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- General Topics
- EATING DISORDERS
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Feeling anxious from day to day is a normal human emotion; however, when these distressing thoughts inhabit a major chunk of the day, it indicates an underlying anxiety disorder. Like most disorders, anxiety manifests itself in different ways, one of which is known as high functioning anxiety. This catch-all term describes people who live with anxiety but continue to function reasonably well and without any apparent limitations.
Despite being an unofficial diagnosis, high functioning anxiety can be extremely debilitating and stressful. The disorder often goes unnoticed as the affected individual continues to function in almost all aspects of life. However, behind the scenes, the disorder takes a significant toll on their emotional and mental well-being. Understanding how to recognize high-functioning anxiety and managing it effectively is the key to overcoming the associated struggles.
The Diagnostic and Statistical Manual of Mental Disorders (DSM) does not recognize high-functioning anxiety as a distinct disorder. Nevertheless, experts often use this term in informal settings to describe people exhibiting the characteristic symptoms of anxiety while maintaining a reasonably high level of functionality across all aspects of life. Such people are often successful in their personal and professional lives, yet struggle with persistent feelings of self-doubt, fear, and stress. Many of them feel very uncomfortable inside and often struggle with self-criticism. [1]
To an outsider, a person with high functioning anxiety and depression appears to be in full control and ready to excel. Such people do not appear to be retreating from life or avoiding any struggle. Many have successful careers, engage in regular community services, and enjoy strong personal relationships. However, behind this successful life, such people hide persistently severe worries, stress, and fear that always keep them on edge.
High functioning anxiety often leads to a combination of physical and emotional symptoms linked to generalized anxiety disorder. These symptoms may include general nervousness, feeling tense, and excessive worry. Additionally, the following are the common signs of high functioning anxiety:
In addition to the mental health issues mentioned above, people with high-functioning anxiety may also develop physical symptoms, such as the following:
The intensity of the symptoms mentioned above may vary depending on the level of functioning.
So far, experts have proposed the following as potential causes of high functioning anxiety.
Experts have identified certain traits that are closely linked to high functioning anxiety. For example, perfectionism is a trait commonly seen in people with high functioning anxiety. It has been found to trigger the condition by pushing them to set exceedingly high-performance standards for themselves. [2] It is not uncommon for this relentless pursuit of perfection to make such people constantly self-evaluate themselves and fear failure.
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Similarly, people who are detail-oriented and highly conscientious are more likely to develop signs of high functioning anxiety. These traits do contribute to success but also nourish a ground for anxiety to thrive.
Cultural and social influences can play a great role in triggering high functioning anxiety. Societal expectations and norms, when it comes to social status, achievement, and success may force a person to strive for more. This is especially true for people living in cultures valuing high achievement as it forces them to maintain a façade of control and competence regardless of their mental health. Experts believe that social media has significantly exacerbated this issue as it has perpetuated unrealistic comparisons and set unachievably high standards for others to gain.
Genetics plays a critical role in the development of different types of anxiety, including high functioning anxiety. Research suggests that anxiety disorders run in the family, proving that it has a hereditary component. Specific genetic variations can impact how the body produces and regulates mood-altering neurotransmitters, like dopamine and serotonin. Hence, it is safe to say that people with a family history of anxiety disorder or borderline autism are more vulnerable to developing high functioning anxiety. [3]
Early experiences, particularly the ones involving trauma or stress, can often lead to the development of various anxiety disorders. Children growing up in environments with lots of criticism, high expectations, or neglect become more sensitive to stress. Additionally, academic pressure, bullying, and changes in family dynamics also trigger this anxiety disorder. Experts believe that these early disorders contribute to shaping a person’s stress response and coping mechanisms, leading to high functioning anxiety.
Various biological factors, such as neurochemical imbalances in the brain, are known to trigger anxiety. Chemicals like gamma-aminobutyric acid (GABA), norepinephrine, and serotonin play critical roles when it comes to mood regulation and anxiety control. Any irregularities in these chemicals can exacerbate the anxiety responses. Moreover, any overactivity in certain neural areas, such as the amygdala, can also contribute to high functioning anxiety.
