Recognizing The Signs Of High Functioning Anxiety

The Happier Approach Podcast Episode 107

Signs of High Functioning Anxiety

In our podcast this week I talk about how to spot high functioning anxiety symptoms and some ways to address them that may benefit you and your mental health. As a mental health coach, I have talked openly about my own experience with high functioning anxiety and how I came to understand it.

Even as an anxiety coach, I still find myself wrestling with the signs of high anxiety and how to navigate my way through it. That’s why in this podcast I break down everything you need to know the signs and symptoms of high functioning anxiety and how it plays a role in our everyday lives. While similar, high functioning anxiety isn’t the same as classic anxiety so let’s explore it a bit more by looking at the symptoms that can help you define your anxieties.

Top High Functioning Anxiety Symptom: Outward Perfection, Inward Anxiety

On the outside, you appear to be the most “with it” woman anyone is ever going to meet–calm, cool, and collected. But on the inside, you are an over-analyzing storm of self-doubt, stress, and anxiety. 

Those of us with high functioning anxiety have developed coping skills and have become so good at hiding our anxiety, even our friends and family would never guess what lay under the surface. 

But these coping skills have left us feeling overwhelmed, exhausted, and still full of anxiety. And what makes it worse, everyone around us sees us as being able to handle anything and just keeps piling on more and more. 

The 10 Symptoms of High Functioning Anxiety

The truth is, high functioning anxiety is more than just feeling anxious. Which means that coping with it can seem like a challenge. The truth is it starts with recognizing when your high functioning anxiety is running the show. 

Once we start learning to recognize the signs of high functioning anxiety and developing the coping skills to deal with our anxiety, we can start calming the storm and finding the ease that we are looking for

Symptoms of high functioning anxiety include:

  • Procrastination
  • Seeking constant reassurance, AKA Praise me, please!
  • Control freak
  • Busy busy busy
  • Lots of negative self-talk
  • Fear of letting people down
  • Lack of sleep
  • Numbing 
  • Physical symptoms
  • Everything is “fine!”

Do these sound familiar? If you’ve been living with mental health anxiety or HFA your whole life these feelings may not seem unusual to you. In fact, you may have defaulted to believing you need to push harder before you find some type of relief from your anxiety.

“Our HFA becomes a double edged sword. On one hand, we have anxiety, a very real condition of overthinking, over-analyzing and constantly doubting ourselves, which is totally exhausting. And then on the other hand, the coping mechanism of choice is pushing, doing, achieving, which causes us to feel totally exhausted.”

Tips On Coping With HFA 

So what should you actually do about it? Even as an anxiety specialist, I have to remind myself of these 

  • Be kind to yourself. Remind yourself that you are human and that this doesn’t mean that you are broken or flawed
  • Be curious about how you are feeling and make checking in with yourself a habit
  • Make the time throughout the day to regularly get out of your head and into your body
  • Sometimes I have to remind myself to stop and check in with my feelings of anxiety or worry and fear. Simply acknowledging my mental state and how I am feeling helps me cope. 

Sometimes I have to remind myself to stop and check in with my feelings of anxiety or worry and fear. Simply acknowledging my mental state and how I am feeling helps me cope. 

References & Resources:

Full Transcript

On the outside, you look totally on top of it. You’re a spouse daughter, sister, friend, employee, and volunteer. You can multitask like a boss and you appear, confident, driven, professional, successful, and responsible. Yet on the inside, you overanalyze every conversation and interaction you have. You believe there is a right way. And if you think hard enough, you’ll find it. You feel the need to over clarify everything out of fear you’ll be misunderstood and start a conflict. You worry about how other people feel even when it’s to your detriment. You constantly stress about what others think of you and you know one day they will find out you’re a fraud. You say you’re sorry for everything, and you’re way too over forgiving. You find yourself taking the blame for others to spare their feelings. And you hustle hard so no one will see this version of you. Those of us with high functioning anxiety live double lives. The outside version, capable, on top of it. And the inside version, stressed, worried, and over analyzing.

