The vast majority of people will likely never be able to tell you’re struggling with anxiety when you’re the first to arrive in the office, the last to leave, have never missed a deadline, and do so while being impeccably put together and prepared.

Anxiety disorders affect almost 20% of adults in the U.S., and while anxiety is known to paralyze its sufferers with fear, it can also have the opposite effect–driving you into constantly overthinking, overachieving, and overdoing.

How can you spot the signs and symptoms of “high-functioning” anxiety, and how can integrative medicine help you treat anxiety disorders? Keep reading to find out.

What is High-Functioning Anxiety?

High-functioning anxiety has evolved as an umbrella term for those who struggle with anxiety, but appear reasonably well-adjusted and successful in various areas of their life–despite their symptoms.

Almost 20% of adults in the U.S. have some kind of anxiety disorder, and at least a portion of those adults consider themselves “high-functioning”.

This type of anxiety often drives an individual to action, instead of feeling paralyzed by indecision or fear. The person with high-functioning anxiety often appears incredibly organized, productive, and is always quick to help coworkers and friends.

Is High-Functioning Anxiety Real?

Though high-functioning anxiety isn’t an official diagnosis, but rather a term used to include people who seem well-balanced in life but struggle with the inner turmoil of anxiety. 

High-functioning mental illness carries even more stigma

Because mental health issues aren’t often visible on the outside, friends, family, and coworkers likely doubt anything is wrong at all if that person is still working, leaving their house, and making money.

But what they don’t see is the mental struggle going on behind the scenes, and because of this, maybe less likely to offer support and have patience when everything “looks” fine.

Integrative medicine seeks to eliminate the stigma surrounding mental illness and anxiety by treating the body and mind as a whole.

Signs & Symptoms of High-Functioning Anxiety

Signs and symptoms of anxiety aren’t always easy to recognize, as is the case with a majority of mental health problems.

Someone with high-functioning anxiety might look like the epitome of success to their peers–always organized, presentable, and prepared.

Coworkers may say this person is productive at work and is always on time, and is quick to offer help and volunteer to take on tasks. Outside of work, friends and family notice a busy social calendar with plenty of leisure activities and commitments.

What many people don’t see is that their success is driven by a crippling fear of failure and self-doubt. Or that the ability to always have work done on time was preceded by weeks of procrastination followed by intense last-minute work.

Or that the drive to please people makes it almost impossible to say no, making this person swamped with work and social commitments. 

Someone experiencing high-functioning anxiety is in a constant battle with racing thoughts, overthinking, and fear.

Someone with high-functioning anxiety may be:

• High-achieving… and have a fear of failure.
• Proactive…and doubt their abilities.
• A perfectionist…and be fearful of criticism with even the smallest mistake.
• Active…because they don’t know how to switch off for fear of being “lazy”.
• Calm…but have racing thoughts.
• Meeting deadlines…but is also exhausted, chronically fatigued.
• Organized…and afraid to disappoint others.
• Hardworking…and procrastinate when stressed.
• Productive…and overthink everything.
• Agreeable…because they can’t say no.

Origins of High-Functioning Anxiety

The fourth trauma response

Most people are familiar with the phrase “fight, flight, or freeze,” as a response to trauma, but there’s a fourth trauma response that’s lesser-known but is a hallmark of high-functioning anxiety.

The ‘fawn’ response, often developed in childhood, involves immediately acting to try to please someone in the interest of avoiding conflict. Choosing a fawn-like response allows someone to preemptively appease those around them by agreeing. They’re likely to ignore personal feelings or desires in an effort to please people.

Over time, this fawn response becomes a pattern, and individuals can have trouble setting boundaries and develop anxiety in professional and personal interactions.

High Functioning Anxiety Leads to Burnout

Burnout is a significant issue as we all feel the social, technological, and economic pressure that causes overwork and exhaustion. Sometimes individual psychological patterns play a role, too.

