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.

Embracing the Both/And Mindset: Letting Go of the Either/Or Perspective

By Jeessy Weston, amft

As a therapist, one of the most common mental hurdles I observe among clients is the dichotomous trap of either/or thinking. We are often inclined to categorize life into black and white, right and wrong, good and bad. While this binary approach may occasionally serve us in decision-making or problem-solving, it frequently oversimplifies our intricate human experiences and realities. I'd like us to consider a healthier, more balanced approach: the both/and mindset.

The Both/And Mindset

This way of thinking is all about accepting that different, even contradictory, things can be true at the same time. It allows us to see and accept the messy, layered parts of life. It's like saying, yes life can be tough, but it can also be amazing, all at the same time.

The Downfalls of Either/Or Thinking

Either/or thinking is a one-way street. It boxes us into corners, makes us judge ourselves harshly, and can turn little problems into big ones.

Imagine you've had a challenging day at work. You made a mistake on an important project, but you also received praise for your communication skills in a tough meeting. The either/or mindset might lead you to label your day as 'bad' due to the mistake. However, the both/and approach allows you to recognize that your day was challenging but also rewarding, that you made a mistake but also succeeded.

By transitioning from the either/or mindset to the both/and mindset, we create space for growth, self-compassion, and resilience.

How to Think in Both/And

Now, let's look at how we can start thinking in both/and:

Embrace complexity

Understanding that life is inherently complex and nuanced is the first step. It’s important to remind yourself that people, emotions, and situations rarely fit neatly into binary categories.

Practice self-compassion

Self-compassion is fundamental in transitioning from an either/or mindset to a both/and mindset. This means accepting that you can be a work in progress and yet still be worthy and capable. Messing up doesn't mean you're a failure. It just means there's room to learn and grow.

Seek balance

Instead of choosing between success or failure, think about learning and growing. Remember, you can be strong and still have moments of vulnerability.

Question your thoughts

If you find yourself thinking in black and white, challenge those thoughts. Ask yourself, "Is it possible for both of these things to be true?" or "Are there other perspectives I could consider?" Most of the time, you'll find there is.

Seek support

Changing a deeply ingrained mindset takes time and patience. If you need support, seek help from a mental health professional who can provide you with tools and strategies to navigate this journey effectively.

Conclusion

In the end, life's a crazy, messy, beautiful mix of experiences and feelings. Embracing a both/and mindset allows us to see and accept all of that. As we learn to let go of the rigid either/or thinking, we open ourselves up to a more forgiving, balanced way of living. And that's something we could all use a little more of, right?

Ambivalence is Two Simple Things

By Anne DeCore, LMFT

Ambivalence is a natural human phenomenon, one that we all experience every day. It is common to want change, and also not want change, at the same time. The brain will contemplate the pros and the cons (the “decisional balance sheet”) of a particular change and then, voila, we find ourselves stuck. We come up with a reason for, and a reason against, and then ambivalence settles in.

As a clinician I regularly see clients experiencing ambivalence. Common ones are: ambivalence about changing one’s alcohol use habits; about whether or not to set a boundary with a family member; about staying or leaving an unstable relationship. My thinking toward ambivalence has been shaped by the works of Bill Miller. Miller is the author of Motivational Interviewing: Helping People Change, and he focuses on the topic of Ambivalence more directly in his most recent book On Second Thought: How Ambivalence Shapes Your Life. His writings, research, and techniques have been praised and used by professionals across disciplines such as teaching, coaching, medicine and psychotherapy to name a few.

Ambivalence, he says, is two simple things: change talk (arguments for change) and sustain talk (arguments against change).

Interestingly, when we want to help a friend or family member whom we think would benefit by a change in their lives we tend to argue for change. But because of the way the brain is structured, when we push for change in someone else, we end up evoking the other side of their own ambivalence. We often cause the other person to talk himself or herself out of changing. This happens between partners in a couple, between parents and kids, between friends, and occurs in the therapy and medical worlds between clinicians and clients: sometimes, the more a clinician pushes for change, the more the client responds with opposition. This oppositional reflex, found in all of us, is called the righting reflex. The clinician’s attempt to help can have a paradoxical effect, reinforcing the maintenance of status quo.

So what then is the path to resolving ambivalence? How does a person decide whether a change is advantageous?

The pathway to breaking through ambivalence is about setting your GPS to a clearly defined destination and asking if making that change helps you get to the coordinates you set for yourself. If you are stuck in ambivalence, have a series of wide-ranging conversations with yourself or with a therapist where you explore what you clearly know you do want in your life. What do you care about most? What do you want your life to mean? To look like? What is most important to you in terms of who you are, and who you want to be? Explore your values and goals. These talks will define the coordinates you want to travel toward. Then, and only then, do you ask yourself, does the change I’m considering help me get there. You look at your goals in relation to the alcohol use, the boundary, the unstable relationship. Does alcohol help you accomplish that goal? Does setting the boundary with the family member help you be the kind of person you described? Is the unstable relationship neutral or does it act as an obstacle to what you care most about?

As friends, family members, or therapists, when we know with clear conviction that a person really needs to make an important change, we need to listen to their sustain talk without trying to reason the person out of it. When we listen with empathy, their need to say it goes down because their experience of feeling understood goes up. Through non-judgement, empathy and curiosity we can be a helpful part of the person evoking their own reasons and motivations for change. As frustrating as it can be at times, we cannot instill in them our reasons for their change.

Reference:

Miller, W. R., & Rollnick, S. (2012). Motivational interviewing: Helping people change. Guilford press.

