Navigating the Maze: Understanding High Functioning Anxiety

By Megan Allcock, AMFT

Anxiety is a common mental health condition that affects millions of people worldwide. While it manifests differently in each individual, there is an unofficial subtype often labeled as High Functioning Anxiety. So what is that exactly?

High functioning anxiety is not an officially recognized mental health diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Instead, it's a term used to describe individuals who outwardly appear to have their lives together while silently battling persistent anxiety beneath the surface.

Some of the key characteristics of High Functioning Anxiety include:

• Perfectionism: Setting impossibly high standards for themselves, striving for flawlessness in every aspect of their lives.

• Overthinking: Constant overthinking and ruminating about past events or future scenarios.

• Procrastination: Ironically, some individuals with high functioning anxiety may procrastinate tasks due to the fear of not meeting their own high standards.

• Constant Worry: Excessive worrying, even about trivial matters, is common as well.

• Difficulty Relaxing: People with high functioning anxiety may find it challenging to relax or "switch off," always feeling the need to be productive or busy.

• Physical Symptoms: While not always present, physical symptoms like muscle tension, restlessness, and gastrointestinal issues are common too.

So how is it different from typical anxiety? The main difference between high functioning anxiety and typical anxiety is the ability to maintain a presence of “normal”. High functioning anxiety often goes unnoticed because individuals suffering from it have developed coping mechanisms to navigate daily life effectively. They may excel at work, maintain social relationships, and fulfill responsibilities, all while concealing their inner stress and anxiety. 

If you think you might suffer from this, here are some tips to help manage it better. 

• Self-awareness: Recognizing and accepting that you have high functioning anxiety is crucial. Understand that it's okay and often necessary to seek help and support.

• Therapy: A therapist can provide tools and strategies to cope with anxiety symptoms as well as navigate some of the underlying causes for your anxiety.

• Medication: Medication prescribed by a healthcare professional may be necessary and very helpful to alleviate anxiety symptoms - usually in conjunction with talk therapy.

• Self-care: Prioritize self-care activities such as regular exercise, adequate sleep, a balanced diet, and relaxation techniques as often as possible.

• Set realistic goals: Challenge the need for perfectionism and set achievable, reasonable goals for yourself. Practice self-compassion.

• Establish boundaries: Learn to say no when necessary. Setting healthy boundaries can prevent overcommitting and feeling overwhelmed.

• Seek support: Share your feelings with trusted friends or family members. Often, simply talking about your anxiety can provide some relief.

So you’ve developed some social anxiety during the pandemic? Now what?

By Megan Allcock, AMFT

According to the National Institute of Mental Health, social anxiety disorder is a mental illness characterized by an intense, persistent fear of being watched and judged by others. This fear makes it difficult to work, hangout with friends and generally function in a “normal” way. While not everyone is diagnosable, there are plenty of people who identify with certain characteristics of this mental illness.

For the past 16 months everyone’s social interactions have been limited. Whether you have been completely isolated, or had minimal interactions with friends, family, or coworkers no one has been living a completely normal social life.

As I sit with clients week after week I have noticed some common themes come up for everyone. First, saying yes to any and all plans offered. Before the pandemic people felt they could more freely choose when they wanted to socialize and when they wanted to have alone time. Now, many people are feeling such a draw to say yes because they have been lacking for so long.

I recommend thinking about how much time you would like to spend doing particular things in your life. Break it down into hours or percentages or whatever works for you. Take into account the things you MUST do each week such as work, exercise, sleep, eating, etc. And then figure out how much time you realistically have for “free” activities. Next, consider how much of that free time you want to spend by yourself and how much you want to spend with others. Having a clear idea of your priorities will help you make more informed decisions.

Second, people are feeling completely depleted from the new expectations being set. We have adapted in the past year to spending time alone, or with very few people. Now many of us are expected to be at the office, then attend happy hours, and have plans during the weekend. We have weddings to make up for, birthdays, etc. It can all start to feel so overwhelming.

Start by practicing saying NO because you are not obligated to say yes to anyone except yourself. If you want to go out to dinner with that friend, then do. If you want to sit at home and read a book alone, then do that instead. The opportunity to go out to dinner with a friend will always be present. Make the choices that work for YOU, not everyone else.

Another theme I’ve seen a lot is the anxiety associated with returning to work. Some people have loved working from home and adjusted to the ability to do laundry or other house chores while working. As businesses start opening and return to offices starts up I have notices a spike in anxiety. There are so many reasons this anxiety may be spiking for you. Some things I recommend to help ease that a bit is setting boundaries for yourself and communicating with your boss effectively.

