Do You Have High Functioning Anxiety? Understanding, Recognizing, and Seeking Help.

Anxiety is a common human experience, but not all anxiety manifests in the same way. High Functioning Anxiety (HFA) is a distinct form of anxiety that often goes unnoticed by the person experiencing it and those around them.

When we consider anxiety disorders, our usual image involves an individual experiencing nervousness, excessive worry, and restlessness.

However, what if, on the surface, this person appears confident, outgoing, and organized? Would we conclude that they don’t require anxiety counseling or therapy?

In reality, that may not be the case. This individual might be dealing with high-functioning anxiety, an anxiety condition that often goes undiagnosed.

“The term ‘high-functioning anxiety’ characterizes an individual who, despite battling anxiety, appears capable of effectively handling the challenges of everyday life,” explains psychologist Adam Borland, PsyD, specializing in anxiety therapy.

Does this description resonate with you or someone you know?

In this article, we will explore what High Functioning Anxiety is, how to identify it, the importance of seeking specialized help, debunking myths surrounding perfectionism, and where to find anxiety counseling in Birmingham, Alabama.

a lawyer working

What is High Functioning Anxiety?

High Functioning Anxiety is a term used to describe individuals who outwardly appear calm, competent, and successful while privately battling intense anxiety. Unlike other anxiety disorders, people with HFA often excel in their careers, maintain active social lives, and have impressive achievements, all while struggling with relentless inner turmoil.

According to National Alliance on Mental Illness, over 40 million adults in the United States grapple with anxiety disorders, causing them to experience fear and apprehension in specific situations, often hindering their ability to function effectively. These individuals may also exhibit exaggerated reactions and physical symptoms like excessive sweating and a racing heart.

Yet, what distinguishes high-functioning anxiety from generalized anxiety disorder (GAD)? The crucial distinction lies in how an individual responds to their anxiety, a subject often addressed in Anxiety Counseling and Anxiety Therapy.

In cases of GAD, individuals tend to lean toward the “flight” response, seeking to distance themselves from anxiety-triggering situations. However, when it comes to high functioning anxiety, there’s a more pronounced “fight” response.

Individuals with high functioning anxiety often push themselves to work harder as a means of combating their anxiety, as explored in discussions within Anxiety Counseling and Anxiety Therapy.

HFA is characterized by a constant state of unease, worry, and overthinking. Individuals with HFA may be perfectionists, setting excessively high standards for themselves and fearing failure. They may constantly seek approval and validation from others, while internally grappling with self-doubt and fear of judgment.

a doctor working

How do I know if I have High Functioning Anxiety?

Recognizing High Functioning Anxiety can be challenging, as individuals with HFA often hide their anxiety well. Some common signs and symptoms include:

  • Excessive worry about the future or past.
  • Fear of making mistakes or letting others down.
  • A need for constant reassurance and validation.
  • Difficulty relaxing or experiencing a sense of calm.
  • Physical symptoms like muscle tension, headaches, and gastrointestinal issues.
  • Difficulty falling asleep or staying asleep due to racing thoughts.
  • Procrastination and perfectionism.
  • Frequent self-criticism and negative self-talk.

GAD-linked symptoms encompass:

1. Excessive anxiety or persistent worry, spanning a minimum of six months on most days.

2. Restlessness.

3. Difficulty concentrating.

If you relate to these symptoms and find that your anxiety is affecting your daily life, relationships, or well-being, it is crucial to seek help.

As high-functioning anxiety lacks official recognition as a diagnosis, there exists a scarcity of research concerning its impact on individuals. Those grappling with high-functioning anxiety may manifest subtler indicators, leading some experts to draw parallels between its signs and symptoms and those of generalized anxiety disorder (GAD).

Within the realm of Anxiety Counseling and Anxiety Therapy, the need for further exploration and understanding of high-functioning anxiety becomes apparent, given its overlap with GAD symptoms.

an anxious woman worrying in bed/ anxiety therapy/ Birmingham Al

Causes of High Functioning Anxiety

Understanding the Origins of High-Functioning Anxiety

High-functioning anxiety is thought to stem from a complex interplay of genetic and environmental factors, with potential contributing factors such as:

1. A family history of anxiety disorders.

2. Exposure to negative or stressful life events.

3. Specific physical health conditions, such as thyroid issues.

4. Substance or alcohol abuse.

5. Early childhood traits of shyness or nervousness.

In particular, individuals who have achieved rapid success, such as physicians handling numerous cases, lawyers becoming partners at their firms, or those receiving frequent promotions, may be particularly vulnerable to high-functioning anxiety, as noted by Dr. Hamdani.

