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  • Writer's pictureKatarina Ament, PsyD, MS

Living with High Functioning Anxiety: What Is It & How Do You Cope?

It's Monday morning and your alarm goes off. You hit snooze once, twice, ok three times. By the time you get up, shower, and grab a coffee, you're already feeling behind. No problem, you think, I'll just skip breakfast and eat at my desk. At work, your inbox is overflowing with unread emails and your calendar is jam-packed with back-to-back meetings. But you stay focused, plowing through your tasks one by one. Before you know it, it's 6pm and you've barely come up for air all day. Sound familiar? If so, you may be dealing with high functioning anxiety.

Life is busy! And while it's normal to feel a little anxious from time to time, frequent feelings of overwhelm, constant worry, and lack of work-life balance may indicate a more chronic issue. If you’re reading this and thinking, “Uh oh, that’s me.” You’re not alone. Anxiety is the most common mental health concern in the US, and it’s estimated that about 1 in 3 people experience significant anxiety at some point in their lives. And to be quite honest, I struggle with high functioning anxiety myself.

These are the people who feel stressed or overwhelmed on the inside while keeping up with activities and appearing okay on the outside, business as usual. You might tell yourself, “Sure I’m stressed, but at least I’m not falling behind at work like Bill,” or “Things have been hectic, but I still manage to keep a clean house and cook my family dinner.” Sometimes these are mental gymnastics we make to convince ourselves we’re okay. And trust me, I’ve done it too. But just because you’re managing and everything looks okay on the surface doesn’t mean it isn’t a struggle.

Today, we’re going to talk about what high functioning anxiety is, some common characteristics, how high functioning anxiety impacts daily life, and last but not least, tips to help you manage stress and anxiety and lead a happier, more balanced life.

What is High Functioning Anxiety?

High functioning anxiety, sometimes abbreviated as HFA, is a form of anxiety that allows you to be outwardly productive despite feeling overwhelmed internally. Unlike generalized anxiety disorder, which may make it difficult to complete daily tasks, people with high functioning anxiety are often able to power through their anxiety and maintain a relatively normal routine. They go to work, care for their families, and fulfill other responsibilities. However, they're operating in an almost constant state of stress, worry, and racing thoughts.

How does High Functioning Anxiety Differ From Other Types of Anxiety?

High functioning anxiety may feel similar to other types of anxiety internally, but it manifests a little differently.

  • Productivity is maintained. People with HFA don't experience significant disruptions in their ability to work, parent, or manage a household in the way those with generalized anxiety may experience.

  • It's often overlooked. Because people with HFA seem to be coping well on the outside, their anxiety often goes unrecognized, even by themselves. Friends and family may not detect any issues.

  • Symptoms are kept private. People with HFA rarely open up about their inner turmoil. They may fear being viewed as weak or incompetent.

  • There's heightened nervous system arousal. People with HFA experience many physical symptoms of anxiety like muscle tension, headaches, insomnia, irritability, and fatigue.

  • Perfectionism is common. People with HFA often identify as perfectionists or overachievers and put excessive pressure on themselves to meet extremely high standards.

Signs of High Functioning Anxiety

So what does high functioning anxiety actually feel like? Some common signs include:

  • Racing thoughts and constant worry. You play out worst case scenarios and struggle to quiet your mind.

  • Irritability. Small frustrations feel like big ones. You may find yourself snapping at loved ones over minor issues and later thinking, “Where did that come from?”

  • Trouble relaxing. You feel guilty about downtime and have difficulty calming anxiety outside of work.

  • Difficulty concentrating. You become distracted by worries and struggle to stay focused.

  • Sleep disturbances. Anxiety and rumination make it hard to fall or stay asleep.

  • Physical symptoms. You have one or more physical manifestations like headaches, nausea, or muscle tension.

  • Feeling overwhelmed. Everyday challenges like having a long to-do list, dealing with computer issues, or getting stuck in a traffic jam spur intense feelings of stress.

  • Seeking control. You micromanage situations and double check things to try to manage the anxiety.