You’re listening to The Happier Approach, the show that pulls back the curtain on the need to succeed, hustle and achieve at the price of our inner peace and relationships. I’m your host, Nancy Jane Smith. All this month, we are talking specifically about high functioning anxiety and how to see it playing out in your everyday life. The challenge of high functioning anxiety is that from an early age, we learn the way to deal with our anxiety is to overachieve. The more we’re doing, the more people depend on us, the more praise we receive, the less anxiety we feel. Over time, this push for praise, accomplishment, and achieving becomes addicting. And we find ourselves doing more and more without the anxiety relief that it once brought us. Our HFA becomes a double edged sword. On one hand, we have anxiety, a very real condition of overthinking, over-analyzing and constantly doubting ourselves, which is totally exhausting. And then on the other hand, the coping mechanism of choice is pushing, doing, achieving, which causes us to feel totally exhausted.

The coping mechanism that used to help is now hurting us, but we feel we can’t stop it because it’s all we know. It starts with recognizing when your HFA is running the show. High functioning anxiety is so normalized if not rewarded in our culture. In this episode, we’re talking about the signs of HFA, because when we can recognize the signs, we can start developing new coping skills to deal with our anxiety. First, let me start by saying high functioning anxiety is not a diagnosable disorder. The usual symptoms of anxiety are present for those living with high functioning anxiety, including catastrophic thinking, excessive worry and irritability. As I shared at the beginning of the episode, people might experience racing thoughts, feeling restless, and an overwhelming sense that they’re never doing enough. But according to the DSM, people with anxiety have clinically significant distress or impairment in social, occupational, or other important areas of functioning. Meaning that their anxiety holds them back from doing things. They often want to hide out, avoid activities or say no frequently. But those of us with HFA, we have the opposite reaction to our anxiety.

We have the desire to achieve more as a way to manage our fears and doubts. So when others see us, they perceive us as an achievement-oriented perfectionist and highly motivated. We’re so good at hiding our anxiety, even our friends and family would never guess that our behaviors are because of our anxiety. HFA can be a very lonely place to be. You develop coping skills to deal with your anxiety, but those coping skills leave you feeling overwhelmed, exhausted, and still full of anxiety. And to make it worse, everyone around you sees you as high functioning and keeps piling on because they perceive you as being able to handle anything. So today, I want to talk about the 10 symptoms of high functioning anxiety so you can start to recognize them. The first one, my personal favorite, is procrastination. True confession, I’m a master procrastinator. In fact, I cleaned my whole office yesterday rather than write this podcast episode. Procrastination goes arm-in-arm with perfectionism, which is another big sign of high functioning anxiety.

We procrastinate because we’re so worried about making it perfect, which is what was so frustrating when I was trying to write this podcast episode. Because I love talking about high functioning anxiety, I love helping people with high functioning anxiety. I am passionate about helping people with this condition because it’s so debilitating. And I love doing my podcast, it’s one of the favorite parts of my job. And yet here I am procrastinating about something I really want to do. That procrastination is directly linked to my anxiety telling me it has to be perfect. Because I care so much about this topic and my podcast, I convince myself there’s no room for error. If I procrastinate until the last minute, then I can blame the imperfections on the deadline. “I ran out of time. That’s why it isn’t perfect.” Does that sound crazy or what? Faulty logic for sure, but those of us with HFA frequently play with faulty logic and try to gain the system to prevent our anxiety from rearing its ugly head. Number two, you seek constant reassurance, aka, “Praise me, please.”

People with high functioning anxiety love praise. Praise keeps the anxiety at bay. As anxiety and worry grow, we can lose sight of those thoughts being irrational and unrealistic. In order to try to calm those thoughts, we need constant reassurance from those around us. So we seek out praise. We do things that will earn us praise. We are the first to say, “Yes, of course. I can do that.” The more responsible we are, the more praise we get. And the more praise we get, the less we worry and doubt that we are okay, that our thoughts are irrational or unrealistic. At least, that’s what we tell ourselves. Again, back to that faulty logic. Number three, being a control freak. Being called a control freak is common for people with high functioning anxiety. By controlling the environment, the people and situations around us, we are controlling our anxiety. One of the ways that many people I know who have high functioning anxiety game the system and make their anxiety work for them is as party planners, they know how to host a party. Yip, that is totally counterintuitive.

