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High-functioning Anxiety: The Hidden Signs

Sometimes when we go through stressful experiences that challenge us, our central nervous system creates intense and loud signals from our body that alert us to danger; aka anxiety.

What is anxiety?

Anxiety is an emotional response driven by fear. From an evolutionary standpoint, the development of anxiety served our ancestors well: Anxiety made us vigilant about potential threats and predators, ensuring we were alert, on the lookout and quickly prepared to move and mobilise energy if needed.

There is nothing inherently wrong with anxiety; in fact, at the right dose, anxiety is adaptive. Anxiety motivates us and is an essential messenger within our body – communicating to us what we care about and what we consider to be important. Anxiety can also protect you if a dangerous situation arises, as it prepares you to either fight, flight or freeze.

However, anxiety can sometimes be chronic in nature and disproportionate to the situation, potentially driving behaviours that are maladaptive that cause more harm than good. Anxiety can manifest in various mental health issues, such as OCD, panic, social anxiety or generalised anxiety. Anxiety can also manifest as ‘high functioning anxiety’, which is not a mental health disorder per se, because it does not tick the box of ‘impacting on a person’s functioning’. That is, high functioning anxiety does not impact on a person’s functioning per se, in fact, quite the opposite. People with high functioning anxiety are often over-achievers, extremely popular or simply just busy bees. However, high functioning anxiety causes chronic stress and can affect your mood, sleep and relationships.

How is high functioning anxiety different from other forms of anxiety?

Many people with high functioning anxiety may not seem like anything is wrong with them. They often do well in their careers, sports and other achievements. Interestingly, many people may not even realise they have high functioning anxiety.

Imagine a car that has a serious issue with the dashboard – you can’t tell what the speed it, how much petrol is in the tank or if there are any other issues with it. When driving the car, your only insight into the cars basic mechanics is your sense of how things are working. Now imagine hitting the accelerator and going from 0-100. If you started at 0, the relatively big jump in the speed would be extremely obvious at first even without a working dashboard to tell you. But now imagine always driving at 100 km per hour. While an increase might be apparent, a steady pace at this speed, with no speedometer, would make it hard to determine how fast you’re driving.

This is what it can be like for someone with high functioning anxiety. Their nervous system is wired to be ALWAYS ON, fast, and go go go… making it tricky for them to realise that they need to slow down and may be running out of fuel in the tank.

For people with intense levels of anxiety, they can also experience low levels of interoception.

Interoception is our bodies capacity to recognise our body’s internal signals. Some examples of this include recognising your hunger, thirst, need to go to the toilet, pain, anxiety, or inner emotional states.

Researchers believe people with high levels of anxiety suppress internal signals (or interoception) to avoid the overwhelm that comes with such sensations, similar to a defence mechanism. This is akin to covering the dashboard in the car to avoid seeing the petrol light on… ultimately, making it tricky to foresee that burn out is around the corner.

How does high functioning anxiety shows up in life? 


Psychologically, someone with high functioning anxiety may experience a racing mind. They may be busy constantly getting stuff done or may feel like they can never switch off or unwind. Relaxing or doing nothing can often be accompanied with feelings of guilt, as they believe they should always be doing something. Being constantly busy relies on adrenaline, which results in adrenal fatigue/burn out.

People with high functioning anxiety often experience rumination or repetitive negative thinking. Psychology researchers believe this gives the individual with anxiety a way to avoid their fears, as they move away from ‘feelings’ by focusing on ‘cognitions’. Rumination can feel helpful, as the individual feels like they are generating ideas about how to avoid potentially bad future events. In the short term, this gives the person a false sense of control, but in the long term this leads to vicious ruminative thought cycles known as worry.

Poor decision making can also be linked to high functioning anxiety as well. Excessive worry or rumination affects clarity of thought, creates a negative bias in decision-making, and impacts on sleep.


To avoid or cope with intense feelings of anxiety, people with high functioning anxiety also engage in behaviours to escape negative emotional states. Escapism (or avoidance behaviours) can be obvious sometimes, like excessive drinking of alcohol or emotionally eating junk food. But this can also be sneakily disguised in less subtle ways. For instance, someone with high functioning anxiety may find themselves avoiding and procrastinating from an important project, because the feelings associated with its importance are overwhelming.

Sometimes avoidance behaviours can be disguised as ‘health-conscious’ behaviours. For example, someone with high functioning anxiety may exercise rigidly and intensely to avoid uncomfortable emotions and gain a sense of control. Similarly, they may control what they’re eating via food rules and diets.


High functioning anxiety can also affect your social dynamics, for example, you may:

  • Express over-concern for others needs
  • Engage in excessive people pleasing behaviours
  • Lack boundaries or an ability to say “no” due to worry that you’ll let other’s down or they’ll be offended

How can Peaceful Mind Psychology help with high-functioning anxiety?

We have a number of Melbourne-based psychologists who take an interest in high-functioning anxiety. Our psychologists will explore the root cause of your high functioning anxiety and whether it’s connected to low self-esteem, unrelenting standards, ADHD or a lack of self-compassion or self-care. We appreciate that high-functioning anxiety has elements that can be helpful to achievement, so our psychologists work towards maintaining your goals whilst reducing overall stress and anxiety.