  • Trouble delegating. You take on too much and struggle to ask others for help.

How does High Functioning Anxiety Impact Daily Life?

HFA takes a toll in both obvious and subtle ways:

  • Relationships may suffer. Because people with HFA are in a constant state of stress, they may come across as impatient, critical, withdrawn, or communicate less effectively than they normally would, which can strain connections with partners, friends, and family.

  • Physical health declines. The cumulative effects of anxiety, stress, and lack of self-care may lead to weight changes, gastrointestinal issues, and frequent illnesses.

  • Mental health worsens. Constant anxiety and worry is a mental health concern in itself, but it can also contribute to sadness, loneliness, reduced self-worth, and depression.

  • Job performance drops. Lack of focus, perfectionism, and constant busyness start to result in mistakes, reduced efficiency, and weaker output, which may not always be apparent to coworkers or employers, but will probably be felt internally.

  • Work-life balance is a struggle. Anxiety may drive you to work long hours and prevent you from relaxing and enjoying non-work hours.

  • Burnout looms. Pushing yourself to the limit day after day leaves you emotionally drained and at risk of burnout.

Managing High Functioning Anxiety

With self-care and balance, you can find relief. Here are some self-care tips:

  • Open up. Many people have experienced some form of anxiety at one point or another. Consider confiding in trusted friends and family or joining a support group. You don’t have to go through it and figure things out on your own.

  • Scale back. Drop unnecessary obligations and learn to say "no." You don’t actually have to do it all and cutting back will allow you to be more present for the things you care about most.

  • Quiet your mind. We all need to take mental breaks. Try out things like meditation, deep breathing, yoga, or mindfulness. If you’re new to this, check out mindfulness apps, YouTube, or join a class.

  • Exercise. As much as we may not like to admit it, there’s definitely a mind-body connection. Physical health improves mental health and vice versa. Take time to invest in yourself and move your body. Exercise is proven to reduce stress hormones like cortisol and release mood boosting endorphins.

  • Improve sleep habits. It’s hard to function well on reduced sleep. Shoot for around 8 hours a night. Take time to wind down before bed, limit electronics, and stick to a schedule.

  • Eat nutritious meals. Again, physical health improves mental health. Check in to see if your body is getting the nutrients it needs. And try to minimize things like caffeine, sugar, and processed foods that can exacerbate anxiety.

  • Laugh it off. Laughter really is one of the best medicines. Studies show laughter actually helps release neurotransmitters or chemicals in our brain that improve mood. If you’re feeling stressed, try watching a funny show or hanging out with a friend who makes you laugh.

  • Take real breaks. Work in order to live. Don’t live to work. Allow yourself real guilt-free time to relax and have fun. Do things you love and spend time with friends and family. After all, isn’t that what life is really about?

When to Consider Treatment for High Functioning Anxiety

People with mild or occasional anxiety often benefit from lifestyle changes like cutting back on caffeine, establishing a solid sleep routine, and making time for hobbies. But HFA can also be chronic and distressing and may require a more proactive approach. Consider seeking professional help if:

  • Anxiety feels unmanageable or exhausting despite your best efforts.

  • Physical symptoms worry you or interfere with sleep.

  • Anxiety causes problems in your relationships.

  • You use unhelpful coping strategies like overeating, overspending, or substance abuse.

  • Your perfectionism has reached unhealthy levels.

  • You have trouble experiencing joy or relaxation.

  • Anxiety holds you back from reaching your full potential.

The good news is anxiety is highly treatable, especially when caught early. A combination of therapy and medication can dramatically improve quality of life.


If you saw yourself in this portrayal of high functioning anxiety, know that you’re not alone. High functioning anxiety is more common than you might think. Many people appear fine on the surface, but struggle internally with stress and worry. Try out some of the strategies mentioned above, reach out for support, and don't be afraid to seek professional help. There are effective strategies and treatments available to better manage anxiety and prevent it from controlling your life. Have hope! With commitment to prioritizing your mental health, you can find moments of calm even on the busiest days.

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