Coping with High Functioning Anxiety Characteristics

Medically Reviewed By Karin Gepp, PsyD
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If you have high functioning anxiety, you may function well on the outside while internally you feel intense anxiety that others may not detect. High functioning anxiety is not a medical diagnosis, but it can still be serious for anybody who experiences it. Anxiety affects around 40 million adults in the United States. The more prevalent anxiety disorders include social anxiety and panic disorder, which affect around 7% and 3% of people respectively. However, as high functioning anxiety is not a recognized medical disorder, it is not possible to detect how many people it affects.

If you experience high functioning anxiety, you may perform well at school or at work, and you may enjoy social activities. However, internally you may feel strong symptoms of anxiety, such as intense fear and a sense that everything is spiraling out of control. You may also experience physical symptoms of anxiety, such as a rapid heart rate.

Read on to find out more about high functioning anxiety. This guide also includes information about how to cope with anxiety.

Quick Facts About Anxiety

  • Around 40 million adults in the U.S. have an anxiety disorder.
  • Types of anxiety disorders include phobias, separation anxiety, social anxiety, and generalized anxiety disorder.
  • Symptoms of anxiety can include sweating, fidgeting, irritability, feeling dizzy, and more.
  • Treatments for anxiety include talk therapies and prescribed medication.

What is a high functioning mental health condition?

A person is creating artwork.
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High functioning mental health conditions are difficult to detect on the outside. With high functioning anxiety, you may function well in your daily activities, but internally you may experience intense feelings of anxiety and dread.

Having high functioning anxiety may actually make you perform better in your regular activities, as they provide a distraction from the internalized anxiety.

High functioning anxiety and depression

High functioning anxiety may exist alongside depression. This depression may be noticeable, as internalized anxiety can lead to low moods.

You may also experience high functioning depression. Outwardly, you may not show any signs of depression, but inwardly you can experience very low moods, low self-esteem, and feelings of hopelessness that others may not be able to detect.

What are the characteristics of high functioning anxiety?

Unlike most medical anxiety disorders, it is possible to divide characteristics of high functioning anxiety into two categories: positive characteristics and negative characteristics.

Positive characteristics

Positive characteristics of high functioning anxiety refer to your ability to perform well in your daily routine. Some people may find that focusing on their work or other activities can help to distract from internalized anxiety, and this in turn can make you a high achiever.

Positive characteristics are typically external and can be noticed by other people. They can include:

  • getting good grades at school
  • achieving good results at work
  • being punctual
  • being well-organized
  • being outgoing and trying new things
  • having a proactive approach
  • showing a willingness to help others
  • being detail-oriented

Negative characteristics

Negative characteristics tend to refer to the internal aspects of high functioning anxiety.

Negative characteristics can include:

  • frequently thinking about “what ifs,” which might involve worst-case scenarios
  • worrying constantly about the future
  • having periods of procrastination followed by periods of intense work
  • comparing yourself to other people constantly
  • being unable to relax or enjoy things in the moment
  • experiencing racing thoughts
  • having feelings of intimidation

You may also experience physical symptoms such as:

You may become very good at hiding these thoughts and feelings from other people.

Learn more about the symptoms of anxiety.

Tips for coping with high functioning anxiety

While you may be able to cope with negative feelings by keeping busy, you may also benefit from practicing different techniques to help you stop rising feelings of anxiety whenever they occur.

These coping mechanisms for anxiety can be particularly useful if you are in situations in which you are not able to distract yourself, such as when you are on your own or trying to sleep.

Concentrate on your breathing

Whenever you feel anxious, concentrate on your breathing. This is a distraction technique you can access wherever you are, and doing breathing exercises can also help you to feel more in control. Take deep breaths, and breathe in and out slowly.

Schedule time for worrying

It may seem counterproductive to actually plan to worry, but if you allow yourself the time you need to think about situations that make you anxious, your thoughts may relax a little more in the meantime. It can help to write down your worries in a notebook so you can reassure yourself that you will come back to them later.

Speak to somebody

If you speak to somebody close to you, such as a friend or family member who you trust, it can help to unburden you from some of the anxiety. It is also important to let somebody know how you feel, as they are unlikely to detect that you are experiencing high functioning anxiety.

Focus on positive outcomes

If you are feeling anxious because of a specific situation, try to replace imagining “what if” scenarios with more positive outcomes.

For example, if you are nervous about an upcoming test, instead of wondering what might happen if you do not do well on the test, focus instead on how hard you have worked, how much you have learned and grown as an individual, and how you might reward yourself for your efforts.

Keep active

Physical exercise can help relieve stress and improve your overall mental well-being. It can help decrease muscle tension, increase antianxiety chemicals in the brain such as serotonin, and distract you from anxious thoughts.

Try complementary and alternative therapies

Some people find complementary and alternative therapies effective in relieving stress associated with anxiety. Examples include:

  • aromatherapy
  • herbal remedies
  • hypnotherapy
  • light therapy
  • massage therapy
  • meditation
  • reflexology
  • yoga

Practice the 5-4-3-2-1 grounding technique

The 5-4-3-2-1 grounding technique allows you to focus on your present surroundings while distracting you from your anxiety. Steady your breathing and follow the steps below:

  • Acknowledge five objects that you can see around you.
  • Acknowledge four things that you can reach from where you are.
  • Acknowledge three sounds that you are able to hear.
  • Acknowledge two things that you are able to smell.
  • Acknowledge one thing that you can taste.

Are there any medical treatments for high functioning anxiety?

While doctors do not recognize high functioning anxiety as a medical diagnosis, you may still wish to contact your doctor to discuss any symptoms of anxiety that you are experiencing.

Your doctor may refer you for talk therapy, and you can also refer yourself. Talk therapies such as cognitive behavioral therapy can help you cope with negative thoughts and feelings.

In some cases, your doctor also may prescribe medication to help to alleviate some of your internalized negative thoughts and feelings. This can include antianxiety medications such as benzodiazepines and beta-blockers to slow down your heart rate.

What can trigger high functioning anxiety?

High functioning anxiety triggers differ from person to person. You may find that your anxiety is worse in specific situations or when you think about certain things, such as schoolwork or your job performance.

However, similar to generalized anxiety disorder (GAD), you may worry about a number of things at any one time, such as money, health, and family. Sometimes, you may become anxious just at the thought of getting through the day.

What other types of anxiety exist?

Around 18.1% of adults in the U.S. have an anxiety disorder. This is around 40 million people.

Medical professionals do not recognize high functioning anxiety as a diagnosis. However, you may wish to contact your doctor to discuss your anxiety. They will be able to determine whether you are also experiencing symptoms of an anxiety disorder.

Types of anxiety disorders include:

Around 19 million adults in the U.S. have a phobia, while 15 million adults experience social anxiety disorder.

Children can experience anxiety. Around 25.1% of children between the ages of 13 and 19 are diagnosed with an anxiety disorder.

View our Anxiety Disorders hub for more information.


High functioning anxiety refers to anxiety that you internalize. On the outside, you may display positive characteristics of performing well and being outgoing, while on the inside you feel negative characteristics, including constant worry, racing thoughts, and feeling hopeless.

Doctors do not recognize high functioning anxiety as a medical diagnosis. However, it can still seriously affect your mood, and it may even trigger depression if you are unable to manage it. Coping mechanisms can help you keep on top of your negative thoughts. These include breathing exercises, focusing on positive outcomes, and keeping active.

Contact your doctor if you experience high functioning anxiety and would like to discuss the possibility of therapy or medication to help ease your symptoms.

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Medical Reviewer: Karin Gepp, PsyD
Last Review Date: 2022 Apr 20
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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