5 Things I Wish You Knew About My High-Functioning Anxiety

To others, I may seem as though I’m totally “normal.” I have a thriving career, loving marriage, and friends and family I can count on. On the outside, my life appears to be well put together. But hidden within that perfect picture are the bags under my eyes from lack of sleep. And behind my smile are teeth whittled down to the nerve from the daily grind—unknowingly working overtime.

That’s because not all anxiety disorders look the same. Some can manifest in more physical ways (think panic attacks, sweating, or tightness in your chest), but sometimes the symptoms are less recognizable. People living with high-functioning anxiety can excel at different areas of their lives and appear to be OK on the surface. But deep down inside exists a different reality.

“Perfectionism, busyness and productiveness are all positive attributes of people with high-functioning anxiety—that’s why society glorifies the benefits,” explains Nicole Lippman-Barile, PhD, a clinical psychologist and certified nutritional therapist consultant with Northwell Health Physician Partners Cognitive Behavioral Therapy Program in Glen Oaks, New York. “But underneath, they are potentially suffering quietly in their worries and fears.”

Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults age 18 and older. But as real as high-functioning anxiety is, it’s not an official clinical diagnosis—mostly because the “functional” aspect is subjective, and it’s not entirely chronic or disabling. But just like any other anxiety disorder, it can have a negative impact on one's physical health, emotional well-being, and interpersonal relationships. And the good news is that it’s highly treatable with cognitive behavior therapy, healthy lifestyle changes, and medication management, if needed.

To bring more attention to this important issue, here are 5 things I wish people knew about my anxiety:

People with anxiety tend to be more sensitive to their environment. I know this because I live it every day. I feel things more deeply so I internalize my emotions a lot. I also worry about things that most people might not think are a big deal—like being thrown off my routine, because having structure provides a sense of comfort and control. With anxiety, it’s often a struggle to enjoy the moment because I always expect the worst, even when there’s no apparent cause for concern.

“One of the emotional staples of high-functioning anxiety is catastrophic thinking,” explains Lippman-Barile. “That includes overestimating the probability that something bad is going to happen and underestimating your ability to actually manage those things.”

I could say, “Give me a minute to collect my thoughts,” but I’d fall right down the rabbit hole. My thoughts have a mind of their own. They think and I follow, pushing and pulling me relentlessly in every direction. Often, I find myself overanalyzing discussions, second-guessing decisions, stuttering to find peace—to find closure.

That’s because with anxiety comes mental preoccupation. It’s the unwanted space invader in your brain. A conscious prison you can only be released from when the coast (your mind) is clear. And it could be what prevents you from staying focused, connecting with others, or being able to express yourself clearly.

Perhaps one of the most frustrating aspects of living with high-functioning anxiety is the misconception that comes with it. Your feelings sometimes get dismissed, since you seem fine and you’re excelling. So they’ll say, “Calm down. Don’t stress it. Just let it go.” But the truth is that every day I’m working on improving my mind, body, and soul, and channeling my anxious energy in positive ways that work for me—whether it’s through creative writing, physical exercise, or pushing myself out of my comfort zone.

Having anxiety means constantly managing motions and emotions that can be productive or self-destructive. It’s exhausting at times, but awareness is key. “We’re more in control than we think we are,” says Lippman-Barile. “Observing your thoughts, modifying behaviors, and making healthy choices can go a long way.”

Another way anxiety can appear is through negative self-talk—you know, that little voice inside your head that tells you you’re not good enough. That’s why I often don’t know what to do with a compliment. It makes me skeptical. And the reluctance builds self-doubt, even though I know I’m completely worthy and capable.

On the flip side, when it comes to negative feedback, I usually believe everything I hear. I absorb it like a sponge without hesitation. Because anxiety has a way of turning your own opinions about yourself inside out and upside down. It’s like a fun house—but it’s not fun at all.

I don’t speak much. I’m shy and introverted. For the most part, I keep to myself. But it’s not for lack of trying. For instance, when I find myself standing in a room filled with people, simply saying “Hello” takes every ounce of energy I have. Because my anxiety holds me back—from putting myself out there and letting people see the outgoing, vibrant person I know I am.

I’m actually a person with a lot to say, but it can be hard to get there. So if you find me hiding under my tongue, come say “Hello” first. It just might make all the difference.

Living with high-functioning anxiety or any anxiety disorder can be difficult, but it can be managed. Speak with a mental health professional if your anxiety becomes too much. And remember, if you are feeling this way, please know you are not alone—there are people and resources that can help.

• Learn more about anxiety disorders.
• Is therapy the key to better living? Find out.
• Make an appointment with Dr. Nicole Lippman-Barile, psychologist.