Getting Help For Your High-Functioning Anxiety
Imagine living in the vibrant city of New York, where the pace is fast and expectations are high. For many New Yorkers, high-functioning anxiety is a silent companion that fuels their drive but also secretly drains their energy. This condition is like wearing a mask of confidence and productivity while hiding a whirlwind of worry and fear beneath. On the surface, individuals with high-functioning anxiety appear as overachievers—organized, punctual, and detail-oriented—but beneath this façade, they often grapple with relentless thoughts, perfectionism, and an intense need for control. Despite their outward success, they may feel like they're constantly walking on thin ice, always on edge and ready to respond to the next challenge. High-functioning anxiety can be both a motivator and a burden, pushing individuals to excel but also leaving them exhausted and longing for a sense of peace amidst the city's relentless hustle. If you're one of these high achievers struggling to find calm in the chaos, therapy can offer a safe space to explore these feelings and develop healthier coping strategies.
You are a successful marketing executive in New York City, known for your sharp insights and ability to meet tight deadlines. On the surface, you appear confident and composed, always ready to tackle the next big campaign. However, beneath this façade, you're constantly plagued by worries about potential mistakes, from misinterpreting market trends to missing crucial details in presentations. Every minor setback sends your mind racing with worst-case scenarios, and you find yourself overthinking every decision, from the color palette to the target audience. Despite your outward success, you feel like you're constantly "performing," pretending that everything is under control while secretly fearing that one mistake could lead to catastrophe. You work long hours, often skipping breaks and neglecting self-care, driven by a relentless fear of failure. Your colleagues praise your accomplishments, but you can't shake the feeling of inadequacy, always wondering if you're truly good enough. This is what high-functioning anxiety feels like—a constant, exhausting battle to maintain a perfect exterior while struggling with intense internal anxiety. It's a silent companion that fuels your drive but also drains your energy, making it difficult to truly relax and enjoy your successes.
“Giving up my anxiety will negatively impact my success.” Is this what you tell yourself?
Like most New Yorkers, your days are busy with work, and family and trying to find a way to manage and balance it all. With all that striving and the many tasks to complete, who has time to think about stress reduction or connecting with a therapist to help you manage your anxiety and mood symptoms? You may even wonder who you’d be without your drive—and your anxiety! Take away the anxiety and you’d potentially lose your edge.
You may not even consider your striving to be an anxiety response. As a therapist, we see this a lot. You haven’t crashed yet, and we would like to help you have an even better quality of life. If you haven’t yet crashed, how can you tell if your level of stress and anxiety is normal? Skillful therapy can help you recognize how your stress, anxiety and unconscious beliefs are behind your super-charged drive. If you spend any time on Instagram, you’ve likely heard of high-functioning depression, as well as high-functioning anxiety. They are unofficial terms not yet recognized by the DSM-5 (Diagnostic and Statistical Manual of Mental Disorder), yet important to recognize and treat because these signs and symptoms can negatively affect mental health and well-being. High-functioning anxiety essentially describes a chronic level of anxiety that might not necessarily meet the criteria for diagnosis of an anxiety disorder but is problematic impacting your health nonetheless.
How does high-functioning anxiety show up in your life?
Overachievers
Overscheduled
Perfectionists
Highly organized
Detail oriented
Overthinkers
Chronic worrying
Racing thoughts
Obsessive checkers
Concerns about disappointing others
Chronic headache, body pain, and tension
Jaw pain, facial tension
Unable to relax
Unable to socialize
Impossible standards for self
Impossible standards for others
Difficulty sleeping
Strained relationships
Increased alcohol and substance abuse
High-functioning anxiety differs from regular anxiety in how individuals cope with and present their symptoms. While those with generalized anxiety disorder (GAD) often exhibit overt signs of worry and fear, such as withdrawal or noticeable physical symptoms, individuals with high-functioning anxiety mask their anxiety behind a façade of productivity and control. They appear organized and successful, using their anxiety as a motivator to excel in work and personal life. However, beneath this surface, they internally struggle with intense anxiety, perfectionism, and a need for control. Unlike GAD, where symptoms are often visible and recognized by others, high-functioning anxiety can lead to feelings of isolation and loneliness as individuals hide their true emotional state. Despite maintaining high levels of productivity, they face constant stress and potential burnout, making it crucial to recognize and address these hidden struggles.
High-functioning anxiety differs from regular anxiety, such as generalized anxiety disorder (GAD), primarily in how individuals respond to and manage their anxiety symptoms. Here's a breakdown of these differences:
Coping Mechanisms
Generalized Anxiety Disorder (GAD): People with GAD often exhibit more overt symptoms like excessive worry, fear, or avoidance behaviors. They might withdraw from situations that trigger anxiety or experience noticeable physical symptoms like rapid heartbeat, sweating, and trembling.
High-Functioning Anxiety: Individuals with high-functioning anxiety, on the other hand, tend to mask their symptoms by adopting a "fight" response. They appear organized, productive, and in control, often using their anxiety as a motivator to excel in work and personal life. Despite their outward success, they internally struggle with intense anxiety, perfectionism, and a need for control.
