Signs of High Functioning Anxiety: Understanding, Recognizing & Managing

The signs of High Functioning Anxiety aren’t always visible to the naked eye, but they can have a major impact on those who experience it. Things may look perfect on the outside, but there’s often a hidden, internal struggle that is left unacknowledged.

We live in a world where the pursuit of success and the image of having it all together often take precedence. We’re faced with images of perfection on social media, where it seems everyone is living the perfect life.

We forget about the silent struggle that many of us face behind closed doors. Beneath the veneer of achievement and composure hides panic, stress and immense anxiety.

What is High Functioning Anxiety?

High Functioning Anxiety, often referred to as “HFA,” is a term used to describe people who appear to have their lives together on the surface but are struggling with anxiety internally. Sound familiar?

Unlike the stereotypical image of someone with anxiety, those with HFA may excel in their careers, maintain active social lives, and fulfill their responsibilities without obvious signs of distress. People will often struggle to believe that you battle with symptoms of anxiety because everything looks perfect on the outside.

high functioning anxiety

Symptoms of High Functioning Anxiety

Identifying high functioning anxiety can be challenging because it often hides behind a facade of success and composure. On the outside, it might look like everything is fine, while on the inside, it’s a completely different story.

The external signs of High Functioning Anxiety are often subtle and can be commonly mistaken for other things, like having a Type A personality.

Chronic Physical Symptoms: HFA can manifest physically, leading to headaches, digestive issues, muscle tension, and even panic attacks.

How It Looks on the Outside

What Causes High Functioning Anxiety
  • Hardworking
  • Detail-oriented
  • High-achieving
  • Ambitious
  • Perfectionistic
  • Organized
  • Well-prepared
  • Calm
  • Performs well under pressure

How it Feels on the Inside

High Functioning Anxiety Treatment
  • Overthinking
  • Overwhelmed
  • Burnt-out
  • People pleasing and trouble saying no
  • Constantly needs to be busy
  • Difficulty sleeping
  • Unrealistic expectations
  • Fear of failure
  • Self-doubt
  • Commonly experiences imposter syndrome
  • Hyper-awareness
  • Difficulty relaxing
  • Avoiding conflict
  • Procrastination

What Causes High Functioning Anxiety?

There’s not just one cause of High Functioning Anxiety. And it can be very hard to track exactly what initially triggered your anxiety. The causes of HFA are multifaceted and may include a combination of genetic, environmental, and psychological factors.

Potential factors that could trigger High Functioning Anxiety include:


A family history of anxiety disorders can increase the likelihood of developing HFA.

Traumatic Experiences:

Past traumas or highly stressful events can trigger anxiety, especially if they haven’t been properly processed. High functioning anxiety can be seen as a type of trauma response.

Personality Traits:

Perfectionistic tendencies and a high need for control can make individuals more susceptible to HFA. If you’re a highly sensitive person, you’re also more susceptible to this type of anxiety.

Environmental Factors:

High-stress environments, such as demanding workplaces or chaotic households, can contribute to HFA.

High Functioning Anxiety Treatment

Symptoms of High Functioning Anxiety

After I recognized that I was struggling with High Functioning Anxiety, it helped me make sense of how I work and why I do the things I do. By understanding my anxiety, I was able to learn how to master it, work with it and master it (to an extent). But this is and was largely due to treatment.

There are loads of different treatment options available if you suspect you’ve got HFA. You just need to find what works for you.


I still attend weekly therapy, and it’s honestly changed my life. Discussing, reflecting and noticing my behavioral patterns has accelerated my growth. It’s made me a better person and has helped me understand how my high functioning anxiety affects my life.

Psychodynamic therapy, cognitive-behavioral therapy (CBT) and exposure therapy can help manage anxiety and change those harmful thought patterns.


Medication for anxiety and depression is a journey. There are so many different types, combinations and dosages. However, medication is a largely debated issue in the mental health community.

There are downfalls (like side effects) and upsides to anxiety meds, but they can aid in alleviating symptoms. If you’re considering medication, you’ll need to book a consultation with a mental health professional and discuss whether medication is the right route for you.

Keep in mind that your mind is your own, and the decision is ultimately up to you and what works for you.

Mindfulness and Relaxation Techniques:

Simple mindfulness techniques are powerful when it comes to helping with High Functioning Anxiety. HFA always wants you to keep busy to avoid thoughts, feelings and all those things you keep busy to avoid. Being busy all the time can lead to burnout, and it can be hard to relax and truly relax. Check in with yourself often.

I am a terrible relaxer, but I find yoga helps force me to do so. Even just ten minutes of mindfulness (even informal mindfulness) or relaxation a day can help reduce stress.

It’s worthwhile spending some time learning to be present and manage stress through techniques like meditation, deep breathing, yoga, and progressive muscle relaxation.


As someone with High Functioning Anxiety, I understand how difficult taking care of yourself can be. Sometimes, it feels almost impossible to do something for you.

Prioritizing self-care practices such as regular exercise, a balanced diet, adequate sleep, and setting healthy boundaries can make a huge difference when it comes to managing HFA.

Support Groups:

Mental illnesses like High Functioning Anxiety can make you feel really alone. It’s not uncommon to feel like you’re the only one. This is where mental health support groups are incredible.

Connecting with others who experience HFA can provide a sense of community and understanding. Some of my best friends struggle with High Functioning Anxiety and knowing I can share what’s happening with me with someone who understands is honestly life-changing.

Stress Management:

I’m almost always stressed about something. If there isn’t something for me to stress about, I feel purposeless. This is something that people with HFA have in common.

The best way around this is to develop coping strategies for stress, including time management and conflict resolution skills.

Do I Have High Functioning Anxiety?

Do I Have High Functioning Anxiety?

If you suspect you may have HFA, it’s crucial to seek professional guidance. While you can Google your symptoms all day, the only way you’ll know for sure is by getting a mental health assessment by a licensed therapist or psychiatrist.

They are the only ones who can provide an accurate diagnosis and tailored treatment plan.

While seeking help isn’t easy, remember that reaching out is a sign of strength, and it’s never too late to address anxiety and improve your well-being.

High Functioning Anxiety vs. Anxiety

High Functioning Anxiety shares many similarities with generalized anxiety disorder (GAD), but there are key differences. I was formally diagnosed with GAD but my anxiety is definitely high functioning.

GAD is characterized by pervasive and excessive worry about a wide range of everyday concerns. Additionally, people with HFA often have specific worries related to performance, perfectionism, or social situations.

While individuals with GAD may have difficulty functioning in their daily lives, those with HFA typically maintain a high level of functionality while experiencing significant internal distress.

High Functioning Anxiety vs. Anxiety

Identifying the Signs of High Functioning Anxiety

Recognizing the signs of High Functioning Anxiety is the first step toward managing it effectively.

If you suspect you may have HFA, remember that you are not alone. Those internal feelings don’t need to be hidden. And despite the fear you may feel, facing them will lead to a better, more fulfilling life.

Mastering anxiety is a journey, a long, bumpy one filled with ups and downs. But you don’t have to do it by yourself.

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