It’s important to note that these risk factors can vary, and experiencing one of them does not necessarily indicate an anxiety disorder. If you suspect you may be struggling with high-functioning anxiety, seeking guidance from a healthcare professional is advisable.

an anxious woman worrying/ counseling for anxiety/ birmingham Al

Distinguishing High-Functioning Anxiety from Other Anxiety Varieties

The realm of anxiety disorders encompasses a diverse array of manifestations. Below, we delve into some of the most prevalent anxiety types, as outlined by the National Alliance on Mental Health:

1. Generalized Anxiety Disorder (GAD): Characterized by ceaseless apprehension about daily life, GAD does not tether its anxiety to specific events but rather perpetuates a more enduring worry. Individuals grappling with GAD may encounter challenges in completing tasks, maintaining focus, and frequently feel drained by their relentless fretting.

2. Panic Disorders: These conditions are often marked by sudden, unanticipated bouts of terror known as panic attacks. These episodes can elicit symptoms such as chest pain, palpitations, breathlessness, and dizziness, occasionally causing individuals to mistake them for cardiac incidents.

3. Social Anxiety Disorder: This affliction takes root in social situations, inducing anxiety when one must participate in conversations or contribute to discussions. It arises from the fear of uttering the wrong words, uncertainty about what to say, or the dread of humiliation.

4. Phobias: Classified as anxiety disorders, phobias trigger intense fear or discomfort reactions in those affected. Phobias can be associated with specific places, objects, or events, prompting avoidance of potential triggers to sidestep panic attacks based on the severity of the phobia.

a depressed woman thinking/ counseling in Birmingham Al

Navigating the Complex Connection Between HFA and Depression

The intricate relationship between anxiety and depressive disorders often intertwines, with both conditions coexisting simultaneously.

The Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study unveiled a significant finding, showing that 53% of patients diagnosed with major depression also grapple with substantial anxiety, leading to the classification of anxious depression.

High-functioning anxiety tends to become problematic when it infiltrates into the realm of depression. This is when most individuals seek help – when daily tasks become daunting, sleep becomes elusive, interests wane, and thoughts of life’s value diminish.

These two conditions often work in tandem, with high-functioning anxiety potentially precipitating depression, while depression can also trigger high-functioning anxiety. Therefore, it is crucial to assess their mutual impact and tailor treatment accordingly.

Identifying HFA: A Guide to Self-Assessment

To ascertain whether you might be grappling with high-functioning anxiety, you can undergo a self-assessment. When it comes to diagnosing anxiety disorders, medical professionals typically commence with a thorough physical examination or laboratory tests. This initial step is crucial as it helps rule out other medical conditions that can manifest symptoms resembling anxiety, such as heart disease or high blood pressure.

If no underlying health issues are uncovered, your anxiety therapist might proceed with a detailed interview or refer you to a mental health specialist for a comprehensive psychological evaluation.

During these psychological assessments, anxiety therapists employ diagnostic criteria outlined in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition). They use these criteria to evaluate your condition for the presence of an anxiety disorder. The key indicators include: (You do not have to experience all indicators to have GAD.)

1. Experiencing excessive anxiety and persistent worry for more days than not, spanning at least six months, concerning various aspects of life like work or school performance.

2. Struggling to control anxious thoughts and experiencing physical symptoms like increased heart rate, fatigue, sleep disturbances, trembling or shaking, nausea, dizziness, muscle tension or aches, restlessness, difficulty concentrating, or irritability.

3. Witnessing how these symptoms significantly disrupt your daily life, causing distress or impairing your social interactions, work performance, or other areas of functionality.

4. Encountering recurrent panic attacks, followed by at least a month of fearing another attack, worrying about its implications, or altering your behaviors due to these fears.

5. Feeling anxious in social or performance scenarios where you might be exposed to new people or subjected to scrutiny by others.

6. Experiencing panic attacks when exposed to these feared situations.

7. Either avoiding such social circumstances or enduring them with substantial distress.

8. Ensuring that your symptoms cannot be attributed to the effects of medication or substance use.

It’s important to note that individuals with high-functioning anxiety may excel in concealing their symptoms, making it crucial to be transparent with your mental health provider about your experiences and concerns. Open communication ensures that individuals suspecting high-functioning anxiety can receive an accurate diagnosis and appropriate support.

perfect blocks except one red one

Is There Help for High Functioning Anxiety Near Me? Why you want a therapist who specializes in perfectionism?

