Do I have high functioning anxiety? Therapist shares 10 Signs

When we picture a person with anxiety we usually picture someone who’s visibly nervous. They may be distressed, restless, speaking rapidly, or paralyzed by their anxiety. For some, however, anxiety is not apparent to those around them. High functioning anxiety is a type of anxiety presentation in which the person looks cool, calm, and collected on the outside, but is deeply struggling internally.

As a therapist who’s been in the mental health field for years, I have seen clients come in feeling like their life needs reconciliation; their external life seems to be going well, but they’re panicked, stressed, or exhausted constantly.

In this article, we’ll break down 10 signs that you’re experiencing high functioning anxiety. By the end, you’ll have a better idea if what you’re experiencing goes beyond everyday stress and may be connected to anxiety.

Sign #1: You Choose “Fight” instead of “Flight”

Anxiety is our “fight or flight” response lighting up. Typically, we recognize anxiety through the flight response. Folks who respond to their anxiety through flight may avoid social situations, or procrastinate on projects, for example.

Those with high functioning anxiety, on the other hand, have a propensity to go towards the thing that is causing them anxiety. While this can result in more actionable behaviours, the anxiety itself is never addressed. Instead, those with high functioning anxiety actually just “white knuckle” – the process of pushing through via sheer willpower, despite distress, through their problems.

Sign #2: You Struggle to Relax and Switch Off

This is a hallmark of folks with high functioning anxiety. Relaxing, sleeping, enjoying our alone time or time with others often feels like it’s off the table. When our anxiety tells us we need to do more, and more, and more, and more, we struggle with rest.

Some people can’t seem to shut off their overthinking, others feel an inner critic creep up the moment they take a breath. Many feel both. Rest feels like something you’re supposed to “earn” and the price never seems to be paid entirely. Oftentimes, folks with high functioning anxiety only rest when our bodies completely give out.

Sign #3: You Overthink Conversations and Decisions

The inner critic will come up again and again if you experience high functioning anxiety. Oftentimes, it’s in the form of overthinking and rumination. 

For example, those with high functioning social anxiety may not avoid attending events, but after the event they will experience strong feelings of embarrassment or shame as they begin to overthink every conversation and interaction. They may reach out to others compulsively to receive assurance that they didn’t do anything wrong, and struggle to believe that they were completely fine.

Similarly, those with high functioning anxiety overthink presentations, decisions, and daily tasks, often analyzing potential outcomes for long periods of time.

Sign #4: Perfectionism Drives Much of What You Do

Everything. Must. Be. Perfect. If you struggle with high functioning anxiety, the consequences for not being absolutely flawless feel severe. Some folks experience this perfectionism in some arenas, others feel it in every area of their lives.

You might find, for example, that the project you had to do for work met expectations a long time ago, but you’re still tweaking, adding, and stressing about it long after it’s finished. You might lose sleep over details people would overlook or not notice at all. 

If something doesn’t go “just right,” a person with high functioning anxiety will often feel an intense bout of shame or worry about the situation, even if, in others’ eyes, they over-exceeded.

Sign #5: You Worry About Letting Others Down

A person with high-functioning anxiety will often be distressed when they perceive someone communicated disappointment or anger in them. Those with high-functioning anxiety are often seen as generous and overachieving in others’ eyes, but struggle to see it themselves. 

They often find themselves attuning to others’ emotions, people-pleasing their way through interactions. They’ll bend over backwards for someone else than risk the possibility of that person being upset. They will overwork themselves in relationships to maintain a positive image to others. Although they’re very often successful at it, they still feel a sense of internal hypersensitivity around potentially failing to meet expectations.

Sign #6: You Experience Physical Symptoms of Anxiety

This is an underrated but very real sign of high functioning anxiety. While a person with this presentation of anxiety may feel mentally capable of taking on an endless number of tasks, sooner or later, they begin to see the effects physically. 

