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Do You Have High Functioning Anxiety?

In our fast-paced and demanding world, anxiety has become an ever-present part of our lives, like a dark cloud in the distance. While anxiety disorders have become increasingly prevalent across the country, high-functioning anxiety has emerged as a unique subtype that presents a specific set of challenges.

High-functioning anxiety, or HFA, is often hard to spot. People with high-functioning anxiety may not look like they have any problems on the surface. They may be successful in their careers, have a large group of friends, and be able to handle day-to-day stressors without any major issues. But underneath all of that, they may be struggling with constant worry, perfectionism, anxious feelings, and a need for control.

In this article, we’ll go over some of the symptoms of high-functioning anxiety, how to spot them, and what you can do if you think you or someone you know may have this condition.

What is High Functioning Anxiety?

High functioning anxiety is a condition characterized by individuals who appear successful, competent, and in control on the outside while internally experiencing significant anxiety and stress throughout daily life. Internally, those with high-functioning anxiety tend to experience chronic worry, fear, and self-doubt. These individuals often set high standards for themselves and feel immense pressure to meet or exceed those standards. Despite their accomplishments, they may struggle with persistent feelings of inadequacy and an underlying fear of failure. While exhibiting some symptoms found in individuals struggling with social anxiety disorder or severe anxiety, HFA is more subtle and may go untreated for longer periods.

High-functioning anxiety is not recognized as an official diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), but it is an accurate way to describe many individuals with anxiety disorders who struggle with common behaviors, traits, and anxiety symptoms. It has gained recognition and popularity as a descriptive term among mental health professionals and individuals who resonate with its characteristics. It captures the unique experience of those who appear successful, driven, and accomplished on the surface but internally struggle with anxiety and its impact on their well-being. By using this term, it allows for better understanding, identification, and validation of their experiences, enabling targeted support and interventions tailored to their specific needs.

What Causes High-Functioning Anxiety?

There is no single cause of high functioning anxiety, nor any anxiety disorder diagnosis. It is thought to be a combination of genetic and environmental factors. Here are some key factors that contribute to developing high-functioning anxiety:

Genetic Predisposition

Individuals with a family history of anxiety disorders may have a higher likelihood of experiencing high-functioning anxiety. Genetic factors can influence one’s temperament, sensitivity to stress, and the functioning of certain neurotransmitters in the brain. All of these factors can contribute to the likelihood of developing a mental illness like an anxiety disorder.

Environmental Factors

Factors such as high levels of stress, demanding work or academic environments, societal pressure, traumatic experiences, or significant life changes can lead to excessive anxiety and negatively impact mental health.

Perfectionism and High Standards

Many individuals with high-functioning anxiety have perfectionistic tendencies and set exceedingly high standards for themselves. The constant pressure to achieve and fear of failure can create a cycle of anxiety and self-doubt. This pressure may stem from experiences in childhood or a high-pressure work environment.

Cognitive and Behavioral Patterns

Negative thinking patterns, excessive worry, and a tendency to overanalyze situations can contribute to the development of high functioning anxiety. These cognitive and behavioral patterns are sometimes shared with other mental health issues, including depression, anxiety, OCD, and personality disorders.

Coping Mechanisms

Individuals with high-functioning anxiety may employ coping mechanisms that temporarily alleviate their anxiety symptoms. However, these coping strategies, such as excessive planning, overworking, or seeking constant reassurance, can reinforce and perpetuate anxiety in the long run leading to a cycle of nervous habits and panic.

What Are the Symptoms of High Functioning Anxiety?

People with HFA may not have any major problems in their day-to-day lives, but they often feel a low level of anxiety that is always present, even if they’re not aware of it. They may be successful in their careers and have a large group of friends, but they also tend to be perfectionists who are always worried about making mistakes. They may also have a need for control and feel like they have to do everything themselves. This can lead to problems in their personal lives, such as difficulty relaxing or enjoying leisure activities. They may also have trouble sleeping and may suffer from physical symptoms, such as headaches or stomachaches.


A strong drive to achieve perfection, accompanied by an intense fear of making mistakes or falling short of expectations.


Constant rumination and analysis of past events, present situations, and future outcomes, lead to excessive worry and difficulty in decision-making.

Need for Control

An overwhelming desire to control situations, outcomes, and one’s own emotions, often results in rigidity and difficulty adapting to change.

Physical Symptoms

While individuals with high-functioning anxiety may not display obvious signs of anxiety, like panic attacks, they may experience physical symptoms such as muscle tension, insomnia, gastrointestinal issues, and headaches.

Imposter Syndrome

Feeling like a fraud despite external evidence of competence or accomplishments leads to persistent self-doubt and fear of being exposed as inadequate.

