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Ask a Therapist: What is "High-Functioning" Anxiety?

Anxiety, Ask a Therapist
3 min read

Dear Therapist: What does it mean to have high functioning anxiety?

Frame Therapist Kim Bielak weighs in…
I absolutely love this question because not only is “high-functioning anxiety” a term we frequently use but rarely define, but it also brings up underlying questions like “When is it a problem?” and “When should I seek help?” Because high-functioning anxiety is more widely accepted in our culture, it can often go unacknowledged or unquestioned for much longer than some other mental health issues.

The first and simplest way to understand high-functioning anxiety is to compare it with its opposite: debilitating anxiety. Debilitating anxiety can cause more extreme distress and inhibit your ability to effectively maintain your job performance, certain relationships, etc. With high-functioning anxiety, despite the anxiety, you’re effectively still able to meet the average demands of day-to-day life.

However, what I think is even more interesting about high-functioning anxiety is that it can also be because of anxiety that you’re able to meet - or even exceed! - the average demands of day-to-day life. People with high-functioning anxiety can often be high-achieving, highly organized, or even highly outgoing, but oftentimes these traits and associated behaviors are deeply driven by anxiety, and quite often a fear that they’re not good enough, underneath the surface.

As mentioned, a big part of the problem is that today’s society often rewards and reinforces high-functioning anxiety. It means we stay at the office late, rarely say no to others, and spend a dizzying amount of time cultivating a certain image on social media, and continue to do so because we get promoted or are awarded a certain social status as a result. But just because high-functioning anxiety can allow you to be “successful,” in order to understand if it’s a problem worth addressing, we have to ask things like: At what cost? Is it worth your mental health? Might there be other ways?

Fortunately there are many ways of working with high-functioning anxiety in therapy so that it’s not necessarily running your life. Healing high-functioning anxiety is ultimately about building confidence, self-worth, and success on your own terms.


About the author: Kim Bielak is an Associate Marriage & Family Therapist (#130527) in Pasadena, California who frequently works with clients with high-functioning anxiety, stress, and burnout using a holistic, mindfulness-based approach. Learn more or reach out directly by visiting her Frame profile here.

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** This blog series is not suited for people who are in immediate crisis. If you are in crisis, please call National Suicide Prevention Lifeline at 1-800-273-TALK(8255) or contact Crisis Text Line by texting TALK to 741741.