

If you experience these symptoms, you should speak to your GP to rule out any underlying health issues.

What causes anxiety or high-functioning anxiety?

The causes of anxiety disorders aren’t fully understood. But your genetics and stressful or traumatic situations can lead to symptoms. Anxiety is linked to certain medications and substance abuse too. 

Sometimes, anxiety might indicate an underlying health issue, and its symptoms can be the first sign that something else might be happening. 

Some health conditions linked to anxiety symptoms include:

• heart disease
• diabetes
• overactive thyroid (hyperthyroidism)
• chronic obstructive pulmonary disease (COPD) — lung conditions that cause difficulty breathing
• asthma 
• irritable bowel syndrome (IBS)
• rare tumours that increase your stress hormones — like cortisol 

How to cope with high functioning anxiety 

If you think you have anxiety or high-functioning anxiety, the most important thing is to get help early by speaking to your GP. This is because high-functioning anxiety can become harder to treat over time, and your symptoms might worsen. 

High-functioning anxiety management tips

While the symptoms of high-functioning anxiety can be highly unpleasant, a combination of lifestyle changes can help manage your symptoms. Some of these include:

• getting regular exercise — like running, cycling, swimming, or high-intensity interval training (HIIT)
• practising mindfulness techniques — like yoga or tai-chi
• mindfulness-based cognitive therapy — using meditation to notice your thoughts and feelings without judgement
• eating a balanced diet — like fruits, vegetables, and omega-3 fatty acids found in salmon and mackerel
• limiting how much sugar and refined carbohydrates you eat — like white bread, white pasta, and breakfast cereals
• cognitive behavioural therapy (CBT) — a type of talking therapy (psychotherapy) that helps you identify and reframe negative thoughts in more positive ways
• antidepressants — your GP might prescribe you antidepressants called selective serotonin reuptake inhibitors (SSRIs). Anxiety disorders are comorbid with depression, so antidepressants might help to improve your overall mood by increasing your serotonin level