If most film and TV tropes are to be believed, then the average person who contends with anxiety is a nail-biting, hand-wringing nervous wreck who has trouble leaving the house and has panic attacks if their barista puts the wrong flavor shot into their morning latte.
The thing is, anxiety can manifest in countless different ways, and those who contend with high-functioning anxiety often do so under the radar, because their coping mechanisms are subtle and internalized.
If you aren’t sure whether you or someone you know is dealing with high-functioning anxiety, try to observe the following, which are good signs that you/they are.
Type A Perfectionism
A person with high-functioning anxiety (HFA) tends to be plagued by obsessive thoughts and worries that intrude on a constant basis. They may not be able to break free from worrying about a particular “what if?” scenario, or even an aspect of their life at that moment. So they immerse themselves in work, or housecleaning, or school, or a particular hobby, in order to try to escape from the downward spiral their thoughts drag them into.
If their entire being is focused on essay research or re-organizing their 800 books by genre, then alphabetically by author, and sub-categorized by color, then slightly less energy is being put towards the fear that plagues them.
In a desperate attempt to get away from the gnawing beast of worry, they might seem like high-energy extroverts: they’ll surround themselves with friends, be workaholics who take evening and weekend classes, and could very well be admired in their social circle. After all, they’re ambitious, energetic, and enthusiastic, right?
Well, no. Not so much.
Chances are that all that energy and enthusiasm is a big façade and just a massive form of escapism. In fact, they’re doing all they can to avoid those in-between times where things quiet down and they’re alone with their intrusive thoughts.
You’ve likely experienced them before when you’ve gone through a crisis like a breakup – when you’re up at 3am obsessing over every conversation, every exchange, every scenario you’ve experienced (or might experience) and you just can’t sleep or think of literally anything else.
Chronic insomnia is something that just about everyone with HFA experiences, and this not only exacerbates the panic, but brings a slew of co-morbid issues along with it: constant headaches, weakened immune system, gastrointestinal disorders, muscle aches…
Imagine how incredibly difficult it would be if that were your life all the time.
That’s what a lot of people with high-functioning anxiety contend with on a constant basis. Is it any wonder why they immerse themselves in activities?
Tics and Twitches
People with HFA who aren’t engaged in immersive projects to distract them, or who haven’t found a type of meditation or therapy that works for them, can internalize their worries. They push them deep down and try to ignore them, but doing that never really works. Those worries and fears just end up manifesting physically, even if the person isn’t aware of them.
Nervous tics like twitches, repeated blinking, cuticle picking, hair pulling, etc. are just a few ways that anxiety can manifest. Some people bite their lips raw, others have difficulty sitting still, so they’ll bounce a leg or twiddle their thumbs.
For some people, these physical manifestations aren’t just the result of repressed worry, but are ways for them to channel their nervous energy so their thoughts aren’t overwhelmed.
As an example, if they’re in a social situation where they’re feeling overwhelmed (too many people talking at once, or the music is too loud, or they’re just flooded with thoughts and emotions), their physical twitchiness may intensify. Some may even need to excuse themselves temporarily – or in some cases actually run out the door – so they can take a few minutes to do some breathing exercises and just calm themselves down.
They might be able to regroup and then go back into the fray, or they might be far more comfortable just leaving at that point, but either one of those decisions will weigh on them very heavily and be absolutely devastating to navigate. If they stay, they know they’ll be uncomfortable and overwhelmed. If they go, they might be thought of negatively or disappoint someone they care about.
Doesn’t sound like an easy thing to contend with, does it?
One of the worst things about HFA is the fact that, since most sufferers give the impression that they generally have all their sh*t together, it’s difficult for others to believe that they’re suffering inside. Much of the time they are simply blind to the turmoil raging under the surface.
After all, if an honors student who also holds down a job and does volunteer work for orphaned baby seals on weekends comes out and says that they’re plagued with crippling anxiety, do you think they’d be taken seriously?
All of their behavior points to a person who is focused, driven, and immensely capable. This is a person with ceaseless drive and energy – how can they possibly be dealing with anxiety?
What an absurd thing to even consider, right?
People who fall into this category often have a far more difficult time getting the help they need because they present as being too “together” to need help. They may have trouble convincing friends and partners that they’re losing their sh*t because those people have only ever seen their “everything’s great!” mask and so can’t even conceive of the possibility that they’re in turmoil.
Even worse, the sufferer may hesitate to open up to others about their difficulties because they’ve worked so hard to maintain this façade for so long that they’re scared their true selves won’t be accepted by the few people they’ve truly allowed close to them.
That mere thought may put them into the throes of a panic attack and prevent them from getting the help they desperately need.
If you feel as though you might be living with high-functioning anxiety, it may be a good idea to speak to a therapist about techniques that can help you cope. Meditation and mindfulness can be immensely helpful for staying in the present moment (try these affirmations for anxiety and these ones to help you stop overthinking), and certain medications may be useful as well, whether prescribed, or herbal.
Some people have found passionflower to be a great plant ally for anxiety, while others use a high-CBD cannabis to combat theirs, if it’s legal in their area. Some dietary changes such as cutting out gluten, dairy, and/or sugar can also be of great help. But please always speak to your healthcare practitioner before you make any major changes of this kind. They will be able to advise to of the pros and cons of the various approaches.
If, instead, you have a friend or romantic partner whom you believe struggles with HFA, please try to be understanding and compassionate. No-one chooses to have these ever-present, nagging worries, and you can rest assured that they would be more than happy to just “let it go” if they were capable of doing so.
These are people who are pretty much prisoners of their own anxieties, and they’re terrified of hurting those they care about by letting them down. If you think poorly of them for a shortcoming you believe they’ve exhibited, understand that they absolutely despise themselves for that very same thing.
These people hold themselves to ridiculously high standards, and thinking that they might have hurt you or let you down because the thoughts they’re battling have won temporarily… well, it’s just devastating.
We could all use a bit more understanding and compassion in our lives, so if you or someone you love is contending with any of this, please be gentle.
Have you suffered from high-functioning anxiety in the past? Or are you coping with it now? Leave a comment below to share your experiences with others who may benefit from what you have to say.
Catherine Winter is a writer, art director, and herbalist-in-training based in Quebec's Outaouais region. She has been known to subsist on coffee and soup for days at a time, and when she isn't writing or tending her garden, she can be found wrestling with various knitting projects and befriending local wildlife.