Anxiety SHARE

High Functioning Anxiety – Living with a Hidden Illness

It’s so easy to feel like you don’t need help. When you live with something long enough, you learn how to power through it. You learn how to keep smiling. You learn how to act as if it’s not a big deal, and find ways to manage it on your own and lonely.

But just because you can’t see it doesn’t mean that it isn’t there, and just because you can manage it doesn’t mean you are struggling. That’s why we see in this amazing piece on The Mighty. It is a story of what it’s like to live with a hidden illness, and why high functioning anxiety is still anxiety.

Anxiety is a Hidden Illness

There is something about living with a hidden illness that pushes people to try to power through it. Maybe it’s that we see visible illness in others and feel like ours is not there. Maybe it’s that if we act like it’s not bothering us, we believe it will go away. Maybe it’s something about the vulnerability of having that illness, and not wanting to open that door to others.

The piece at The Mighty illustrates these competing challenges. It does an amazing job showing what millions of those with anxiety struggle with every day, simply because they can. Relevant excepts from the article:

  • High-functioning anxiety looks like… Achievement. Busyness. Perfectionism. When it sneaks out, it transforms into nervous habits. Nail biting. Foot tapping. Running my fingers through my hair.
  • It’s silent anxiety attacks, hidden by smiles.
  • It’s always being busy but also always avoiding, so important things don’t get done. It’s letting things pile up rather than admitting you’re overwhelmed or in need of help.
  • It’s going back and forth between everyone else has it together but you, and so many people have it tougher than you.

Every type of anxiety is different. A person with more generalized anxiety may struggle with nervous ticks, habits, and behaviors, but most of the time can push it back in favor of the day. A person with panic attacks can learn to have panic attacks in secret – feeling like they’re about to die, but doing so without worrying others. A person with PTSD may do anything they can to act like it’s not bothering them, hoping to be the hero that people see them to be.

But it is a struggle. It is always a struggle.

They say that anxiety is related to intelligence, and that the smarter you are the more likely you’ll struggle with anxiety symptoms. Perhaps that intelligence is a double edged sword, causing you to feel like you can do something to stop it without help, or giving you an “inner voice” that makes you feel ashamed of your anxiety, rather than motivated to stop it.

One of the most interesting parts about this piece, however, is that while millions of people are living with hidden anxiety right now, their desire to hide their anxiety may be making their anxiety worse.

“A first good step is staring at it straight on and calling it by its name.”

Anxiety is your mind trying to tell you that you’re in danger, and doing whatever it can to get you to react in a way that leads you towards safety. Anxiety expects you to respond. It’s almost literally priming you to run away, with symptoms like:

  • Increased Heartbeat – To make it easier to run.
  • Sweat – To cool you down when you run.
  • Faster Breathing – To help you get oxygen when you run.
  • Twitching – To give you fast reflexes while you run.
  • Trouble Thinking – So you don’t forget that you should probably start running.

But when you hide your anxiety, none of that has an outlet. Instead, it’s worse. Suddenly, you’re now anxious about trying not to tell someone. You’re anxious about whether or not you can stop the thoughts. You’re anxious from self-doubt, feeling like you know you’re being irrational but can’t control it. Maybe you’re also anxious because now your armpits smell from all the sweating.

Hiding your anxiety can lead to other, tangentially related anxiety contributors as well. Hiding your anxiety is extremely lonely. It’s hard to feel supported when others do not go what you’re going through, even though support is one of the best ways to overcome anxiety.

Hiding anxiety also keeps anxiety in your own head. But when you have anxiety, your own head in your enemy. Thoughts spiral out of control. Your brain becomes more and more active, leading to more and more anxiety, leading to worse and worse thoughts.

Anxiety is a hidden illness. But keeping it hidden doesn’t make it better. It often makes it worse.

Distractions as a Cure

"It’s always looking for the next outlet, something to channel the never-ending energy. Writing. Running. List-making. Mindless tasks (whatever keeps you busy). Doing jumping jacks in the kitchen."

The author of the article talks about how when you live with “high functioning anxiety,” you often seek out distractions. These distractions are there to tire out the thoughts in your head by tiring out the rest of you, and they serve a purpose – to give you something else, anything else, so that anxiety isn’t what defines you in that moment.

Distractions, though, do serve a useful purpose. Anxiety can break down your own stress coping ability. That constant barrage of stress and tension that comes from feeling anxious makes it harder and harder to cope. Like a muscle, the more you tire your stress coping ability without letting it rest, the more you tire it out – and possibly put it at risk for injury.

Distractions are that rest period. Finding something that you can do that takes your mind off of your anxiety, even just a little bit, does help you rebuild a little bit of your stress muscle. It’s imperfect. It’s slow. It’s not necessarily a cure on its own. But those distractions do give you a few seconds of rest time to make it easier for you to learn to cope with anxiety in the future.

The Chicken and Egg

"High anxiety can be a natural consequence of a busy lifestyle, but its existence is akin to the chicken and the egg. Which came first, the anxiety or the busyness? Am I always moving because I’m anxious or am I anxious because I’m always moving?"