Pay attention to the parts of working from home that worked for you and try to see how you can implement some of those while being in the office. If that means bringing some comfort items in such as your favorite mug or blanket, do it! Having a serious conversation with your boss or supervisor about how working from home impacted your mental health could also be an important step. Ask if you could have a hybrid work option. Remember that the only person who will advocate for your needs is YOU.

Overall, give yourself some grace because this is a big adjustment period. There has been so much change in the past 16 months and although there is a lot of excitement about seeing people, it also comes with a cost. Be kind to yourself when it feels a little awkward. Be kind to yourself when you’re not in the mood to go out. Remember you are rebuilding a muscle. When a person trains for a marathon they don’t start by running all 26.2 miles immediately, they have to build up slowly. This concept applies for you building your social muscle back. It will take time for you to be able to be social the way you used to be (if you even want to go back to that) and that is OKAY.

The Next Phase & Living in the Grey

Image by Lilli Caré for the New York Times

By Sasha Taskier, LMFT

In the beginning of March, when many of us were beginning to quarantine, there was so much anxiety. How big are the risks? Will we get sick? How long will this last? Will the grocery stores restock? Will we have enough food? Will we keep our jobs? Of course, all of these questions persist, but the palpable anxiety has diminished (for many of us) as we’ve settled into new routines, transitioned from in-person to Zoom meetings and gatherings, and have continued to keep our day-to-day life confined under our roofs.

For many of us, it has been incredibly difficult (isolating, no childcare, homeschooling, more stress and fighting at home, etc.), AND we’ve also had the privilege of staying home, staying safe and staying healthy. Now, as we begin to enter the next phase of all this - and we see our neighboring states open up their parks, bars and restaurants and Chicago begins to “soften” on the lock down - I’ve been seeing another spike in tour collective anxiety. There is a new sense of uncertainty, a new challenge for us -- how to live in a grey area of risk.

Just weeks ago, it was pretty black and white - you can only leave the house for emergencies, essential services and groceries. Restaurants, bars, playgrounds, schools, the lakefront are all closed. Now, we each have a million and one questions to ask ourselves; can a friend come over if we stay outside and are six feet apart? Can grandparents finally come see their grandkids? If daycares reopen, is it safe to send our children? Should we go to a restaurant if outdoor seating is available? The list goes on and on… and unfortunately, there are no clear answers.

Anxiety breeds in uncertainty. When we perceive risk, when we feel scared or threatened, it grows. This is an unprecedented time in our collective memories, and this new phase is no different. Many of us have to ask some really hard questions of ourselves and our families and friends. Navigating school, playdates, gatherings etc, will now all require a new level of personal introspection, couple & family communication and trust in our communities.

Here are some resources that may be helpful as you and your families begin to think about next steps and make decisions about what feels safe for you and your loved ones:

A New Thing to Fight About; Virus Risks, Jessica Grose Interview with 3 couples: When Couples Fight about Virus Risks, Jessica Grose

What Parents Should know as States ReOpen, Annie Sneed

Safety Advice for Reopening, Andrea Petersen

The Horror of the Corona Virus Data Log, Amanda Mull

5 Grounding Exercises for When Anxiety Hits

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By Caitlin Nelson, LMFT

Anxiety is often not a favorite feeling. It can make us feel panicky, tense and not in control. While helpful in small amounts, anxiety can feel overwhelming when it is more intense. Grounding techniques are helpful in-the-moment exercises to decrease those feelings of anxiety and bring us back to the present. Here are five quick grounding exercises to try when you’re feeling anxious:

1. The “54321” Technique

- Name 5 things you can see right now (tree, bookcase, etc)

- Name 4 things you can feel right now (feet on floor, back on couch, etc)

- Name 3 things you can hear right now (music, people talking outside, etc)

- Name 2 things you can smell right now (fresh air, food cooking, etc)

- Name 1 good thing about yourself (I am thoughtful, I am strong, etc)

2. The Category Game

Try to name as many different items in a category that you can remember, such as different types of dog breeds, movies you’ve seen, cities you’ve visited, types of food, etc.

3. Square Breathing

- Inhale for 4 seconds

- Hold for 4 seconds

- Exhale for 4 seconds

- Hold for 4 seconds

- Repeat

Focus on how your breath feels coming in and out of your body during this exercise, and make sure to breathe from your diaphragm so that your belly expands before your chest.

4. Repeat a mantra or soothing statement to yourself

- “I can handle this”

- “This feeling will pass”

- “I am safe right now”

5. Remind yourself of things you are looking forward to in the next week

- Trying a new restaurant

- Going to a movie

- Spending time with a friend