This Is How to Know If You Have High-Functioning Anxiety

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Those people who push themselves to be more organized, more detail-oriented, more proactive and achieve more? They may look together on the outside. But if they also feel anxious on the inside—yet anxiety doesn’t stop them from doing what they’re doing—they may be experiencing high-functioning anxiety.

According to Gauri Khurana, MD, a clinical instructor of psychiatry at Yale University School of Medicine and a psychiatrist in the New York City area, people with high-functioning anxiety are able to accomplish tasks and manage themselves well in various personal, social and professional situations, but will internally feel the same symptoms as those with generalized anxiety disorder. Those include impending feelings of doom, anxiety, increased heart rate, headaches and stomach upset.

“Since they are able to manage their day-to-day needs, patients with high-functioning anxiety do not meet criteria to be formally diagnosed with an anxiety disorder,” Dr. Khurana explains. “Patients that are diagnosed with generalized anxiety experience impairment in being able to take care of themselves, [such as by being] so anxious that they cannot turn their minds off at night, end up not sleeping enough and not being able to complete their tasks during the day.”

How do you know if you have high-functioning anxiety?

According to Dr. Khurana, some more obvious signs of high-functioning anxiety include feeling as though you can’t stop worrying internally, constantly imagining the worst outcome, constantly being in a state of dread, experiencing panic attacks regularly (but silently), and seeming like you have superpowers in terms of getting everything done.

“Internally, your mind and anxiety do not give you a moment’s peace; there is always something to worry about,” she says. “When you leave work for the day, [you] often go home and are exhausted, and despite being tired, [you] cannot sleep because [you] are still worrying.”

How are symptoms different from traditional anxiety?

For any psychiatric disorder, symptoms and severity exist on a spectrum, Dr. Khurana says.

“[For example,] everyone experiences difficulty concentrating at times — it could be because we didn’t sleep the night before, we are sick, we may be stressed/distracted by something else,” she explains. “[People with anxiety] cannot concentrate on the task at hand (or almost any task) because they are preoccupied by worrying about other things that are often unrelated to the task, such as, ‘how will I leave the building if there is an earthquake?’”

In these situations, people with traditional anxiety can’t redirect their thoughts no matter how hard they try to refocus, and their mental symptoms may spill over into physical symptoms such as shaking hands, hyperactivity, jaw clenching, and panic attacks, Dr. Khurana says.

When should you see a mental health professional?

If you’re experiencing any type of anxiety symptoms, Dr. Khurana recommends starting with talking with a mental health professional about it to approach it head-on.

“Sometimes just acknowledging that you are putting an unreasonable amount of pressure on yourself is helpful in managing your life so you don’t constantly feel overwhelmed,” she says. “Often, strategies to manage physical and mental symptoms can help, [such as] evaluating family patterns of stress, as well reevaluating your goals and lifestyle.”

If a few months of therapy do not feel like they are helping sufficiently—in other words, that you are still experiencing significant feelings of dread and panic for most of the day—then Dr. Khurana recommends discussing antidepressants for your anxiety; you may also need to seek care from a psychiatrist or a general practice physician who can prescribe them.

“Anxiety is a biological condition and it should be treated no differently than a broken leg—both would require medication and lifestyle accommodations to help you be your healthiest self,” she says.

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