How To Thrive With High Functioning Anxiety From A Psychologist Who Knows


If you’re living with high functioning anxiety, observers likely see only your enviable attributes. They marvel at the high achiever, who is incredibly kind and compassionate, completely pulled together, and persistently upbeat and happy. In other words, you seem invincible.

But that’s just how you appear to others.

On the inside, you almost always feel worried and stressed. And yet you have found a way to (mostly) befriend your anxiety and use it to your advantage. As a matter of fact, you have accomplished some pretty amazing things (at least in others’ opinion) with your anxiety in tow.

To be clear, high functioning anxiety isn’t a diagnosis. It’s a catch-all term used to describe a growing population of people who live with anxiety but describe themselves as functioning reasonably well, if not optimally.

When it comes to high functioning anxiety, the key is in your level of “functioning.”

People with Generalized Anxiety Disorder (GAD) might be more prone to high functioning anxiety than others. Yet that doesn’t mean that everyone with GAD has high functioning anxiety.

Usually, highly functional anxious people are undiagnosed with any form of anxiety, that’s because diagnosable anxiety is largely measured via its impact on your life, or your functioning. The outward performance of high functioning anxiety so overshadows their inner struggles that they either don’t recognize their anxiety for what it is or they are afraid to let it go.

After all, if you’re a member of the highly functioning anxious population there are some pretty amazing perks to the nearly constant worry and stress:

But these perks aren’t free. The inner conflicts that only people with high functioning anxiety understand include:

  • You may struggle to balance all the priorities (because “everything is a priority”) andtake good care of yourself too.
  • You can struggle with finding the right balance between good enough, perfectionism and procrastination.
  • You may feel “unsettled” and uncomfortable in your skin most of the time.
  • You may struggle with falling asleep, staying asleep and/or getting quality sleep.
  • You are prone to using chemical help to “numb out” and relax – alcohol, sleep-aids, sugary foods, etc.
  • You may need reassurance to make difficult decisions. With so many different variables to consider, they all seem to be of the same relative importance.
  • You may chatter or indulge in other nervous habits (playing with your hair, cracking your knuckles, biting your nails, etc.) when you’re feeling anxious.
  • You may need to do repetitive things (count your steps, rack back and forth, etc.) to calm down your thoughts.
  • You may not be able to say “no” and, as a result, have an overloaded schedule.
  • You may be difficult to read. Others may even describe you as stoic, unemotional or cold.
  • You may struggle with mental and emotional fatigue because you’re constantly on the go trying to achieve your next task or goal.
  • You may be loyal to a fault in relationships.
  • You may persistently overthink situations and opportunities.

When your ability to manage your inner struggles begins to wane, your ability to continue performing at the same peak level can follow suit.

Now, instead of being your reliable friend and motivator, your anxiety starts to take on a hard edge. Its messages are no longer well-spoken bits of encouragement or reminders. Instead, your anxiety starts to yell and demand attention. This is when you are likely stretching yourself too thin, and can start to feel more like a basket case than the powerhouse you have always been.

If this is what’s happening for you, the friendship you’ve had with your anxiety is slipping. And instead of being a helpful motivator, your anxiety is starting to feel more like a tyrant.

When your anxiety begins feeling tyrannical and your functioning is curtailed, your anxiety is no longer high-functioning.

But you can regain the friendship you’ve always had with your anxiety. It’s not gone and permanently replaced with a cruel, judgmental oppressor. You just need to start doing a few things differently.

  • Remind yourself that you are in control. 

By acknowledging that you have choice about how you experience your life, you’ll be able to start harnessing what Sonja Lyubomirsky calls the 40% solution for remaking yourself. And you’ll be better able to employ the suggestions for re-friending your anxiety. Once you do that, anxiety can become more moderate and you’ll be able to reclaim the powerhouse you truly are.


  • Embrace a growth mindset.

Allow yourself to continuously learn. Imagine that everything you experience is an opportunity to grow and learninstead of an opportunity to fail and judge. When you’re open to learning something new, you can see the possibilities that exist and shift your attitude away from anxiety’s negativity bias.


  • Practice grounding techniques.

