When Looking Like You Have It All Together Is Unsustainable

Although high functioning anxiety is not a formal mental health diagnosis, it describes a very real experience for many women who appear to be functioning well while internally struggling with significant anxiety. The challenge is that because things appear fine from the outside, many women suffer for years before seeking support.

What is high functioning anxiety

High functioning anxiety is a term popularized by social media to describe people who experience significant anxiety while continuing to perform well in their daily lives. A clinical anxiety diagnosis, by definition, requires that the individual experiences significant distress or impairment in functioning in their personal or professional life.

That is, that sometimes anxiety presents in ways that people struggle to attend work, engage socially, or even leave the house. High functioning anxiety, on the other hand, shows up when people are still performing well in their day to day lives but do so despite much distress. Furthermore, the distress that people with high functioning anxiety experience is often not visible to others. 

Symptoms of anxiety include:

• Excessive worry that is difficult to control
• Restlessness or feeling “on edge”
• Difficulty concentrating
• Irritability
• Becoming easily tired
• Sleep difficulties
• Muscle tension

The internal message often sounds like:

• I need to stay on top of everything.
• I can’t let anyone down.
• I should be able to handle this.
• What if I make a mistake?

How high functioning anxiety shows up in women

Anxiety disorders are one of the most common mental health conditions and women experience anxiety disorders at a higher rate than men. While anxiety can affect anyone, many women experience unique social, cultural, and relational pressures that shape how anxiety manifests in their lives.

Women can become so accustomed to functioning with a high level of distress that they assume it is simply part of their personality. They may describe themselves as perfectionists, overthinkers, people-pleasers, or highly responsible individuals without realizing anxiety is driving much of their behaviour.

The influence of media

Social media and cultural influences often play a role in establishing unrealistic and unsustainable expectations of women. A ‘day in the life’ reels shared by women feature a social media influencer managing a household or professional career that looks flawlessly polished – of course this idea is appealing. However, in most cases, it is a distortion of real life and can lead to comparison and self-criticism.

Perfectionistic tendencies

Perfectionism is the act of over achieving for fear that your efforts (or yourself) alone won’t be perceived good enough and that mistakes or flaws are unacceptable.

Perfectionism can sound like:

• I need the birthday party to be memorable (I’ve been editing the Pinterest board for weeks)
• I can’t leave the house without looking a certain way
• I always review emails excessively before pressing send

Perfectionism can also show up as avoidance. That is, if the perfect outcome is not materializing it is common for individuals with perfectionistic tendencies to procrastinate or avoid while experiencing much distress.  

Overthinking and rumination

Symptoms of generalized anxiety include both excessive worry and worry that is difficult to control. This can sound like replaying conversations, second guessing decisions, seeking excessive reassurance, and self-doubt. Overthinking and rumination can also make it harder to fall asleep. 

People pleasing and absent boundaries

People pleasing behaviour is somewhat of a misnomer. People pleasing is less about pleasing others and more about the avoidance of perceived conflict, confrontation, or disapproval. It is the absence of personal boundaries and difficulty saying “no” or fear of disappointing others. 

People pleasing is closely related to high functioning anxiety in women. It can show up as not setting limits, avoiding important conversations, or making decisions that are detrimental. 

Managing high functioning anxiety

While anxiety is an uncomfortable experience, it is important to note that it is not inherently negative. Anxiety can provide important information about what we value and in some cases can help improve our performance.  Of course, if anxiety or worry is excessive, causing significant distress, or interfering with living your best life it may need to be addressed. 

Managing setbacks, mistakes, and criticism

One of the most important aspects of managing high functioning anxiety is the ability to accept that mistakes are an inevitable part of being human and move forward following setbacks. This requires practice with making mistakes, taking risks, and experiencing perceived criticism or disapproval. 

Commonly high achieving women have limited experience with mistakes or perceived failures as they have worked very hard to avoid it in the first place. Taking values-based risks and exposure to feared outcomes plays an important role in anxiety treatment. 

Examples of values-based risk taking can look like:

• Applying for a job before you feel ready
• Turning in an assignment that is ‘good enough’
• Declining a volunteer request that you don’t have time for
• Initiating a difficult conversation

When to seek help

Fortunately anxiety is a highly treatable condition. If you find that efforts to manage anxiety require more support, mental health therapy with a mental health therapist, psychologist, or medical professional would be beneficial.