Anxiety or High Functioning Anxiety?

Anxiety versus high functioning anxiety… what’s the difference?


The general definition of anxiety is “a feeling of worry, nervousness, or unease, typically about an imminent event or something with an uncertain outcome.” It’s important to state that EVERYONE has anxiety, it’s just a matter of to what degree you experience it. But in order to be diagnosed with any type of anxiety-based disorder, you need to meet what we call “Clinical/Functional impairment”. Functional impairment refers to the limitations you experience in functioning in the social and occupational spheres of life. This basically means your anxiety symptoms are causing issues in major areas of your life: work, school, home, relationships, self-care, communication, etc.


In my blog, Anxiety 101, I discuss what it looks and feels like to experience anxiety. So, here’s the big secret: High Functioning Anxiety (HFA) IS anxiety. Yup, good ole fashioned anxiety. We have to set a standard for something to be called an illness and by definition, HFA is not an illness. Anxiety that does not meet criteria for diagnosis or functional impairment as we know it, but still causes distress or can compromise your quality of life. It is excessive anxiety that causes a person to live life under duress, while still not preventing activity. They are on edge but pushing through.[1]


The difference is the person with symptoms typically does not meet clinical impairment. You wake up feeling uneasy and nervous, but get up and get dressed for work anyway. Typically, you are stable in your employment and are often in positions of authority or management. By every stretch of the imagination, you are functioning. Going to work, taking care of kids, attending school, attending some social events, completing tasks, but you do it under duress. You have a spouse and children and may even report being happy in your marriage. You may try to express your feelings to an older person and the elder may feel like their life was harder, so you have nothing to worry about. Another indicator is that you have been told by a clinician that you are not ill enough to continue treatment and are therefore sent away without any resources or referrals. You seek therapy and are often referred to groups or told “Well it sounds like you have it all together”. As a client, you don’t have the language to articulate to the clinician that no, in fact, I am not altogether.


You may feel exhaustion, hopelessness, loneliness or isolation because no one understands or takes your complaints seriously. They brush it off and normalize your symptoms by saying things like “everyone has that, you just have to keep going.”

In short, you are experiencing symptoms of anxiety, but because they are not stopping you from completing your daily tasks, you don’t think you have a legitimate problem. That coupled with friends telling you everyone goes through it, older people telling you that’s just how it is, and clinicians telling you that are aren’t ill enough to stay in their office, all adds up to you not getting the support that you need.


What do you do?


1. Get educated: Learn about anxiety and how it is impacting you specifically- knowledge is power. When you understand your symptoms, it demystifies your experience. Instead of feeling out of control, you can put a name to it and take steps to address it.


2. Take care of yourself:

Self-care (slow down, take time off work, take a weekend trip/staycation), practice deep breathing, journal, imagine the best possible outcome and focus on it... Essentially, do things that help you to feel at ease and relaxed.


3. Speak to a professional: Go see a therapist, but this time, go back with a better understanding of your symptom presentation. Tell them what it is like on your worst day. Tell them how upsetting it is to experience your symptoms. Do not go in there and attempt to make it sound “not so bad”. This is not the time to downplay your symptoms and try to make yourself appear more put together than you are. This is the time to tell someone about all those times you struggled quietly and felt like you would never get the support you needed.


Also, see a psychiatrist. Listen, don’t sleep on medication. The myth is that once you start, you will be stuck on if forever… not true! You can take mediation long enough to stabilize you and lift your mood. When you concurrently take meds and receive talk therapy, you learn the behavioral techniques needed to change your symptoms presentation.


Your experience is valid! Never be afraid to take action to improve your mental state and ultimately, your quality of life!


And remember, Therapy is a LIfestyle!





[1] (http://www.health.com/anxiety/high-functioning-anxiety-disorder-symptoms).

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