9 Surprising Symptoms of High Functioning Anxiety

symptoms of high functioning anxiety

The idea of an anxious person may conjure up notions of nervous energy, scattered chatter, even a sense of panic. Symptoms of high functioning anxiety, however, are usually veiled behind the appearance of success and on-point composure.

While people with Generalized Anxiety Disorder (GAD) are more prone to high functioning anxiety, the latter is not a diagnosed mental health disorder. It is, instead, a catch-all term – however contemporary – to describe a growing population of people who live with anxiety, but describe themselves as functioning reasonably well.

According to the Anxiety and Depression Association of America, anxiety disorders affect 40 million adults in the United States every year. That’s 18.1% of the population. And, while anxiety disorders are easily treatable, only 36.9% of those affected receive treatment.

Circulating amongst the remaining 63% is a population of people masked behind symptoms of high-functioning anxiety. And their inner suffering may be so overshadowed by their outward performance that they either don’t recognize it or are afraid to let it go.

This unique population has figured out a way to use anxiety as a protagonist to their tendency for intense caring. Instead of allowing their anxiety to hold them back, they convert it into production.

Like anything else, high functioning anxiety has both positive and negative characteristics. On the plus side, the outward appearance is that of an outgoing, punctual, proactive, organized, helpful, passionate, loyal over-achiever.

The proclivity for detail-orientation adds an extra boost of excellence in the workplace, and can be a basis for trust amongst colleagues and peers.

On the negative side, some of these experiences can evoke challenges like insecurity, racing thoughts, nervousness, overthinking, insomnia and people-pleasing.

In the context of anxiety, detail-orientation can easily translate to agitation, perfectionism, and even obsessiveness. And more often than not, the drive toward performance will trump acknowledging the inner struggle and often the willingness to seek help.

Because of their ability to channel anxiety into desired productivity, high functioning anxious people are, in essence, at odds with themselves. And, because the rest of the world is likely to applaud and even envy their energy and success, they often navigate this unique form of anxiety in silence.

Below is a breakdown of 9 of the most notable symptoms of high functioning anxiety:

1. High sensitivity and deep caring.

High-functioning anxious people connect easily with others, care about pleasing them, and resonate with deep empathy. They operate from full hearts, which can lead them to “care a lot about too much.” While most people would care less in order to be less encumbered, high-functioning anxious people aren’t capable of dumbing down.

The challenge, of course, is to balance all the priorities (because “everything is a priority”), and to remember to take good care of themselves,as well. People who take on so much have to be healthy and up to the task. Sleep, exercise, nutrition and self-kindness are essential allies for the high functioning anxious life.

2. Perfect is ideal. Good-enough is tolerable.

High functioning anxiety is about production. While the desire for perfection can be a driving factor, high-functioning anxious people know when to take “good-enough” as a compromise in order to check things off an endless list. Their ability to pivot on their motivations allows them to stay productive without getting lost in the details.

If and when they are unable to shake their perfectionism, procrastination is the usual result.

3. Uncomfortable a lot of the time.

What most people would recognize as an occasional (and usually unwelcome) discomfort, high functioning anxious people think of as the norm. They can be “unsettled” and uncomfortable in their own skin much of the time. And being so isn’t indicative of a pathology. It simply “is,” and is actually foundational to their drive and ability to accomplish so much.

4. Evenings can be active instead of restful.

High functioning anxious people tend to have a lot of energy, and will often take on tasks others would not. Always having “too much to do” goes along with the territory, as does the drive to complete tasks with accuracy and polish.

While the rest of the world sleeps, high functioning anxious people are often amping up. They can stay active well into the evening – even burning the midnight oil — completing tasks, perfecting those already done, and creating new ones.

Working into the night can be a private, chaos-free way to execute with the level of care that is so important to this unique population. It can also be a productive outlet for the extra energy with which they live.

5. Sleep requires effort and a routine.

Because the anxious person’s mind doesn’t slow down, the body doesn’t, either. The weight of worry, racing thoughts and planning make falling asleep, staying asleep, and getting quality sleep difficult.

Combatting the detrimental physical and mental effects of insomnia and sleep deprivation necessitates discipline around sleep. Strategies for ensuring healthful sleep might include:

  • Calming rituals like a bath, shower, meditation and/or reading to quiet the mind.
  • Setting a firm bedtime to intercept the temptation to indulge the mind’s busy-ness.
  • Using sleep props (e.g. a mouthguard, ear plugs, eye shades, controlled air temperatures) to block out sensory stimuli and maintain healthy sleep.

6. Planning for the next day is a habit.

Whether planning the next day or the next year, the high functioning anxious person is prone to using evenings to plan. Looking at calendars, laying out clothes, responding to emails – all are ways of channeling anxiety into productivity…ahead of schedule.

7. Using chemicals to relax. 

Anxiety disorders of all kinds have a variety of root causes – fear, trauma, genetics, physical chemistry, etc. The high functioning anxious person, however, doesn’t have time to sit with these antagonists. There is work to be done, appearances to be upheld, success to be won, and active distraction often helps keep these deeper concerns at bay.

But relaxing and facilitating sleep can be challenging when the culprits of anxiety aren’t addressed, and “numbing out” can be a key way of relaxing. Alcohol and other means of self-medicating are often part of the high functioning anxious person’s nighttime routine.

8. Procrastinating

Procrastinating is another way to think about high functioning avoidance. Different from avoidance, procrastination offers anxiety a productive outlet, just not quite the most productive outlet. You might need to clean off your desk, and feel better for having done so, but that extra time and focus can be costly when facing down an important (and inflexible) deadline. Procrastination will almost always drive up anxiety – the trick is to decide how much extra anxiety you can afford  to feel.

9. Needing reassurance to make difficult decisions.

Difficult decisions can be hard for most of us, but for an anxious person, they can be a grueling process. Because you can conceive and care so much about a variety of potential outcomes, you may need help thinking through all the various possibilities and struggle beneath the weight of the variables.

Support from trusted coworkers and friends can help an anxious person identify the most important variables, sort the most probable outcomes, and arrive at a decision that strikes the best balance between the available alternatives.


Symptoms of high functioning anxiety can be especially conflicting for those who live with them. There is always the duel between performance and the optimal level of anxiety needed to achieve it. And dulling the double-edged sword by asking for help can seem more threatening than keeping the anxiety hidden.

As with anxiety disorders in general, however, high functioning anxiety is very treatable…if recognized and addressed. And doing so doesn’t have to involve a mindset of “fixing” something that is “wrong.” It can actually be a means of embracing and managing a unique asset in the context of clarity and self-care.

Bottom line: if high functioning anxiety is making you miserable, it’s probably not doing its job as well as it could.

If you are struggling to maintain balance in your relationship with anxiety, your anxiety might be trying to tell you it’s time for a better way. As you probably know, doing something sometimes feels better than just about anything else.

What if your high functioning anxiety is nudging you to try something new? Few of us really change until we have to.


Looking for more help with anxiety? Check out my book, Hack Your Anxiety, sign-up for my free mini-ecourse to help you hack anxiety’s most common challenges, or subscribe to my newsletter.

Photo credit: Photo by Mimi Thian on Unsplash


Alicia H. Clark, PsyD