Why would someone with a high need for perfection and a lot of self-doubt want to host a party? By hosting a party, they can control the situation, the people, the environment, the timing. Hosting can decrease some of the anxiety that comes with parties and it’s also one of those behaviors that masks our anxiety. Because we’re so good at hosting, no one would know we’re dealing with anxiety the whole night. And talk about a lot of praise, when we host a good party, we get lots and lots of praise. Number four, busy, busy, busy. The busier you are, the more you can avoid the anxious negative thoughts. My clients are some of the busiest people I know. This busy is more than having too much on your plate, this busy is a deep seeded need to keep pushing, keep doing. It is a sense of trying to outrun all your doubts and insecurities by pushing yourself as hard as possible and getting as much praise as possible. Ironically, people with high functioning anxiety frequently say to me, “I just want some time to relax. Some free time to do nothing.”

But when they get that time, inevitably their anxiety consumes them so they fill it up as quickly as possible with stuff. A great example of this is when you’re in the car alone and finally have a chance to relax, listen to your favorite music and chill. But people with high functioning anxiety fill this time with educational podcasts or news. And the estimated arrival time on the GPS becomes the time to beat. They turn it into a competition, challenging themselves to beat the GPS arrival time as if there will be a team of cheerleaders giving you praise when you arrived three minutes before your GPS says you will. Number five, you experience a lot of negative self-talk. Negative self-talk is at the root of high functioning anxiety. Everyone has a monger, that negative inner critic. But people with HFA have a cruel unrelenting manipulative monger. When I was doing my book tour for The Happier Approach, I realized that some people had an annoying voice that was critical at times. But those HFA have a voice that never stops.

Our monger is like wearing a straight jacket, keeping us stuck in black and white thinking and afraid to engage in our lives for fear of doing it wrong and being hammered. Many of the behaviors I describe, procrastination, busy, busy, busy, being a control freak, are all the ways we cope with our very loud mongers. Number six, one of your biggest fears is letting people down. The fear of disappointing someone, making a mistake, or worse, hurting someone without realizing it can be crippling for those with high functioning anxiety. The push towards overachieving comes from a need for appreciation and love. And we feel, or as that evil monger tells us, that appreciation and love only come if we earn it. So we are constantly vigilant about what other people think about us. Ever spent the evening obsessing when someone doesn’t reply to your text message, assuming it’s because they’re mad at you? Yip. That is high functioning anxiety rearing its ugly head. Number seven, lack of sleep, aka, rewinding, replaying and over-analyzing. People with HFA usually have insomnia.

Falling asleep isn’t a problem, but inevitably you’ll wake up at 3:00 AM spinning out about a recent conversation, your to-do list, or worrying about an upcoming project. People with HFA are master analyzers. They replay, rewind, and overanalyze just about everything. No matter how well a conversation went with somebody, you’ll always replay that conversation in your head fearing that you may have said something wrong. Replaying, rewinding over and over making sure you didn’t mess up. Because with HFA, we fear people finding out that we are full of doubt and insecurity. Number eight, numbing. People with high functioning anxiety are masters at numbing. Alcohol, food, shopping, social media, phone apps, TV, exercise, anything that will shut off our brains and bring us some quiet. Often, the only way we can do that is through numbing. This is another one of those symptoms that feels like it’s helping but in reality, it’s hurting us. Numbing actually makes our anxiety worse. When we overspend, overeat, over-drink. Or overindulge, it often causes a boomerang effect of more anxiety. Number nine, physical symptoms.

Another way that HFA is different from regular anxiety, rarely does someone with high functioning anxiety experience a full blown panic attack. They might feel overwhelmed, hyper stressed or anxious, but the pain and “feel like I’m going to die” sensations that comes for a panic attack, they don’t appear very frequently. But that doesn’t mean you don’t have physical symptoms. In addition to the lack of sleep, there is indigestion, high blood pressure, irritable bowel syndrome, headaches, and backaches. People with high functioning anxiety tend to think these symptoms are normal or just the price of doing business. But these are our body’s way of sending us signals that our anxiety is out of control and we need to make some changes. Recognizing these symptoms can be challenging because we live so much in our heads sometimes forgetting that we even have a body until it’s screaming at us so loudly that we end up with raging headaches or severe IBS. Number 10, “Fine. Fine. Everything’s fine.” People with high functioning anxiety tend to be very even keel, at least on the outside.