Modern life is full of stressors that directly trigger and exacerbate high functioning anxiety. Stress coming from financial pressures, demanding jobs, personal relationships, and social expectations can exacerbate the signs of anxiety to the point that it turns into high functioning anxiety. Many societies now equate success with consistent achievement and productivity which may make many people feel inadequate and anxious.
Catastrophic thinking, negative thinking, and other similar cognitive patterns are commonly seen in people with underlying high functioning anxiety. It is common for such people to think often, constantly dwelling on their ongoing problems while imagining worst-case scenarios as their result. These cognitive distortions push people into a cycle of anxiety that eventually becomes impossible to get out of.
People of all age groups and genders are prone to developing high-functioning anxiety. However, some groups are naturally at a higher risk, such as women who are twice as likely to develop this issue than men. This increased risk comes from various factors such as more societal pressure, relationship concerns, and gender roles.
Other people at a higher risk of acquiring high functioning anxiety include those:
To get a diagnosis of high-functioning anxiety, a mental health professional conducts several laboratory tests along with a physical examination to rule out other potential causes with similar symptoms. If no physical cause of the symptoms is identified, psychological evaluations are conducted to make a diagnosis.
In general, mental health professionals rely on the DSM-5 criteria to identify an underlying anxiety disorder. This criterion includes the following:
Since people with underlying high functioning anxiety can control or mask their symptoms, it is imperative to talk to a healthcare professional about ongoing symptoms and concerns with full honesty. Honest conversations ensure that affected individuals receive an accurate diagnosis and commence effective treatment tailored to their specific issues.
A typical high functioning anxiety treatment program involves a combination of lifestyle modifications, therapeutic strategies, and occasional use of medications to control symptoms. Because an individual with high functioning anxiety typically appears successful and therefore reluctant to seek help, the treatment approach must involve understanding and empathy.
CBT is one of the most effective therapeutic modalities to treat anxiety disorders. It focuses on identifying and changing negative behaviors and thought patterns, which may otherwise fuel the underlying anxiety disorder. [4] Following are some common techniques used in a CBT session:
This therapeutic approach is highly beneficial for people with high functioning anxiety. The technique involves helping people accept anxiety as a natural part of their lives and committing themselves to actions aligning with their values. The following are some common components of ACT:
In some cases, experts may prescribe medications to keep high functioning anxiety and depression in control. [5] Some commonly used drugs in this context include the following:
Remember that medications for high functioning anxiety must only be taken after consulting with a healthcare professional due to varying individual needs and possible side effects.
In addition to professional treatment modalities mentioned above, the following self-help strategies can also help effectively manage the ongoing issues:
Each person has a different energy level and needs. Some individuals thrive when they are on the move while others require time to decompress. Individual needs, such as nutrition, self-care, sleep, work-life balance, and exercise, highly vary from one person to another. The important thing is to tweak daily life in a way that brings peace.
Accepting criticism may be the most difficult aspect of high functioning anxiety. Many people with this issue get defensive or snap back when faced with criticism. However, a therapist can help them acquire skills to step back and evaluate their feedback before responding impulsively.
People with underlying anxiety very commonly compare themselves to others, constantly feeling as if they need to improve. Such comparisons reduce the element of contentment and joy from life while refueling high functioning anxiety.
Many people with high functioning anxiety hide their symptoms, believing that they have to manage their symptoms alone as discussing them may lead to negative outcomes or criticism. In reality, having a support system can help ease their anxious thoughts and enable them to worry less about certain triggers. [6]
This practice involves being more aware of the present moment and concentrating on it to promote peace and calm.
High functioning anxiety often causes people to fixate on society-defined success, such as having the perfect house, car, job, or material possessions. For them, these items become important just because other people value them. To get over these fixated ideas, a therapist can help with learning how to think outside society’s expectations and align the ongoing
Boundaries can help people with high functioning anxiety establish rules for themselves while improving relationships with others. As a part of this tip, such people learn how and when to say no to avoid overextending themselves. At the same time, boundary setting allows such people to say yes to opportunities stretching their comfort level. [7]
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