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Many people manage to function quite well at work and in relationships, but still have nagging worries or thoughts of disaster. The anxiety may not interfere much with your life, but it can still cause suffering. Here we look at what to do if you have high-functioning anxiety.

What is high-functioning anxiety?

High-functioning anxiety is not a diagnosis but describes people who outwardly function well in work, school, and relationships, despite experiencing significant anxiety symptoms.

In healthcare settings, the problem might be better described as a mild to moderate anxiety problem, where people are not so limited by their symptoms that they avoid too many things.

People with high-functioning anxiety may seem successful but may still have difficulties with worry, fear and other anxiety-related symptoms.

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Symptoms of high-functioning anxiety

With mild to moderate anxiety problems, people can still function relatively well in everyday life. You may have a job and close relationships but still experience difficulties where you worry a lot about things other people don’t think much about and may try to compensate for your fears by over-performing. Read more below.

Anxiety can be linked to disorders such as social anxiety and generalised anxiety disorder (GAD), or a stress problem that develops into sleep disorder insomnia. It is important to get an assessment by a professional for the right treatment. Some characteristics of high performance anxiety include:

  1. Excessive worry: Constantly worrying about the future, planning and overanalysing situations.
  2. Perfectionism: Thoughts of having to perform perfectly in all situations, often driven by fear of failure or being judged.
  3. Overcompensation: Working extra hard to hide their anxiety, which can lead to high performance but also to exhaustion if stressed.
  4. Need for constant busyness: Difficulty relaxing and the need to always be busy to avoid anxious thoughts.
  5. Social anxiety: Anxiety about social situations and how others perceive you.
  6. Sleep problems: Difficulty falling asleep or sleeping through the night due to worrying thoughts.
  7. Physical symptoms: Can also be related to stress and include muscle tension, stomach problems, rapid heartbeat, and fatigue.

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Can high-functioning anxiety be treated?

All anxiety problems can be treated, regardless of how well you function in life. Often the anxiety has some impact even if it doesn’t limit your life completely. The main recommended treatment for anxiety problems is Cognitive Behavioural Therapy (CBT), which involves an individualised analysis of problem situations and thought patterns. It talks about the feelings, thoughts and behaviours associated with the anxiety and changes behaviors and thought patterns to reduce suffering and improve quality of life.

Another treatment for anxiety problems is Acceptance and Commitment therapy (ACT), which focuses on values and how to live by them. Compassion-focused therapy (CFT) works a lot on self-compassion and working with feelings of shame, which can drive performance in a way that makes you feel bad.

Treatment of anxiety at a mild to moderate level is usually done in primary care while more severe problems, where you are often more limited in your function, are treated at a specialist level. A treatment in primary care can be between about 4-10 sessions and at Lavendla we have several licensed psychologists and qualified therapists who are ready to help you.

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A first step to seek help

If you recognise the symptoms, it is good to seek help. It is possible to improve your quality of life, even if you are functioning well externally. Our service offers contact with psychologists and therapists who are ready to support you through your journey. We make the hard things easier.

12 common questions and answers about high-functioning anxiety

What is high-functioning anxiety?

High-functioning anxiety is not a diagnosis but describes people who outwardly function well in work, school, and relationships, despite experiencing significant anxiety symptoms.

Is high-functioning anxiety a diagnosis?

Anxiety disorders come in different severities: mild, moderate, and severe. High-functioning anxiety is likely to be a milder form because the symptoms do not interfere as much with everyday life.

Can high-functioning anxiety be treated?

Any type of anxiety problem can be treated, no matter how much it affects your daily life.

What are the symptoms of high-functioning anxiety?

Anxiety can mean worrying a lot about different things, such as what others think, how you perform and whether you have done enough. The symptoms can be linked to social anxiety, generalized anxiety disorder (GAD), stress issues and sleep problems.

I have trouble sleeping, is it high-functioning anxiety?

Worry can lead to the development of sleep problems, but if these problems persist long enough, you can develop insomnia, which is the diagnosis for sleep problems.

How is high-functioning anxiety treated?

High-functioning anxiety is treated like any other anxiety disorder, using cognitive behavioural therapy (CBT).

Can exercise affect anxiety problems?

Yes, any kind of exercise can be helpful to feel better, but you may also need psychological treatment.

I stress a lot, is it anxiety?

Stress and anxiety can have similar symptoms, but people often don’t avoid things as much and worry as much when they are stressed as they do when they are anxious. But you can have a lot of performance-based thoughts and behaviours in both conditions.

I worry about everything, why do I do that?

If you have generalised anxiety disorder (GAD), you often worry about a variety of things, and it is possible to get help.

How does social media affect high performance anxiety?

Social media can amplify anxiety by creating a sense of inadequacy as individuals compare their lives with others. This can cause people to worry and pressure themselves to perform in a way that reduces their quality of life.

I feel exhausted, is it anxiety?

Being tired can be a basic anxiety problem if, for example, you are afraid of failure and overperforming. But, in the case of stress-related issues, there may be other driving forces including not enough recovery over a long period. If you have symptoms of fatigue syndrome, you should be assessed by a doctor first.

Where can I turn if I need help?

Lavendla makes it simple to book an online session with a therapist or psychologist to describe your problems and start planning a treatment programme. We help make the difficult easier.

Treating anxiety step-by-step

Here we walk you through how treatment for high-functioning anxiety could work. There is help available and these are steps you can take:

Understanding and assessment

The first step is to understand that you have an anxiety problem and that it is okay to seek help for it. A professional psychologist can help you evaluate your situation and understand your problem. You may also be asked to complete assessment forms.


You will learn about your anxiety and how it affects you both physically and mentally. It is important to understand what happens in your body and mind when fear arises.

Tools for changing behaviours and patterns

You will work on identifying and changing patterns of thinking that are linked to your anxiety. Together with your therapist, you will explore situations and learn how to deal with them. You will also be given homework to practise between sessions.

Follow-up and evaluating progress

You will have support from your psychologist throughout the process. At the end of the treatment, you also receive a plan to continue practising and maintaining progress over time.

Feel free to book an initial session with one of our licensed psychologists or therapists to see how we can help you. We make the difficult easier.

Lavendla – Making the difficult easier

Written by dominic

Dominic is a Cape Town-based copywriter and editor with a background in psychology.