“Never let them see you sweat” is a mantra that you believe to the depth of your soul. They pride themselves on having it all together, being peoples go-to person, and always being able to say yes. Negative emotions, sadness, fear, doubt, anger, well, those feelings, they’re just not acceptable. So people with high functioning anxiety develop a tendency to not only ignore their bodies, but they also ignore their emotions. They concentrate so much on the outside world, keeping other people happy, earning praise, accomplishing and doing that they have no relationship with their internal world. They’ve stopped listening to themselves and they’ve lost any sense of loyalty to themselves. People with high functioning anxiety are some of the most loyal people you will ever meet. They will go to the ends of the earth for their loved ones and anyone on their inner circle, but often at the expense of their own health. Okay. So you’ve listened to all the symptoms and you’re like, “Yes, that’s totally me. Okay. So what do I do about it?” Here are some of my tips. When you notice any of these symptoms, be kind to yourself. Be kind to yourself.

Remind yourself you are human and anxiety is something you’re dealing with as a human. It doesn’t mean you’re weak or broken, it means you have a tendency to see the world through an anxious lens. That’s it. Be kind. Be curious. Randomly throughout the day, ask yourself, “How am I feeling right now?” I will include a feelings list in the show notes, but you don’t have to do anything with that feeling. Just start acknowledging that it exists, that’s what’s important. Notice you have a body. Again, randomly throughout the day, get into your body. Set reminders on your phone to do a full body stretch, or engage in the five senses meditation. Take a few minutes to go through each of your senses, “What am I feeling? Seeing? Hearing? Tasting? Smelling?” I love this meditation and I don’t really like meditations, but I love this one because you can do it with your eyes open just about anywhere. And it immediately brings you into your body. Also, when you’re in the bathroom, actually look in the mirror. So often we don’t really see ourselves in the mirror.

I will say silently to myself, “Hey there, sweet pea. How’s it going today?” That simple act of acknowledging my humanness is so healing. Simply noticing as I did yesterday, that my coping skill of procrastination isn’t helping the situation and lovingly encourage myself to buckle down and get to work helps decrease the effects of the anxiety. High functioning anxiety can be controlled. It involves noticing when you’re living from a place of anxiety and slowly bringing yourself back into your body. Yes, I know it’s completely counterintuitive to what your body is telling you to do. But trust me, it works. I love the holidays. Hands down, it’s my favorite time of year. My family has lots of traditions and I love every single one of them. But a few years ago I was feeling burnout. My high functioning anxiety kicked into high gear and I was tired of saying yes to everything. “Of course, I can bake five dozen cookies for the party.” People-pleasing, “Can I find the perfect gift?” And perfectionism, “We have to do it this way. It is how we have always done it.”

I wanted to do it differently, but I didn’t want the same old advice to take a bubble bath, meditate, or take a break. I wanted to find real strategies for building more connections, having more peace and soaking up everything I loved about the holidays. So I started Live Happier Through the Holidays, a daily note delivered to your inbox each day of the holiday season. Here’s how it works. Each morning from the Wednesday before Thanksgiving, November 21st, through Christmas, you will receive a note from me in your inbox. Think of it as a daily message from your biggest fan, my gift to you. 30 days of wisdom and grace delivered to your inbox so we can remember why we love the holidays so much. You don’t have to white-knuckle your way through the holiday season, we can do this with more grace and calm. Join me, just visit\holidays to sign up.

Like the show? I would love for you to subscribe on your favorite podcast player and then head over to Apple podcasts and leave a review. And do you know someone who struggles with high functioning anxiety? Tell them to listen as well. I am so excited to share with you The Happier Approach. So to find out more, visit me at