High-functioning anxiety is not an official clinical mental health disorder but can create serious issues and be chronic and somewhat debilitating. Individuals experiencing high-functioning anxiety tend to keep it concealed as much as possible. Still, in doing so, they may incur more stress and anxiety that prevents them from healing mentally and emotionally.
Anxiety disorders and substance abuse often co-exist. Sometimes a person’s anxiety is provoked by drugs or alcohol, and sometimes substance abuse is motivated by anxious feelings as a misguided means of self-medication.
In either case, both conditions require professional treatment concurrently as not to let one unaddressed problem contribute to a relapse regarding the other. And fortunately, many of the same addiction treatment methodologies, such as psychotherapy and counseling, can also help with anxiety.
Moreover, high-functioning anxiety and addiction are both very treatable conditions. Those who seek help and are serious about recovery can expect a significant improvement in their symptoms.
High-Functioning Anxiety Facts and Statistics
People with high-functioning anxiety typically deal with many of the symptoms commonly associated with anxiety disorders. However, they do not meet the criteria for an anxiety disorder diagnosis, even though their condition may be troubling on a regular basis.
To elaborate, the tension and stress they experience are not severe enough to interrupt their lives in obvious, discernible ways. For this reason, among others, the suffering of individuals with high-functioning anxiety remains largely hidden from the world. But despite their continued ability to maintain employment, attend school, handle family duties, and manage their personal and financial affairs, persons with high-functioning anxiety are still suffering and functioning at less than their full potential.
Over time, high-functioning anxiety can take a heavy physical and psychoemotional toll on those it impacts. If these persons don’t ask for help, they may develop more debilitating and severe mental health conditions later in life.
An estimated 40 million U.S. adults aged 18 will experience an anxiety disorder in any given 12-month period. This represents more than 18% of the population aged 18 or older. The lifetime incidence of anxiety disorders for adults nationwide is nearly 29%.
12-month incidence rates for specific anxiety disorders include the following:
- Obsessive-compulsive disorder (OCD): 1.0%
- Panic disorder: 2.7%
- Generalized anxiety disorder (GAD): About 3%
- Post-traumatic stress disorder (PTSD): 3.5%
- Social anxiety disorder (SAD): 6.8%
- Specific phobias: 8.7%
Among individuals suffering from symptoms of anxiety-related mental health conditions, less than 37% will receive treatment for their disorder, and this number is lower among persons with high-functioning anxiety. However, the uncomfortable symptoms of those afflicted will overlap with those of one or more of the currently recognized anxiety disorders. For every individual diagnosed with a specific condition, many others experience comparable effects and suffering because of it.
Symptoms of High-Functioning Anxiety
Unlike official clinical disorders, high-functioning anxiety does not typically induce intense physical symptoms that influence thoughts and behavior. However, when anxiety is experienced, it may include some physical issues, such as elevated heart rate, sweaty palms, and stomach problems. Still, these symptoms usually aren’t intense enough to limit activity or be readily apparent to outside observers.
High-functioning anxiety is often compared to generalized anxiety disorder (GAD) because of its omnipresent yet somewhat ambiguous nature. However, there are overlaps with other anxiety disorders as well, and in contrast to GAD, high-functioning anxiety doesn’t typically produce debilitating physical responses or cause notable avoidant behaviors.
Instead, high-functioning anxiety sufferers tend to push through their thoughts and feelings and do what they have to do. However, they frequently feel unease before, during, and after their experiences with individuals or environments that cause them stress.
The behavioral and emotional symptoms of high-functioning anxiety can include the following:
- Worry and stressful feelings that undermine attempts to relax
- Perfectionism and constant feelings of dissatisfaction with one’s performance
- Workaholism at home, work, or school
- Tending to overthink and overanalyze everything, frequently second-guessing one’s own decisions
- Not being comfortable with emotional expressions and an unwillingness to discuss genuine feelings
- Frequent precipitating anxiety before a wide variety of events or interpersonal encounters
- Incessant fears of failure or the negative judgments of others
- Superstitions and compulsion to repeat certain behaviors to relieve anxiety
- Occasional insomnia and sleep difficulties
- Irritability and readiness to become frustrated or discouraged when countering setbacks
- Difficulty saying no, no matter how time-consuming or inconvenient the request may be
- Exhibiting a falsely happy disposition that is underlined by secret pessimism that conflicts with positive public expressions
- A wide range of unconscious nervous habits (fingernail biting, hair twirling, idle scratching, lip chewing, etc.)
High-functioning anxiety sufferers often lack adequate self-esteem and self-confidence. They attempt to counterbalance their insecurities by continually pushing themselves to improve their performance at certain tasks/hobbies or to please others. Unfortunately, their goals are frequently unrealistic, and their failure to meet them only reinforces their persistent feelings of tension and inadequacy.
Diagnosing High-Functioning Anxiety
When stress and anxiety are anecdotally reported, and life-altering effects are found to be present, mental health providers will attempt to establish whether a clinically-recognizable anxiety disorder can be diagnosed. If they cannot, they may use “high-functioning anxiety” as a default diagnosis.
If a medical or mental health professional believes a patient is experiencing significant effects of high-functioning anxiety, they will likely discuss options with that individual and offer additional ideas moving forever. Despite not having a precise diagnosis nature, high-functioning anxiety is a condition that can cause significant distress and leaves those who suffer wanting relief. Since it responds well to cognitive-behavioral therapy, most medical professionals will recommend that path to recovery.
Causes and Risk Factors
Persons with high-functioning anxiety do not respond to external circumstances but instead to internally-generated fears that can ultimately absorb them. Factors that can contribute to stress can often be traced back to past experiences, the fight-or-flight response system, or to certain personality traits that have been present since infancy.
Among the common risk factors for high-functioning anxiety also include the following:
- Childhood shyness/social anxiety
- Demanding, highly critical parents
- Childhood physical, sexual, or emotional abuse
- Exposure to traumatic and stressful events, either as a witness or experiencer (e.g., violence, sudden loss of a loved one, severe illness, natural disaster, etc.)
- Family history of anxiety disorders, especially in parents
- Personal history of depression
- Highly stressful job or career
- Long-term financial or legal problems
Treatment and Prognosis
Treatment rates for anxiety sufferers are relatively low, and this is especially true when other mental or behavioral health disorders are present such as substance abuse. Despite this, these conditions may be highly responsive to therapeutic intervention.
Treatment for high-functioning anxiety typically revolves around psychotherapy, which is best administered to anxiety-afflicted patients in mental health or addiction treatment centers, depending on the issues with which one is struggling. When individuals enter residential rehab programs for anxiety, they will be exposed to valuable learning opportunities in individual and group therapy sessions and life skills and coping skills classes. They may also receive instruction in holistic stress management techniques like meditation, biofeedback, yoga, art and music therapy, and more.
Medication may also be prescribed for use during and after residential programs, often in the form of anti-depressants or anti-anxiety medications (benzodiazepines) that have been clinically proven to be effective against anxiety symptoms or alcohol/drug withdrawal.