5 Signs of High Functioning Anxiety

Dr. Morgan Camp M.D.


Our modern lifestyle, for many of us, involves a degree of "fake it 'til you make it". We're going through the paces of the day, meeting deadlines, getting things done, but under all that busyness, is real anxiety and worry. Just because you don't broadcast your anxiety doesn't mean it can't cause harm! Here are 5 signs that your anxiety is well-hidden, and what to do about it.

Everyone knows that looks can be deceiving. The way something–or someone–appears on the outside rarely tells the entire story of what’s going on within. This is especially true for those with high functioning anxiety.

High functioning anxiety is exactly what it sounds like; while a person may appear successful, put together, and well-adjusted, their brain and body are experiencing a storm of fear and stress. While the body’s anxiety response is the same as in other anxiety disorders, high functioning people present the signs and symptoms in a different way–from procrastination and perfectionism to poor sleep and burnout.

So if you appear to be “fine” to the outside world but are struggling with persistent fear, worry, and stress you can’t seem to shake, you might identify with these 5 signs of high functioning anxiety. 

First, it’s important to understand this type of anxiety and how it relates to other anxiety disorders.

Is High Functioning Anxiety Real?

It’s easy to underestimate the seriousness of an anxiety disorder, especially for those that have never experienced it. High functioning anxiety is even trickier to spot and diagnose, as it can take on the guise of the high achiever, perfectionist, or high-energy go-getter. 

Friends, family members, and co-workers may simply conclude that you just need to take a vacation–or they may not even see any signs at all. Many people with high-functioning anxiety, who already suffer from acute self-criticism, have simply become very good at masking and hiding their internal struggle.

But is this a real anxiety disorder, or just a quirky personality trait? While high functioning anxiety does not have its own criteria as a mental health diagnosis, it is another form of anxiety disorder.

Anxiety is a part of everyday life, acting as the body’s way of problem-solving, performing a task well, or alerting us to danger. When anxiety gets out of control, though, it can make daily life difficult. According to the National Institute of Mental Health, those with anxiety disorders experience excessive anxiety and worry most days for at least 6 months. Symptoms vary depending on the person, though they generally include:

  • Muscle tension
  • Feelings of restlessness or being “on edge”
  • Irritability
  • Becoming easily fatigued
  • Excessive worry with difficulty controlling it
  • Poor sleep quality
  • Difficulty concentrating (1)

Those who experience high functioning anxiety struggle with these same symptoms. They simply manifest in ways that aren’t visible to most people or don’t appear concerning. It’s the difference between a person experiencing a panic attack and a high achiever that always puts in extra hours at the office. While both experiencing anxiety, one would be visibly distressed while the other may be internalizing their panic.

If you’re not sure if this describes you, let’s take a look at 5 signs of high functioning anxiety that might resonate with you.

#1: You’re A Perfectionist

Perfectionists believe that their value lies in being or doing things perfectly. They often set impossibly high standards for themselves, striving for unreachable goals. While perfectionism can cause positive outcomes–such as doing well on a test or performing a task without errors–the results are rarely perfect to the perfectionist. (2)

Since no one can be perfect, the perfectionist constantly falls short of their own standards. This causes a spiral of critical self-talk, continuing the anxiety loop and fueling the disorder. Though it may appear to others that you’re talented, successful, and motivated, the internal dialogue is often very different. High functioning anxiety tells you that you’re never good enough, or you’ll fail, or no one will like you if you’re not perfect–but these are things you rarely share with the outside world.

#2: You Procrastinate

This second sign of high functioning anxiety goes hand-in-hand with perfectionism. Putting things off is often a way to avoid the stress of trying to be perfect. Worrying about being a failure or falling short of one’s internal perfect standards is sometimes too much to bear for those suffering from an anxiety disorder.

The procrastinator often delays a task because their anxiety magnifies the bad things that might happen if they fail. These imagined scenarios can become so stressful that avoiding the source of worry is the default response. This usually leads to more anxiety or unhealthy coping behaviors.

#3: You Experience Racing Thoughts And Can’t Relax

When you have high functioning anxiety, it can be difficult to truly relax. A day-spa trip with friends or vacation might still be enjoyable, but anxious thoughts always seem to nag at the back of your mind. Preoccupation with to-do lists, work tasks, family or relationship problems, overthinking, over analyzation, and existential dread often make it difficult to feel stress-free.

Additionally, a heightened anxiety state can snap a person out of their attempts at relaxation quicker than the average person. Racing thoughts are like a movie reel that never turns off, and this can disrupt other areas of life.

#4: You Have Trouble Falling Or Staying Asleep

With the body on a constant high alert, it can be difficult to get a good night’s rest. Racing thoughts that continue while trying to fall asleep can make it hard to sink into a deep slumber. Additionally, worrying about not being able to fall asleep can increase the body’s stress response and make it even harder to rest.

Research also shows that those with anxiety are more likely to have a high sleep reactivity. This means their sleep cycles can easily be disrupted, sometimes leading to insomnia. Lack of sleep puts stress on the body, making it even more difficult to control anxiety.

#5: You’re Easily Irritable

The burden of trying to function while coping with anxiety can make minor inconveniences, difficult personalities, or unforeseeable events even more irritating. With a stress response system that is already in overdrive–and the effort of maintaining a state of high function–small things that don’t bother others may set you off.

High Functioning Anxiety Help

Struggling with any anxiety disorder can be difficult, but the internal chaos of high functioning anxiety can lead to burnout and poor health. However, there are many ways to get help and cope with anxiety. Good mental health practices, like mindfulness, exercise, yoga, deep breathing, and meditation can all help calm the nervous system and help you cope with anxiety.

Since the brain and body are intrinsically connected, supporting both is vital in relieving symptoms of high functioning anxiety. A natural, science-backed supplement like Be Serene can help promote a state of calm and boost mental resilience.

If you recognize any of these signs in yourself, remember that your anxiety does not define you. Remember the moments it may have helped you and the successes you have achieved–despite struggling internally. Dealing with high functioning anxiety is proof that you are strong, capable, and have the power to find ways to cope.


  1. Anxiety disorders. https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml  
  2. Burgess A. Anxiety and Perfectionism: Relationships, Mechanisms, and Conditions. Perfectionism, Health, and Well-Being. https://doi.org/10.1007/978-3-319-18582-8_8  Published September 15, 2015.
  3. CL; KDAAJRD. The impact of stress on sleep: Pathogenic sleep reactivity as a vulnerability to insomnia and circadian disorders. Journal of sleep research. https://pubmed.ncbi.nlm.nih.gov/29797753/  

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About Dr. Morgan Camp M.D.

Dr. Morgan is an expert in Functional and Integrative Medicine with a Strong Emphasis in stress related illnesses like anxiety and insomnia. In addition to his 20 years of work in Functional Medicine, he has expanded his practice to include work on the deeper aspects of our being that point to the root cause of our illnesses working with Mind Body Wellness, Energy Medicine, and Healing with Consciousness.
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