What Does It Mean To Have “High-Functioning” Anxiety?

Photographed by Ashley Armitage.
Anxiety can manifest in a number of ways. Whether it's constant, draining panic attacks or bouts of stress and mood changes, many people consider themselves high-functioning because they feel as if they have a lid on their anxiety, and that it's not a huge problem for them.
It's not an official clinical diagnosis, but Kati Morton, LMFT, says that plenty of people may self-identify as having high-functioning anxiety, because they have symptoms of anxiety but feel that it doesn't interfere with their day-to-day life.
"Many people will struggle without being completely debilitated, so they don’t meet the criteria for an anxiety disorder, whether that’s generalised anxiety disorder or a panic disorder," she says.
For someone to be diagnosed with an anxiety disorder, Morton says they need to have exhibited at least three symptoms of anxiety over the course of six months, including trouble sleeping, restlessness, and difficulty controlling worry.
People who identify as having high-functioning anxiety may have only a few symptoms of anxiety, and may even experience panic attacks, but "they’re still able to get up and go to work, either through sheer force or [because] the symptoms are not as intense," Morton says. "Then that would be high-functioning anxiety."
But, just because high-functioning anxiety isn't listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM), which doctors use diagnose mental health disorders, doesn't mean that it isn't something people can experience. After all, an estimated 40 million adults in the US experience anxiety, and it's reasonable to say that many of them experience it in different ways. In the UK more than 1 in 10 people are likely to have a ‘disabling anxiety disorder’ at some stage in their life. However, part of why "high-functioning anxiety" isn't an official diagnosis is because being functional can mean a lot of different things to different people.
"Everyone’s resiliency is different and that’s not something we can put on a scale, and that’s why it’s hard to define exactly what high-functioning means," Morton says. "Because each individual person is going to be different, and that’s why the DSM isn't the be-all, end-all."

Even if you’re functioning, that doesn’t mean that you’re not suffering.

Kati Morton, LMFT
But, even though you might think you can function well in the present moment, your anxiety may still affect you in the long run. Dismissing those symptoms, Morton says, could make them more difficult to deal with later on.
"I think sometimes we need to dig a little deeper to understand how much the anxiety is affecting us in our lives and our ability to function overall," she says.
One question she likes to ask her patients is, "When was the last time you felt really good?" As in, when was the last time you were happy, felt like things were going your way, and you slept a full night? And how does that compare to now?
"If we’re [anxious but] still able to get up and go to work or school, we can lose sight of how we could feel," Morton says. "It becomes our new norm, and when it comes to anxiety, it can creep up, like maybe you had a few sleepless nights, or had to go splash your face with water before that big meeting."
If you've been experiencing some symptoms of anxiety that have been ongoing for more than a week, Morton says it's best to ask a doctor for help, even if you think you're high-functioning.
"Get help sooner rather than later," she says. "Even if you’re functioning, that doesn’t mean that you’re not suffering."
If you are experiencing anxiety and are in need of crisis support, please call Anxiety UK on 0333 212 5820.
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