People with high functioning anxiety can appear hardworking, helpful, and organized, but on the inside, there is a deep fear of failure, disappointing others, and judgment–and it can lead to burnout.

Burnout is a state of emotional, physical, and mental exhaustion caused by excessive and prolonged stress. It occurs when you feel overwhelmed, emotionally drained, and unable to meet the demands of your life. 

A high functioning anxiety person arrives at burnout by:

• Rumination and excessive worrying – “What if” thoughts can ruin attempts to relax and prevent a separation between work and home life.
• Constant need for reassurance – Doubting your abilities can make it harder to feel positive, motivated and satisfied with life.
• People pleasing – An inability to say no can lead to an overwhelming workload and a lack of control over your schedule.
• Perfectionism – Constantly wanting to prove yourself can lead you to do more than necessary–and more than is healthy.

Treating High-Functioning Anxiety

Conventional medicine commonly treats anxiety disorders with cognitive-behavioral therapy (CBT), medications such as selective serotonin reuptake inhibitors (SSRIs), and techniques like mindfulness training.

An integrative medicine approach also addresses factors that impact your mind and body, such as genetics, nutrient deficiencies, hormones, and gut issues. 

Manage Anxiety with Integrative Medicine 

Therapy and medication are tools, but it’s equally important to look at what you are consuming and how you’re taking care of your body (and mind), and everything else around you.

To evaluate the root cause of your anxiety, your integrative medicine doctor may recommend:

• Food sensitivity testing
• Hormone evaluation
• Nutrient deficiency tests
  

Don’t wait until your next panic attack–get to the root cause of your anxiety issues today. Making an appointment with a provider is simple and easy.

While a visit with your doctor is recommended to help you manage anxiety, there are simple methods you can begin at home, like: 

• Practicing meditation, or begin your day with positive affirmations.
• Stick to a routine – Wake up and go to bed at roughly the same time each day.
• Get regular exercise.
• Limit caffeine intake.
• Follow a brain-healthy diet.
• Reduce sugar.
• Don’t drink to excess.
• Manage stress by making time for leisure activities or intentional relaxation

Since mood disorders often begin in the gut, it’s beneficial to optimize your nutrition, and make sure to increase intake of mood supportive vitamins and minerals, such as:

• Magnesium
• B6
• Vitamin D

Supplements to promote calm and relaxation:

• L-theanine
• Rhodiola
• Bacopa
• GABA
  

Daily Tips

Whether you’ve already sought professional help or are still in the process, here are some tips you can try on your own to reduce your anxiety.

• Commit to spending 10 minutes a day working on your mental health.
• Before you do any cognitive work (changing your thoughts), look at lifestyle changes such as limiting caffeine, eating a healthy diet, and getting regular exercise.
• Sleep hygiene is important too, such as sticking to a regular bedtime, and not staying in bed if your mind is racing. Instead, get up and do something else until you feel tired
• Look at some of your thought patterns. For example, anxiety involves a lot of negative predictions (“What if I don’t make this deadline” or “I know I will make a fool of myself during this presentation!”).
• When you notice a negative thought, try countering it with something more realistic or helpful, such as “I always make my deadlines, and even if I miss this one it won’t be the end of the world.”
• Find coping strategies for nervous habits such as biting your lip or chewing your nails. Practicing deep breathing or progressive muscle relaxation can help control tension.
• Learn how to use a competing response to address your nervous habits. This technique has you perform an action that is incompatible with the nervous habit—such as chewing gum to keep you from biting your lip.

Ask yourself why you hold on to your anxiety. Are you afraid that if you are no longer driven by anxiety, that you will stop being an overachiever?

These are real concerns that you will need to address as you work on reducing the effect your anxiety has on your life. This will involve refuting the belief that you can’t accomplish things without your anxiety.

It may take some adjustment, but you will find a new groove that gives you a healthy balance between your mental well-being and getting things done.