High-functioning anxiety – why you look fine but feel overwhelmed

High-functioning anxiety – why you look fine but feel overwhelmed?

You might be the person who always gets things done.

You go to work, answer your emails, meet your deadlines and remember everyone else’s appointments. You may be reliable, organised and someone that other people turn to when they need help. From the outside, you seem fine, but internally, things can feel very different.

Your mind may rarely switch off. You might spend hours thinking about what could go wrong, replaying conversations, worrying about whether you have upset someone, or wondering whether you have done enough. Even when everything appears to be under control, you may feel tense, exhausted or overwhelmed. This is sometimes described as high-functioning anxiety.

What is high-functioning anxiety?

High-functioning anxiety is not a formal mental health diagnosis. Rather, the term is often used to describe people who experience significant anxiety while continuing to function well in their everyday responsibilities. The difficulty is that functioning well can make anxiety harder to recognise. You may be achieving at work while feeling completely depleted. You may be caring for your family while privately feeling that you are barely coping. You may appear calm and capable while your thoughts are racing. Because you are still managing to do what needs to be done, you may question whether your anxiety is “bad enough” to deserve attention...It is.

When being capable becomes a way of coping

Sometimes anxiety becomes closely tied to being productive, prepared or in control.

You might:

• constantly plan for what could go wrong

• struggle to delegate because you feel things need to be done correctly

• find it difficult to say no

• overthink decisions, even relatively small ones

• repeatedly check your work or seek reassurance

• feel uncomfortable when you are not being productive

• take responsibility for other people's feelings

• become easily overwhelmed when several demands arise at once

• struggle to relax without feeling guilty

• have difficulty falling asleep because your mind is still working through the day

These behaviours can be quite effective in keeping life moving. The problem is that they can also become exhausting. If being prepared reduces your anxiety, you may become increasingly prepared. If checking something gives you temporary relief, you may check it again. If saying yes prevents the discomfort of disappointing someone, you may continue saying yes even when you have nothing left to give. Over time, coping with anxiety can become a full-time job.

“But nothing is actually wrong”

One of the confusing things about feeling anxious is that it does not always require an obvious crisis. You may have a good job, supportive relationships, financial stability or a life that looks relatively settled. And yet you may still feel anxious.

This can lead to thoughts such as:

“I have no reason to feel this stressed.”

“Other people have much more to deal with.”

“I should be able to handle this.”

“I'm coping, so maybe it's not really a problem.”

Comparing your internal experience with how you appear externally can make it difficult to acknowledge what you are experiencing. Anxiety is not always visible.

Looking beneath the anxiety

Therapy can involve more than learning how to make anxious thoughts go away.

Sometimes it is useful to become curious about what your anxiety is doing for you.

For example, if you feel that you must always be in control, what feels likely to happen if you are not? If you find it difficult to say no, what does disappointing someone mean to you? If you are constantly trying to anticipate problems, what might it feel like to simply not know what is going to happen? If you are very hard on yourself, what happens when you make a mistake? These questions can help us move beyond the surface of anxiety and begin to understand the patterns underneath it.

You don't have to wait until you stop functioning

People sometimes seek therapy only when their usual ways of coping stop working. Perhaps you are sleeping poorly, becoming increasingly irritable, withdrawing from people, struggling to concentrate or finding that things that once felt manageable now feel overwhelming. You may still be going to work and doing what is expected of you. But internally, you may feel as though you are running on empty. You do not have to wait until you are no longer functioning before taking your emotional wellbeing seriously. Therapy can provide a space to slow down and understand what is happening beneath the pressure to keep everything together.

Rather than simply asking, “How can I cope better?”, it can sometimes be important to ask, “Why do I feel that I have to cope this way in the first place?”

Understanding these patterns can create the possibility of doing things differently, with less pressure, less self-criticism and more room to recognise your own needs. If you recognise yourself in this, you don't have to look like you are struggling for your experience to matter.