Yes, there is help available for High Functioning Anxiety. It’s essential to work with a therapist who specializes in anxiety, particularly one who understands perfectionism. Perfectionism often accompanies HFA, and a therapist well-versed in treating perfectionism can provide tailored strategies to address it.

Anxiety counseling and therapy can help individuals with HFA learn to manage their anxiety, develop healthy coping mechanisms, and improve self-esteem. Therapists can guide individuals in setting more realistic goals and expectations, ultimately alleviating the pressure they put on themselves.

high achieving professionals/ Counseling for perfectionism/ Birmingham Al

But what if I lose my Edge? Myth that being hard on self and setting unreasonable goals helps you achieve

One common misconception is that being hard on oneself and setting unattainable goals is a recipe for success. While it’s true that setting high standards can motivate you, it’s essential to strike a balance. Constantly striving for perfection can lead to burnout, chronic stress, and a decline in mental health.

Therapists who specialize in perfectionism understand the importance of setting realistic goals and maintaining self-compassion. Losing your edge doesn’t mean settling for mediocrity. It means recognizing that you can achieve great things without sacrificing your mental and emotional well-being in the process.

Pros and Cons of Embracing High-Functioning Anxiety

Embracing high-functioning anxiety comes with its own set of advantages and disadvantages. People who experience high-functioning anxiety often exhibit traits such as exceptional organization skills, a knack for meeting deadlines, and a talent for troubleshooting problems, which can be seen as positive attributes at first glance.

However, on the flip side of the coin, individuals may grapple with feelings of shame and embarrassment when it comes to letting their guard down due to the fear of appearing vulnerable. Concealing their symptoms from others is a common practice among those with high-functioning anxiety, which can lead to internal struggles.

Finally, those with high-functioning anxiety frequently find themselves trapped in a cycle of perfectionism, prone to overthinking, and reliant on seeking reassurance from others. They may struggle with assertiveness and find it challenging to say “no” when necessary. Often, they tend to ruminate on negative thoughts and engage in worst-case scenario thinking, further exacerbating their anxiety.

a man in a therapy session/ counseling Birmingham AL

Counseling for High Functioning Anxiety in Birmingham, Alabama

If you’re seeking anxiety counseling in Birmingham, Alabama, you’re in luck. The city offers a variety of therapists and mental health professionals who can provide specialized care for High Functioning Anxiety. When searching for an anxiety therapist in Birmingham, be sure to include keywords such as “Anxiety Counseling,” “Anxiety Therapy,” “Birmingham Anxiety Therapist” and “Counseling for Perfectionism ”in your online search to find professionals with expertise in this area. Or look no further than the therapists at Empower Counseling. We specialize in Acceptance Commitment Therapy for anxiety and counseling for perfectionism.

A smiling man


High Functioning Anxiety is a real and challenging condition that affects many individuals, often in silence. Recognizing the signs, seeking specialized help, and debunking the myths surrounding perfectionism are crucial steps in managing HFA effectively.

If you suspect you have High Functioning Anxiety or know someone who does, reach out to a qualified therapist in Birmingham, Alabama, at Empower Counseling to embark on a journey toward better mental health and a more balanced life.

Ready to kick start your journey to therapy? Follow these simple steps:

  1. Reach out to Empower Counseling and schedule your initial appointment.
  1. Get acquainted with your therapist.
  1. Embark on your journey towards personal growth and success.

We offer anxiety therapy and counseling for perfectionism to teens, college students, young adults and professionals. Through online and in person counseling we help Samford students, University of Alabama students, Auburn University students and others move away from anxiety and perfectionism so they can enjoy their best college experience. Empower Counseling, Lucia, Marti, Savannah, and Kathryn, also offers counseling for Depression, eating disorder treatment, difficult life transitions, bipolar disorder, self-esteem issues, women’s issues, trauma and PTSD, Your team at Empower Counseling is ready to help you. And Kathryn is an executive coach and life coach. If you are overwhelmed, inefficient, or ineffective, Kathryn can help you streamline, organize, and be your most productive self,

Other helpful blog posts:

When To Seek Therapy: Recognize The Signs – Insights From A Birmingham Therapist

What Does Anxiety Look Like For You? A Personal Letter From An Anxiety Therapist Birmingham Al.

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