But as the author addresses here, there may become a point when the distractions are not a cure, but a cause. When everyone is fighting for your attention, or when you can’t sit and rest comfortably because you have too much to do, or when you never sit still and start to require the stimulation.

You can sometimes tell the difference when you’re alone and free. If you have a moment that the weight of all you have to do is lifted and you feel the calm of having nothing on your plate, it’s likely that your anxiety is caused by your busy lifestyle. If the anxiety never seems to go away, especially not when you’re alone with your thoughts, it’s likely that anxiety itself is the issue.

But the unspoken question is – does it matter? If you’re struggling with anxiety in any scenario, and unwilling or unable to speak out about it to others and get the help that you need, then you’re still struggling, and the cause of that anxiety remains not as important as the need to treat it.

How We Become High Functioning and Why We Let it Linger

Living with anxiety is a constant challenge. For many of those that have anxiety, the initial experience is overwhelming.

  • You Withdraw
  • You Fear
  • You Worry

You may find yourself drained, depressed, or always on edge and miserable. You are anything other than high functioning. But then that survival instinct kicks in. You want to be better. You FORCE yourself to “be better.”

Maybe you have a fear of social situations, but you make yourself go out there and be around people. Maybe you have panic attacks while at work, but you force yourself to go to work anyway. Maybe you are anxious about hurting your new child, but you force yourself to be there for your new child.

But you’re not necessarily better. You haven’t cured your anxiety. What you’ve cured is your willingness to let anxiety control you. You stood up to anxiety like a big bully, but you still know that at any moment that bully can shove you in a locker. You stopped giving the bully your lunch money, but you risk the abuse just the same.

This is how you develop high functioning anxiety. You didn’t cure the anxiety. You simply learned to live with it anyway. You habituated yourself to it, like a mouse that learns to live with the snake. But you’re still there with it, in the cage.

Why it Helps to Be Vulnerable

Imagine you are feeling sick. So sick that it makes you pale, and people keep asking you if something is wrong. Getting a spray tan doesn’t cure the illness. It only makes it less visible to the naked eye. You wouldn’t convince yourself that you’re better – or that you should be better – just because your paleness is gone. You still know you have the illness, and it is just as bad as it was before.

This is what it’s like living with high functioning anxiety. But those that struggle often respond by feeling like they need to keep it to themselves. That they need to “smile through it.” That they need to continue to power forward, alone, despite the dangers their brain is telling them are present.

It’s lonely.

But what about if we let others know? What about if we opened ourselves up to be vulnerable, and were open about our anxiety issues? What if we came out from behind the curtain, and let everyone know that we’re not a great and powerful wizard, but an ordinary person putting on a show?

What is it that you really lose?

The real question is what you gain. You gain the potential support and understanding of those around you. You gain people that know you better than they did before. You gain the positive feelings that come from people knowing who you really are, not the mask you wear.

"It’s when you’re social enough to get invited to things, but so often find yourself standing in a room where it feels like no one knows you."

You strengthen connections with others because you’re able to be your true self. You don’t have to put on a show that puts you in situations that you’re not ready for, or forces you to lie to people about why you can’t go out because you don’t want to admit it’s because it’s one of the “bad days.”

Perhaps most importantly, you become more willing to get help. Because if you’re open to people knowing about your anxiety, you’ll be more open to the idea of letting someone help you stop it. It’s a lot easier to feel like you can seek out help from others when you’re not feeling ashamed of your struggle.

The Struggle and Solution for a Hidden Illness

Anxiety is not like other diseases, and in some ways it’s not like other mental health challenges. Anxiety is one of the only conditions that can be pushed aside, even when it’s eating you up inside. It’s one of the only illnesses where you can struggle terribly, but still act like nothing is wrong in order to remain social or active. It is one of the few that can hit you severely at any given moment, while you remain the same to anyone that sees you.

But just because people can’t see it doesn’t mean it’s not there, and if your hope is to cure the hidden illness, it helps to treat it like it is – an illness, a curable one, and one that benefits from showing it to others and seeking out the help that it desperately deserves.

Special credit to author Sarah Schuster for her excellent description of living with anxiety. If you haven’t yet read the article, please do so now.

Author: Micah Abraham, BSc Psychology, last updated Jul 23, 2018.

Frequently asked questions

What do I do next?

We really suggest people take our anxiety test - it provides a breakdown of how your particular anxiety manifests itself.

I have a question about anxiety or mental health - can you answer it?

Please don't send us questions about your specific mental health issues. They should really be answered by a professional who knows your history.

We are a small team, and it is simply impossible for us to handle the volume of people who need their questions answered. Our anxiety test was created exactly for that purpose - so that people can work on their mental health problems themselves. Please make use of it.

I have an editorial comment or found a mistake.

Great! Please use our contact form and our editor will receive it. We really appreciate such comments because it allows us to improve the quality of information provided on this website. We appreciate any ideas including article suggestions, how to improve user experience and so on.