What does high functioning anxiety or depression look like?

You may have heard people around you using the term “high-functioning” to describe themselves and their mental health. Phrases such as high-functioning anxiety and high-functioning depression are being used more and more, but what do they mean?

High-functioning anxiety and depression are not technically clinical diagnoses because they are not listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a handbook used by mental health professionals. However, many practitioners and researchers recognize that people can experience symptoms of anxiety or depression and continue to be highly functioning, productive individuals. Those who have high functioning anxiety or depression may not appear to struggle with it on the surface, despite experiencing symptoms internally. To others, they may seem to have it all together or go about their days as they normally would.

What Does High-Functioning Anxiety Look Like?

People with high-functioning anxiety may experience symptoms of anxiety disorders, such as excessive worrying most days, feelings of restlessness, fatigue, difficulty concentrating, irritability, muscle tension, or trouble sleeping. However, these symptoms do not cause significant problems across areas of their lives and do not inhibit daily functioning. Some common characteristics of individuals with high-functioning anxiety include:

• High-achieving, with a fear of failure
• Extremely organized & detail-oriented
• Engages in nervous habits, such as nail-biting, hair twirling, lip biting, leg shaking, etc.
• Perfectionist with a harsh inner critic
• Active & needs to keep “doing,” finding it hard to relax
• Appears calm on the outside, but may have racing thoughts 
• People pleaser who has a hard time saying no
• Procrastinates when stressed 
• Talks a lot or has nervous chatter
• Overthinks and overanalyzes everything
• Difficulty expressing emotions 
• Need for repetitions and reassurance 
• Tendency to dwell on the negative

What Does High-Functioning Depression Look Like?

Similarly to high functioning anxiety, individuals with high-functioning depression may not meet the criteria for a clinical diagnosis of depression, but are able to function normally most of the time. Thus, their depression is often not clear to others or themselves. Typical symptoms of depression would include persistent sad mood, feelings of hopelessness, worthlessness, and/or guilt, loss of interest in hobbies or activities, fatigue, irritability, trouble sleeping, changes in appetite or weight, or thoughts of death or suicide. The following may be characteristic of an individual with high-functioning depression:

• Feeling a little down most of the time
• Poor self-esteem
• Difficulty making decisions
• Low energy and motivation 
• Performs well at school or work, but has difficulty focusing on tasks
• Crying a lot without any concrete reason
• Forcing oneself to engage in social activities when they’d rather withdraw 
• Feeling overwhelmed 
• Feeling lonely 

The Role of Stress

Before determining whether or not you have high-functioning anxiety or depression, it is important to first consider current stressors and evaluate their impact on your life. April is National Stress Awareness Month. We all experience stress in response to challenging circumstances and some times are more stressful than others. This is our body’s normal response. However, if these symptoms persist well beyond a stressful event or are consistent and unrelated to specific stressors, you may be experiencing high-functioning anxiety or depression. 

This truly highlights the importance of good mental health care and scheduling check in’s with a mental health therapist. The opportunity for building insight and awareness of our emotional loads and the management of that load is done best with the help and insight of a professional who can guide you through this. Everyone should consider seeing a therapist! When you are ready to do so, you can visit our therapist’s page to find a clinician who fits you best. 

Sources: nimh.nih.gov, rtor.org, psyccentral.com, waldenu.edu, health.usnews.com, washingtonpost.com