High-Functioning Anxiety: Signs, Causes and How to Cope

Signs of high-functioning anxiety

Physical signs are common too: trouble sleeping, tiredness, a racing heart, headaches and teeth grinding. See anxiety symptoms, teeth grinding and tension headaches.

If you’re looking for a nudge to slow down, Stress Awareness Week in early November is a useful prompt.

Why it’s easy to miss

• From the outside, everything looks fine, so friends, colleagues and even doctors may not notice.
• Anxiety can look like ambition, so it’s often praised rather than questioned.
• You may tell yourself others have it worse, or that worry is what keeps you successful.
• The costs (poor sleep, exhaustion, irritability) build up slowly. See burnout symptoms.

High-functioning anxiety vs generalised anxiety disorder

“High-functioning anxiety” is a popular phrase, not a diagnosis. Many people who use it may actually meet the criteria for generalised anxiety disorder (GAD). The NHS describes GAD as feelings of stress or worry that affect your daily life and are difficult to control, with symptoms such as difficulty sleeping, restlessness, irritability, poor concentration, tiredness, tension, stomach problems and palpitations.

Being able to keep going at work doesn’t mean the anxiety isn’t real or doesn’t deserve help. GAD is treatable, and you don’t have to wait until you’re struggling to ask for help. See how to deal with anxiety.

Perfectionism and high-functioning anxiety

Perfectionism often sits at the heart of high-functioning anxiety. A large 2017 analysis of 284 studies found perfectionism was linked with a wide range of mental health problems, including anxiety and depression. Setting high standards isn’t the problem; it’s the fear of falling short and the harsh self-criticism that go with it. See imposter syndrome, people pleasing and low self-esteem.

High-functioning anxiety at work

• Over-preparing and re-checking work
• Struggling to delegate
• Answering emails late at night or at weekends
• Dreading feedback, even when it’s usually positive
• Feeling unable to take breaks or holidays

Try setting a clear finish time, batching emails, and practising “good enough” on lower-stakes tasks. See how to relieve stress and working from home and mental health.

Signs it’s tipping into burnout

High-functioning anxiety can keep you going for a long time, but the strain adds up. Warning signs that it’s becoming too much:

• You’re exhausted even after a weekend or holiday
• You feel cynical, detached or numb about work you used to care about
• Small tasks feel overwhelming, or you’re making more mistakes
• You’re getting ill more often, or sleeping badly most nights
• You’re relying on caffeine, alcohol or sugar to keep going
• You snap at people or cry more easily. See why am I so irritable? and crying for no reason

If several of these sound familiar, it’s a sign to slow down and get support now rather than pushing through. See burnout symptoms and signs of a nervous breakdown.

How to cope with high-functioning anxiety

1. Name it. Recognising “this is anxiety, not reality” helps you step back.
2. Schedule rest like a meeting. Rest is part of performing well, not a reward.
3. Set boundaries on work hours and say no more often.
4. Challenge perfectionism: ask “what’s good enough here?”
5. Calm your body daily with slow breathing or yoga nidra. See box breathing.
6. Move every day to burn off stress hormones.
7. Protect your sleep and switch off screens before bed. See anxiety at night and how to stop overthinking.
8. Cut back on caffeine and alcohol. See does caffeine cause anxiety?
9. Talk to someone you trust about what’s really going on.

A daily routine can help you switch off. Our Magnesium Glycinate Sleep Complex is a caffeine-free evening drink with L-theanine, and magnesium contributes to normal psychological function. Some people take our Flow CBD Oil, with ashwagandha and maca, as part of their day. CBD isn’t a treatment for anxiety. The FSA’s 10mg a day figure for CBD is precautionary advice rather than a legal limit, set while longer-term safety research continues. At Evopure we think it is a very cautious figure, and many adults use more. If you go above it, increase slowly, and check with your GP or pharmacist first if you take any medication.

When to get help

See a GP if worry is affecting your sleep, health, relationships or enjoyment of life, even if you’re still managing at work. Adults in England can refer themselves to NHS Talking Therapies for CBT, which works well for anxiety. If you feel unable to cope or have thoughts of harming yourself, call 999, NHS 111 or Samaritans on 116 123.

Related guides

• Why stress can bring you out in hives.
• What the research says about natural supplements for anxiety.
• If you’re close to burning out, our guide to time off work with stress explains fit notes, sick pay and a phased return.
• If you can’t switch off after work, see signs your work-life balance is off.
• Our guide to magnesium for anxiety, including what the NHS recommends instead.
• The best mushrooms for anxiety.
• Why you dread things days or weeks ahead (anticipatory anxiety).
• If the worry centres on being judged in meetings or at social events, read our guide to social anxiety.
• If you notice everything and tire quickly in busy settings, see highly sensitive person: signs and how to cope.
• Curious about CBD? Our evidence guide to CBD for anxiety explains what the research does and doesn’t show.
• If you want to show support with a present, our guide to gifts for someone with anxiety keeps it low-pressure.
• Not sure if it is anxiety or stress? See our guide to stress symptoms and how the two differ.
• Curious about CBD? Read how to choose the best CBD oil for anxiety in the UK first, including the checks that matter and when to see your GP instead.
• If the pressure is mostly coming from your job, see the signs of stress at work and how to raise it with your manager.
• If you’re curious about adaptogens, our guide to ashwagandha for anxiety explains what the trials did and didn’t show.