Grounding techniques help bring you to the present and out of the whirling thoughts in your head. Although these techniques are often recommended for stopping a panic attack, they’re also very helpful for regularly reminding yourself to be present. And being present allows us a reprieve from the past and future where the least useful anxiety tend to operate.One of the easiest, most effective and portable techniques is the 54321 “game.”

o   Name 5 things you can see around you right now and describe them.

o   Name 4 things you can feel with your body.

o   Name 3 things you can hear right now.

o   Name 2 thing you smell or enjoy smelling.

o   Name 1 thing you like about yourself.


  • Practice breathing techniques.

You can calm your nervous system and relieve stress by deep breathing. One helpful breathing technique is belly breathing aimed at triggering the “all clear” response to your brain.

Place a hand on your belly. Breathe in through your nose for a count of 5. (You want to breathe deep enough that your hand rises with your belly on the inhale.)Hold this breath for 1-2 counts, then exhale through your mouth. You want to aim for no more than 8 breaths each minute.

As you regularly practice belly breathing, you’ll notice that you feel more relaxed. You will also notice that your anxiety is less tyrannical and more friendly.


  • Stay organized.

By staying organized and planning ahead, you feel more in control andless anxious. This is partly because organization and planning help you to make thoughtful, reasoned decisions and stay focused in pursuit of your goals.

You’re making it easier to pay attention to what you need to do instead of wondering where you put that file you need. And this will decrease your stress in accomplishing your tasks and achieving your goals.


  • Manage your expectations.

There are 3 practical ways to manage your expectations:

1. Make no assumptions. Ask questions to make sure you’re clear about not only who’s doing what and by when, but also what’s expected of you by others.

2. Communicate. One of the best ways to manage expectations is to frequently and honestly communicate with everyone involved – even if that “everyone” is just you. That way you’ll be up-to-date on any changes that need to be made to the plans you have in place.

3. Learn to say “no.” Sometimes expectations simply aren’t realistic. Saying “no” to unrealistic ones whether they’re yours or someone else’s, is a key factor in managing expectations.


  • Learn to be OK with uncertainty.

Being OK with uncertainty doesn’t have to mean that you’re worry-free. Actually, a study in the journal Emotionpoints to the need to embrace your anxiety during waiting periods, and do something with it. Planning for contingencies allows you to take control of anxiety, and better cope with uncertainty in general. 

When you’re OK with uncertainty, you accept that you don’t know the future.

Hope for the best but prepare for the worst. (And preparation is one of the super powers everyone with high functioning anxiety has.)


  • Manage your meals.

Fueling your body with healthy food is one of the most basic andhelpful things you can do for yourself. And when you have high functioning anxiety it’s also one of the most important.The key is to make it easier for you to eat well – without having to use as much willpower. The book Slim by Designis filled with scientifically-based suggestions for simple changes you can make to your eating, shopping and food ordering patterns to support your nutritional needs.


  • Take a stand.

Remember power posing? Amy Cuddy has proven that “making yourself big” for just a few minutes changes your brainin ways that build courage, reduce anxiety, and inspire leadership.Regularly taking the time to pay attention to your posture and how you’re holding your body for just a few minutes will help you remain friends with your anxiety.


  • Catch enough ZZZZZZs.

Getting enough sleep is one of the foundational ways to keep your high functioning anxiety high-functioning. That’s because sleep loss saps energy, concentration and emotional control.Of course, one of the challenges of any type of anxiety is getting enough rest. One way to deal with getting the sleep you need is to set and keep a relaxing bedtime routine with a set bedtime. Another tip is to allow yourself to sleep when you’re tired.

When you get the rest you need you’ll find it easier to absorb new situationsand consolidate your memories. Sleep also clears the brain of toxic metabolic byproductswhich helps keep your brain functioning well.


  • Write it down.

Journaling can be a very effective way of coping with and befriending anxiety. According to James Pennebaker, Ph.D., “By writing, you put some structure and organization to those anxious feelings. It helps you get past them.”To actually achieve the stress-reducing benefits of journaling, you must use it to interpret your experiences. In other words, you’re journaling about the emotions associated with your experiences to work through them, not just casually mentioning them in a “Dear Diary” note.