Miller, W. R. (2021). On Second Thought: How Ambivalence Shapes Your Life. Guilford Publications.

Scheduling Time for Rest

By Megan Allcock, AMFT

I often find myself sitting with clients who feel like they need to be doing more, whether it be at work, in their personal life, in their relationships, and even in regards to their mental health. For a while I thought maybe it was just a certain type of client, perhaps those high achieving perfectionists. I’ve started to notice every single client is feeling this way in at least one area of their life.

 In recent years there is a lot of language around “boss babes” and this idea that we constantly as humans need to be moving and being productive. The intensity level of hustle culture has reinforced to everyone that if you’re not busy and running yourself ragged then you aren’t doing enough. This is incredibly false. 

Productivity is a concept I find many people struggle with. The constant push and pull to be productive while desperately wanting and needing rest seems to be never ending. The thing is though, rest IS productive. Our bodies inherently need rest to function and be able to be our most productive selves with the other areas of our lives. Let's use marathon training for an example, most people don’t run 20 miles the day before running a marathon. In fact, they don’t usually run for the two or three days leading up to the marathon. They do this so that their legs are well rested and ready to run their fastest and longest distance. 

Life is kind of like a marathon, so when you do something big like run 26 miles, you need to rest before and after. This doesn’t just apply to the big stuff, but the small events in life as well.  One way I find it helpful to force yourself to rest is by scheduling it. Try picking a specific day a week to have just time for yourself to lounge, watch tv, do whatever you want that feels restful to YOU. Rest looks different to everyone, so make sure you’re listening to your body.

Healing Isn’t Linear

By Megan Allcock, AMFT

With the start of the new year I think there is often this pressure for people to reflect on what they did in the past year and how they want to be “better.” Now there isn’t anything inherently wrong with reflection and wanting to grow, in fact it’s a wonderful aspiration to have. I think sometimes though it doesn’t leave room for the idea that many things in life take more than a year to heal, process and move on from. And even when it is healed, there will always be difficult days or moments of struggle because healing isn’t a linear process.

Let's use asthma as a metaphor here. Typically, asthma is worse in the winter because the dry air can irritate the airways. Now in the summer someone’s asthma will still exist but perhaps isn’t as severe. Similarly, if someone with asthma is working out that could cause a flare up more than sitting on the couch. Now if we think about mental health this way, I think there is a lot more flexibility in the space and grace we can give ourselves to heal.

With trauma and mental health in general, there will be seasons of life where something is more triggering than other times in life. Let’s say for example someone has mostly processed a childhood trauma experience, but they get into a new relationship and their new partner does something that brings up feelings related to their initial trauma. There will be moments that people don’t feel fully healed anymore from that. It doesn’t undo all the work they’ve done, but it really drives home the point that healing isn’t linear. It is OKAY to have time periods that are more difficult than others. There are so many factors that contribute to having bad mental health, so next time you want to be mean to yourself practice reminding your brain that healing isn’t linear and bad days are all a part of the process.

Mindful Living

By Karen Focht, MA, LMFT

I’ve noticed that in today’s day and age we often hear language around the concept of Mindfulness.  Even when recently driving in my car I heard an advertisement for health insurance, which focused on creating a “mindful moment” of reflection and awareness. What does this really mean, to be mindful?  What does it mean to incorporate mindfulness into our daily lives and self-care?

I recently attended a two-day workshop on Mindfulness led by Ronald D. Siege, PsyD, and quickly found myself challenged to the core.  The concepts of mindfulness that were taught during this workshop included seeing and accepting things as they are, experiencing the “richness” of the moment and freeing ourselves from having to “act skillfully”.  On the other hand, the training emphasized that mindfulness practice is not having a blank mind, detaching from our emotions, escaping pain and withdrawing from our life and reality. 

On the first day of training, Ronald Siege led a guided meditation that lasted hours.  Ok, to be totally honest it was about 30 minutes, but I found myself completely challenged through this process.  Why was it so hard to stay present in the moment?  Why did it feel like this exercise took hours rather than minutes?  Our brains are conditioned to continuously process thoughts that can often be distracting to our emotional process.  This is often how we cope to distract from anxious or painful thoughts and emotions.

As I sat in the midst of this mindfulness experiment, I found myself criticizing my inability to stay focused on the here and now.  My mind quickly drifted from my breath (where my focus was suppose to be) to my endless list of to do’s that were not being concurred due to attending a 2 day training.   The instructor immediately introduced the concept of “acceptance and loving-kindness”.  As I sat in self-criticism, I experienced tremendous validation in the idea that a wondering mind was expected, and that in these moments we can "gently and lovingly" guide ourselves back to letting it all go.  During this particular exercise the primary focus was on our breathing process. I can’t tell you how many times I had to lead myself back to my breath.  It felt like every 10 seconds or so!  Although it wasn’t a natural process for me personally, I gained so much insight into how easily I can distract myself from difficult thoughts and feelings along with the criticism attached to these feelings.  

Since completing this training I have found myself working harder to adopt the concepts of mindfulness practice in my day to day life.  It’s never easy, nor perfect, but it has created a new gentle and loving tone within.  Please take a moment to check out these resources on Mindfulness that include guided meditations. Give them a try and allow yourself to practice embracing the moment and providing self-compassion and acceptace. 

Resources on Mindfulness

http://www.mindfulness-solution.com/DownloadMeditations.html

http://www.sittingtogether.com/meditations.php

http://themindfulnessapp.com/

https://www.headspace.com/