How to Treat High Functioning Anxiety

Are you ticking all the boxes in life, yet you can’t seem to enjoy it to the extent you want to? Maybe you’re anxious, restless, or having difficulty concentrating? Does it feel like you can’t stop worrying, even though when you tell people about it, they say, “What!? You’re amazing!” or “But you’re doing so well!” These are hallmarks of high functioning anxiety.

High functioning anxiety is a subset of generalized anxiety that is often difficult to recognize — within yourself, or by others — precisely because you seem to be doing so well. Others view you as confident, organized, and successful. But on the inside, it’s like the weight of the world is bearing on you. And the fact that your anxiety and stress is so invisible to others actually kind of makes it worse. It feels like the people around you don’t see you — I mean, really see you.

I see you. I want to help.

What is high functioning anxiety?

Anxiety is a response to a threat — real or perceived. From over ten years of clinical experience, I have found that people with high functioning anxiety almost view it as a superpower of sorts. That is, one reason you function so highly is because you have trained yourself to be on the lookout for threats. Often, this leads to a habit of catastrophizing, or expecting the worst. Many times, when I work with clients with high functioning anxiety, they have come to me because they no longer want to feel so anxious, yet they are actually very reluctant to give up the catastrophizing that causes the anxiety, because they see it as playing an important role in their success.

The problem is that the way we feel is directly linked to the way we think. To be able to catastrophize without anxiety is not really an option on the table.

But you’re not wrong if you believe anxiety is beneficial in some important ways. Anxiety, in moderate amounts, is healthy and adaptive: in the moments before we walk into an interview or give a presentation, before we walk into an important meeting, when we are asserting for ourselves, and so on. Anxiety can help in these situations by keeping us alert and motivating us to try our best. It lets us know when a challenge is ahead, so we can be physically and mentally prepared to meet that challenge. Anxiety is a built-in performance-enhancer. And, it shows that we care. No one is anxious about things they don’t care about.

But the key to all of this is that we are talking about moderate anxiety — the kind that shows up at important times to prepare us for a specific challenge and then dissipates when that challenge passes. While it’s normal to worry on occasion, or to have a sleepless night during a time of unusual stress, it isn’t healthy feel intense anxiety on a daily or near-daily basis. And it isn’t healthy to feel anxious about anxiety — to worry about worry. Here are some warning signs to look out for:

• you’ve abandoned things you used to enjoy because of anxiety
• you’re feeling lonely because your anxiety is preventing you from meeting your emotional needs
• you’re regularly losing sleep from excessive worry
• you find it hard to relax
• you’re always tired or fatigued
• you’re having physical symptoms like restlessness, headaches and physical pain, muscle tension

If this sounds like you, then your anxiety has problem surpassed that moderate level…and since you’re reading this, you are probably aware of that.

How therapy for high functioning anxiety can help

With therapy, you can make remarkable progress on your high functioning anxiety in as little as a few months. The process looks roughly like this: We first work to explore and understand your anxiety — where it is coming from, how it is affecting you, and the things that are reinforcing it. Often, this will include exploring environmental factors (e.g. work life, home life, social life, etc.) as well as habits of thought and behavior. From there, we will implement specific methods to make positive changes to these things based on what we have discovered. This is a highly individualized process. No two people’s experiences are the same, and therefore no two solutions are the same.

With a little time and practice you will start to gain the skills to manage your anxiety, and once you start to have some success with this you like likely start to develop a sense of agency over it; you will start to feel not like someone who anxiety happens to, but someone who knows how to manage anxiety when it happens. This doesn’t mean your anxiety will go away completely. After all, you wouldn’t want it to. A good analogy is to think about a backpack or suitcase– you know it’s there, and some days it’s heavier than others, depending on what you’re carrying, but it doesn’t keep you from doing the things you need and want to do — it doesn’t hold you back.. That’s what your relationship with anxiety can become. You” learn how to channel anxiety positively and use it to your benefit. That’s not to say it won’t ever feel uncomfortable — at times, it will. But it won’t keep you from being you, and that’s the important thing.

How John can help you to treat your high functioning anxiety

I have ten years of experience working with high functioning anxiety (and anxiety of all stripes). I have been trained in cognitive-behavioral therapy (CBT) for anxiety by the Beck Institute, a leading CBT training center. CBT is widely regarded as a gold-standard therapeutic treatment model for anxiety.

I supplement my clinical experience and training with insights from practical philosophy. Many of the brightest minds there ever have been have put deep thought into how to live good lives, and this thought bears directly on how to overcome fears and anxiety, how to cultivate healthy relationships with ourselves, and how to best face uncertainty.

You have the choice of traditional online therapy and in person walk and talk therapy.

Online therapy may be best if you prioritize convenience (no commute!) while walk and talk therapy may be best if you want to try something different, get some exercise, and enjoy the beauty of nature during your session.

Want to learn more about my approach to therapy? Check out my approach to therapy page.