It’s important to know that not everyone with high-functioning anxiety will have all of these symptoms. And, even if someone does have all of these symptoms, it doesn’t necessarily mean they have high-functioning anxiety. These symptoms can also be caused by other conditions, such as a personality disorder or major depressive disorder.

If you or someone you know is experiencing any of these symptoms, it’s important to seek professional medical advice from a psychiatrist or other mental health professional. They can help you determine whether the symptoms are due to high-functioning anxiety, generalized anxiety disorder, a different anxiety disorder, or another mental health condition altogether.

How is High Functioning Anxiety Diagnosed?

If you are experiencing any of the above symptoms, consider making an appointment with a psychiatrist. Through a thorough psychiatric evaluation, they can help you determine if you have an anxiety disorder or another mental health condition.

There is no specific test for high-functioning anxiety. Instead, doctors will typically use a combination of self-report measures, clinical interviews, and observations to make a diagnosis.

There are several different assessment tools that mental health professionals can use to diagnose HFA. These include self-report measures, clinical interviews, and observer-rated measures. Self-report measures are surveys that ask about your symptoms and how they’re affecting your life. Clinical interviews are conducted by mental health professionals. They’ll ask you about your symptoms, how long you’ve been experiencing them, and how they’re affecting your life. Observer-rated measures are completed by people who know you well, such as your friends or family members. They’ll rate your symptoms and how they think they’re affecting your life.

If you think you or someone you know has high-functioning anxiety, it’s important to seek treatment. HFA can be a debilitating condition, but there are treatments that can help. With treatment, you can learn to manage your symptoms and live a full and happy life.

What are the Treatment Options for High Functioning Anxiety?

Fortunately, there are many proven methods for treating anxiety disorders. Once high-functioning anxiety is identified, appropriate support and treatment can significantly improve an individual’s well-being. There are a number of different treatment options for HFA.


Cognitive-behavioral therapy (CBT) and other evidence-based therapies and mental health services can help individuals develop coping mechanisms, challenge negative thought patterns, and manage anxiety disorders effectively.


In some cases, medications may be prescribed to alleviate some anxiety symptoms. Anxiolytics are medications that treat anxiety, some forms and antidepressant medications such as selective serotonin reuptake inhibitors (SSRIs) may also alleviate symptoms of anxiety.

Lifestyle Modifications

Encouraging individuals to prioritize self-care, stress management techniques, regular exercise, and healthy sleep patterns can contribute to overall anxiety reduction.

Support Networks

Engaging with support groups, counseling services, or seeking support from friends and family can help an individual stay on top of their symptoms, while also encouraging accountability and open communication.

Other treatment options for HFA include medication and relaxation techniques. Relaxation techniques, such as yoga or meditation, can help you learn to manage your anxiety.

If you’re struggling with HFA, it’s important to seek treatment. With treatment, you can learn to manage your symptoms and live a full and happy life.

How to Cope With HFA: Top At-Home Strategies

If you’re struggling with HFA, there are a number of things you can do at home to help cope with your symptoms. Here are some at-home strategies that can help:

Identify your triggers

Make a list of the things that trigger your anxiety. This can be very helpful because as you identify your triggers, you can slowly start to work through them. Common triggers for HFA include:

  • Caffeine
  • Stress
  • Lack of sleep
  • Certain foods
  • Alcohol

Try to avoid or limit your exposure to these triggers as much as possible. If you can’t avoid them completely, try to do things that will help offset their effects, such as exercising or drinking plenty of water.

Exercise regularly

Exercise is a great way to reduce stress and anxiety. It can also help improve your mood and energy levels. Try to get at least 30 minutes of exercise every day. This can be anything from going for a walk to playing a sport.

Create a routine

A structure can be helpful for people with HFA. Creating a daily routine can help you feel more in control of your anxiety. This routine can be as simple or as detailed as you want. Just make sure to include things that help you relax and de-stress, such as exercise, relaxation techniques, and spending time with loved ones.

Treat High Functioning Anxiety

Although high-functioning anxiety is not an official diagnosis, it serves as a valuable term to describe individuals who navigate their daily lives with a hidden anxiety disorder. The prevalence of anxiety disorders in today’s society, coupled with the pressures and demands of our modern world, contributes to the development of high-functioning anxiety.

If you or someone you know is dealing with high-functioning anxiety and seeking professional support, we encourage you to reach out to Neuro Wellness Spa. As a leading provider of comprehensive mental health services, Neuro Wellness Spa offers specialized anxiety treatments and therapies tailored to the unique needs of individuals with anxiety disorders. Contact us today to learn more about how our anxiety treatments can benefit you.

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