People with high functioning anxiety often experience:

• Chronic fatigue
• Muscle tension (especially neck, shoulders, back, and jaw)
• Teeth grinding or jaw clenching
• Frequent headaches or migraines
• Difficulty falling asleep or staying asleep
• Racing heart or heart palpitations
• Shortness of breath
• Excessive sweating
• Trembling or shakiness
• Digestive issues (nausea, stomach aches, diarrhea, constipation, bloating)
• Loss of appetite or stress eating
• Frequent colds or getting sick more often
• Unexplained aches and pains
• Skin issues that flare with stress (e.g., acne, eczema)
• Nail biting, skin picking, or other nervous habits

The effects are a little like “whack-a-mole;” you push down and through your anxiety and stress, but it comes up in a new way. While folks who experience  this may still be “technically” able to push through and keep achieving, their body takes the toll.

Sign #7: Others Seem to Think You’re Doing Okay

This is a huge one. It is not at all uncommon for friends and family of people with high functioning anxiety not to notice what’s going on. This is because, as discussed previously, high functioning anxious folks work very hard to ensure that the outside world goes unaffected. 

This often makes things confusing for the person struggling; when things look okay from the outside and people think you’re doing well, it’s hard to identify if you are experiencing anxiety.

Sign #8: You Always Need to Have Things Organized

What seems like “nice to haves” for other people can become very necessary for the person with high functioning anxiety. They may feel like if their space is a mess, or their routine is thrown off, the world’s coming apart at the seams. 

When the inside world feels like it’s barely being kept together, it can feel much more detrimental to have the outside be disorganized, so the stakes feel higher. Folks with high functioning anxiety will often work very hard to maintain order externally. 

Sign #9: Your Self-Worth Is Tied to Achievement

A person with high functioning anxiety will feel their worth waver depending on how much they’ve achieved. Their sense of self often goes up and down depending on how productive they’ve been, how much they’ve accomplished, or how useful they’ve been to others.

On the surface, this might look like ambition. A high functioning anxious person may be seen as driven, reliable, and successful. Internally, however, there can be a persistent fear that if they slow down, make mistakes, or fail to meet expectations, your value as a person somehow decreases.

This creates a difficult cycle. Achievement temporarily soothes anxiety by providing reassurance that you’re “doing enough” or “being enough.” Unfortunately, that relief is often short-lived. Before long, the bar moves again. The next project, the next goal, the next responsibility becomes the thing that determines whether you feel okay about yourself.

Sign #10: You Feel Exhausted Despite Appearing to Have It All Together

People with high functioning anxiety are often carrying an invisible mental load. They’re planning ahead, anticipating problems, managing other people’s emotions, double-checking details, monitoring their own performance, and trying to prevent anything from going wrong. Even during moments that are supposed to be relaxing, their minds may still be running through to-do lists or worst-case scenarios.

Because they continue showing up to work, maintaining relationships, and meeting responsibilities, others may assume they’re coping well. In reality, many describe feeling like they’re constantly running on fumes.

The difficult part is that high functioning anxiety is often reinforced by external praise. People commend your work ethic, reliability, and ability to handle so much. What they don’t see is the anxiety driving it all or the toll it’s taking behind the scenes.

Getting Therapy in Toronto for High Functioning Anxiety

If you recognize yourself in several of these signs, it doesn’t necessarily mean you have an anxiety disorder. Many of these experiences exist on a spectrum and can worsen during periods of stress. However, if anxiety feels like it’s constantly dictating your choices, affecting your physical health, disrupting your ability to rest, or making it difficult to enjoy your life, know that there is help available.

Around 1 in 4 Canadians will experience an anxiety disorder at some point in their lifetime. The good news is that anxiety is highly treatable. Therapy can help you understand the patterns that keep anxiety going, develop healthier ways of responding to stress, and build a relationship with yourself that isn’t based solely on achievement or perfection.

I offer a free 15-minute consultation call where we can discuss your experience, answer any questions you have about the therapy process, and explore whether we’re a good fit to work together.

To book your free 15-minute consultation, click here or email me here.