External Appearance vs. Internal Experience
GAD: The anxiety symptoms are often visible to others, leading to recognition and support from family and friends. People with GAD may struggle with daily tasks due to their anxiety.
High-Functioning Anxiety: Despite experiencing similar anxiety symptoms, individuals with high-functioning anxiety appear calm and composed externally. They are adept at hiding their internal turmoil, which can lead to feelings of isolation and loneliness as they avoid showing vulnerability.
Impact on Daily Functioning
GAD: Anxiety can significantly impair daily functioning, making it difficult to complete tasks or engage in social activities.
High-Functioning Anxiety: Despite the intense internal anxiety, these individuals manage to maintain high levels of productivity and social engagement. However, this comes at the cost of constant stress and potential burnout.
In summary, while both types of anxiety involve similar symptoms, the key difference lies in how individuals cope with and present their anxiety to the world. High-functioning anxiety is characterized by a more covert expression of symptoms, where individuals appear successful and in control but secretly struggle with anxiety.
Seeking Treatment For High-Functioning Anxiety
You may possess the self-awareness to recognize that you have many of the above symptoms. Your ways have served you well, and yet some part of you knows that it’s just not sustainable. It will catch up to you, and you’ve probably heard that stress is a killer. It’s a good thing to know that you can identify and begin tracking the connection between your stress and symptoms. It’s not too late to find balance and even work with a skilled anxiety therapist before you go on to develop a diagnosable anxiety or depression condition. Your high stress and anxiety can easily develop into a generalized anxiety disorder, major depressive disorder, social anxiety, agoraphobia, phobias, and obsessive-compulsive disorder.
How does high-functioning anxiety Impact on Your Physical Health?
Left unchecked, high-functioning anxiety can have deleterious consequences for your physical health. If you know anything about Polyvagal Theory, you know that we humans are biologically programmed to have a physiological response to a perceived threat such as a tiger in the wild. We have a spontaneous release of adrenalin and cortisol, our heart rate increases, are muscles are primed to run. When this response is activated, the body remains in threat response mode until the threat is resolved. Life on the daily in New York City with your morning commute and people on their phones multitasking can leave your body and nervous system in a perpetual stress response. Your body is not meant to live in such an elevated state all the time.
How can I course correct before it’s too late?
As stated earlier, begin to notice and observe yourself. If you find yourself feeling despair or overwhelmed, this may be a sign to give yourself permission to slow down or find a professional to help you. Sometimes others see unhealthy behaviors and responses. Instead of meeting the concerns of others defensively, be open to taking their concern seriously. Let others help you scale back a bit if this is an option. When stressed, many find that important relationships are impacted as well as an increase in alcohol use and substance abuse. In short, high-functioning anxiety stresses your work and your personal life.
It seems like it’s an all or nothing thing living in New York City, how can i find balance?
You may believe that anxiety is a good thing and that some degree of anxiety is helpful. Many believe that their high anxiety serves them, and it does to some extent until it doesn’t. If you’re living on wine and Xanax, you aren’t thriving. Not suggesting a move to the country and giving up your wine completely. You may learn that if you begin to make some small changes, you can maintain your edge and still be productive and successful.
What therapy options exist for high-functioning anxiety?
In my Manhattan psychotherapy private practice, I see plenty of highly anxious, high-achievers. I’m always delighted to help people find balance and perspective. There are many ways to achieve this and for some, medication is helpful. For others, a combination of interventions including, psychodynamic psychotherapy, cognitive behavior therapy (CBT), EMDR Therapy and IFS therapy.
About Holistic Psychotherapy & Wellness Manhattan
Kimberly Seelbrede, LCSW is a New York State licensed Psychotherapist, EMDR Practitioner and Couple Therapist with a private practice in New York City, Montana and virtually. As a wellness psychotherapist and holistic consultant, she has received advanced, extensive training in Trauma Therapy, Psychoanalytic Psychotherapy, Internal Family Systems (IFS), Eye Movement Desensitization Reprocessing (EMDR), Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), Somatic Experiencing (SE), and Nutrition & Integrative Medicine For Mental Health. She is passionate about honoring the exquisite interplay of the mind-body connection. Kimberly Seelbrede specializes in anxiety & mood disorders, trauma and women’s mental health. She brings over 20 years of counseling, coaching, and healing experience to her holistic practice and transformational work.
In addition to online therapy for anxiety, depression, trauma and relationship struggles, Holistic Psychotherapy & Wellness offers a wide variety of online services to fit the needs of busy professionals. New Yorkers often lead fast-paced and complex lives, which makes work-life balance and managing career, family and social obligations a challenge. Psychotherapy and wellness practices provide the support to help clients cultivate resources, resilience and enhanced emotional health, as well as uncover conflicts and obstacles that may interfere with having the life they desire.
Curated Lifestyle Interventions Protocols
Women’s Mental Health Perimenopause & Menopause