Did you know that anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults, or about 18% of the population every year? And it appears that number is climbing. In 2019, 8.1% of respondents to the National Household Pulse Survey reported symptoms of anxiety. Compared to data collected from April 23, 2020 to March 29, 2021, an average of 30% of respondents now report symptoms of anxiety.
While navigating life during a global pandemic has definitely brought on its own unique set of challenges, our collective desire to “get back to normal” may be giving rise to a unique form of anxiety: high-functioning anxiety.
“High-functioning anxiety gives us the ability to still engage in our surroundings. The panic, fear and worry are all still present, but less invasive,” says Alex Podowski, LPC, an intensive outpatient program therapist at Texas Health Behavioral Health Center in Uptown.
That being said, we want to know more about high-functioning anxiety, what it looks and feels like and the treatment options available.
What Is High-Functioning Anxiety?
Before we go any further, we have to clarify that high-functioning anxiety is not a formal clinical diagnosis. Instead, it’s a popular social phrase to describe a level of anxiety that still results in a high or moderate level of functioning. Because those with high-functioning anxiety can, well, still function at a high rate, the term also tends to be less harshly stigmatized.
While high-functioning anxiety is anxiety, Podowski adds that the trendy name may actually take away from the severity of the situation — for both the person suffering and those observing.
“[The name] seems to perpetuate our hustle culture and/or the idea of, ‘if you are still functioning, it must not be that bad’ — which is false,” she explains. “I, oftentimes, lean into the idea of just because you CAN do something, does not mean you SHOULD be doing something. Ultimately, people can function with different levels of [mental illness], but that does not always mean the outcome will be continued forward momentum in that person’s life.”
What “High-Functioning” Anxiety Can Look or Feel Like
The idea of ‘pushing through’ often creates a higher risk of more severe anxiety in the future, Podowski adds. But it can be difficult for someone to identify mild anxiety, or “high-functioning,”, within themselves or others since there can be such a wide range of symptoms and many can seem vague or similar to other conditions, such as stress. Because of this, you may not even realize you’re suffering from anxiety and therefore don’t seek help while it’s still in a mild form.
“‘High-functioning anxiety’ would look like racing thoughts, perpetually negative outcomes being created in your head, lots of internal personal judgment talk (i.e. “why can’t I do this”, “what is wrong with me”, “this is never going to work out”, etc.),” Podowski explains. “However, it is possible to still take action with lower levels of anxiety. The actions might still be anxiety-provoking, but action can occur, nonetheless.”
In contrast, Podowski adds that Generalized Anxiety Disorder (GAD) has more debilitating symptoms that become so difficult to manage that our body shuts down for us.
“Essentially, we might know it is good to get up and get out and be social, but generalized anxiety will create an internal dialogue full of catastrophic thinking that makes it almost impossible to move,” she explains.
Lifting the Stigma and Asking for Help
Even today, the stigma around mental health is still incredibly alive, according to Podowski, which leaves people functioning from a dangerous and unsustainable space much longer than needed.
“I think most mental health concerns go undiagnosed until they present at such a debilitating level that it cannot be ignored, and anxiety is no different. Anxiety is often swept under the rug and minimized by peers/family/workplaces,” she explains. “There are lots of statements like, ‘Just get up and do it,’ or ‘Everyone gets anxious,’ which might be true because most people do get a level of anxiety or panic at some point in their lives. However, generalized anxiety disorder (GAD) is much more complicated than that. Essentially, telling someone with GAD to “just get up and go, it won’t be that bad” is like telling someone with a stomach bug to stop vomiting — it is impossible.”
So how can you discern whether what you’re feeling is in direct relation to an anxiety-provoking moment in time (a move, a big project at work, an upcoming event, etc.) or something more? Podowski says to remember that sometimes we have triggers that will make us anxious, such as the ones stated above, but if more and more things are becoming triggers, it may be a sign of something less temporary and more serious.
“Something that can help differentiate is the idea of something being uncomfortable, but not intolerable,” Podowski adds. “As anxiety goes unmanaged, more and more things become intolerable (physically feels impossible to take on a task that used to feel manageable), and we begin to experience anxiety attacks (difficulty breathing, racing thoughts, increased heart rate, dizziness, nausea, upset stomach, severe headaches, crying spells and isolation.)”
It’s OK to ask for help, no matter where you are on the spectrum of anxiety or mental health. Like anything else, anxiety left untreated can worsen, pulling us from things we used to love to engage within.
Getting the Help You Need
Podowski adds that the beauty of treatment is the abundance of options, especially now as the pandemic has normalized telehealth services that make getting behavioral health treatment even more accessible to more people. The pandemic has also brought up the importance of taking care of our minds versus just our bodies.
“There are lots of options for treatment,” Podowski says. “For some individuals, it is stepping into outpatient therapy to gain some coping skills, learn your triggers and just talk about some of the things plaguing your day-to-day before it builds to be too much for one person to handle. For others, it could look like starting with exercise, yoga, mindfulness or meditative practices.”
More severe forms of anxiety require a higher level of care, sometimes in conjunction with medication management. That can look like joining intensive outpatient programming, partial hospitalization and even inpatient therapy if someone is unable to do even the most basic of tasks due to their anxiety.
Podowski encourages people to start the dialogue early, saying it’s never too early to get help, even if that help just looks like carving out an hour of your time once a week to talk about your stressors with someone that can help you increase your coping skills and relieve your stress.
“I think normalizing anxiety is a great place to start,” Podowski adds. “Open a dialogue about things we are anxious, nervous, stressed or angry about and encouraging others to share too. It can also be helpful to just ask someone if they need anything. The idea that we are supposed to do life alone is something that can keep us stuck in patterns that we might not need to be enduring.”
If you are starting to feel burnout, high levels of stress or see dysfunction in your day-to-day, Texas Health Behavioral Resources are offered at 18 locations throughout North Texas. For additional information or to find resources, call (682) 626-8719.