  • Be caring and compassionate.

People with high functioning anxiety care. They care a lot about nearly everything.Rather than trying to curb your nature, you can work wonders when you embrace it. Your caring nature holds within it the capacity to calm your excessive worry.

When you’re generous with others, your physical and mental health benefit. When you’re compassionate, you’ll find your stress decreases. When you’re kind, you feel happier.

And when you turn your caring and compassionate nature on yourself (especially when you’re procrastinating), you’ll find that your worry and stress become less bothersome.


  • Spend time with your friends.

Building and maintaining friendships is an important way to cope with stress and anxious thoughts. Supportive relationships help you bounce back from stress.Talking about your worries with a trusted friend or friends allows you to vent your pent-up emotions and struggles. It also provides a safe place for you to hear their suggestions for how you might deal with the frustrations you’re facing.


  • Laugh it off.

Having a sense of humor about stressful situations helps you worry less about them. Being able to genuinely laugh about a situation means you’ve had to think about it differently. Instead of it remaining a stressful or worrisome thing, you’ve found a funny angle through which to view the stressful situation.Choosing to focus on the funny instead of the anxious angle will help you navigate the situation more easily.


  • Get moving.

Exercise is one of the most important ways you can cope with worry and stress. Regular exercise and physical activity can also improve your self-esteem and sense of wellbeing. And when you’re feeling good about yourself and life in general, you’re not worrying or feeling stressed out.


  • Cry it out.

You know those times when you’re feeling so stressed you want to cry? Go ahead and do it.Biochemist Will Frey found that emotional tears are filled with stress hormones. When you stress-cry, you allow your body to rid itself of the extra stress hormones which has a calming effect.

If you happen to stress-cry in front of someone who cares for you, you’ll (usually) elicit their compassion and strengthen your emotional intimacy. In other words, you’ll have the support you need to help you cope with the stress you’re feeling.


These science-backed tips for befriending your anxiety will help you transform it from a tyrant back into a friend. When you’re on friendly terms, you can reap more of the perks your high functioning anxiety has to offer.

And in order to remain friends, there are a few things you’ll need to do.

First, prioritize the basics: sleep, nutrition and exercise. These are foundational to life, regardless of the presence of any kind of anxiety. We all need adequate sleep. We all function better when we fuel our bodies with healthy foods. And we all feel better when we’re moving our bodies.

Look at the list of tips above and incorporate the ones that most easily work into your daily routine. And if you’re having a hard time deciding which to add, start with the deep breathing (if you can make “deep breathing” a link that goes back to the breathing techniques bullet that would be ideal). You’re breathing anyway, so taking just a minute or two to focus on your breath can help make this tool increasingly more accessible when anxiety could ramp up.

Dealing with high functioning anxiety isn’t always easy, and at times it can feel more like a hindrance than a help. When this happens, and you get stretched too thin, you can wonder why the anxiety that has always spurred you on seems to have turned on you, now threatening to hold you back.

If this happens, recognize where you have fallen out of balance, and reclaim control. You have the tools to befriend your anxiety, so you can return to being the powerhouse of high achievement, compassion, kindness, and happiness you are.


For more help with managing anxiety, check out my new book, Hack Your Anxiety, register for my free mini-ecourse by signing up for book bonuses here, or check-out my anxiety and relationships blogs.  

Photo by Bruno Nascimento on Unsplash

Alicia H. Clark, PsyD


  1. Gitanjali on April 27, 2019 at 12:00 pm

    Hi Alicia! It was a very nuanced & beautifully sensitively written read.. Liked how the inner high functionality yet the struggles have been co-emphasised & importantly the helpful ways How to regain the friendship one has had with one’s Anxiety ???

    • Alicia H. Clark, PsyD on May 6, 2019 at 4:45 pm

      Hi Gita,
      Wow, thanks so much for taking the time to comment. Very much appreciate your weigh in, and especially the mandate to make better friends with our anxiety.
      Wishing you all the best,

  2. Desiree Matthews on November 29, 2020 at 2:03 am

    It would be really helpful to know how to work with high functioning anxiety folks in a positive way. Any ideas?