When we think of anxiety, we often picture someone visibly struggling—maybe battling panic attacks or avoiding social situations. But anxiety isn’t always easy to spot. High-functioning anxiety is a quieter, more hidden form of anxiety. On the outside, people who experience it may seem organised, confident, and even successful. On the inside, though, they’re battling constant worry, overthinking, and a never-ending need to do everything just right.
You might know someone like this—or even recognise yourself in this description.
How Does High-Functioning Anxiety Show Up?
The tricky thing about high-functioning anxiety is that it often hides in plain sight. Here are some common signs:
- You overthink everything. Replaying conversations or worrying about the “what ifs” is a daily habit.
- You’re always busy. Saying “yes” to everything—even when it’s too much—feels like the only option.
- You push yourself hard. While others might call you a perfectionist, you see it as doing your best (even when it’s exhausting).
- Relaxing feels impossible. Even during downtime, your mind is racing with to-dos and “what needs fixing.”
- You feel physically tense. Headaches, fatigue, or muscle pain are constant companions.
- You’re afraid to fail. The thought of making mistakes or disappointing others is overwhelming.
- You put everyone else first. Pleasing others often comes at the expense of your own needs.
These behaviours might look like strengths to others, but they often come from a place of fear, self-doubt, or the need to avoid criticism.
Why Is It Called “High-Functioning”?
The term “high-functioning” simply means that despite the anxiety, you’re still managing daily life—work, relationships, errands. But just because you seem to be handling it all doesn’t mean it’s easy or healthy.
People with high-functioning anxiety often feel like they’re running on empty. It’s like being on a treadmill set to “sprint”—you might not fall off, but that doesn’t mean you aren’t exhausted.
What Causes High-Functioning Anxiety?
There’s no single answer, but several factors might contribute:
- Family history. If anxiety runs in your family, you might be more likely to experience it.
- Personality. Being a perfectionist, a people-pleaser, or highly self-critical can set the stage for high-functioning anxiety.
- Stressful environments. High-pressure jobs, academic demands, or personal struggles can make anxiety harder to manage.
- Past experiences. Trauma or chronic stress in childhood or adulthood can also play a role.
How Common Is Anxiety in South Africa?
Anxiety disorders, including high-functioning anxiety, are more common than many realise. According to the South African Stress and Health (SASH) study, 30.3% of South Africans experience a mental health condition at some point in their lives. Anxiety disorders are the most common, with the highest rates in the Western Cape and the lowest in the Northern Cape.
Globally, studies show similar trends. Anxiety is one of the most widespread mental health challenges, yet forms like high-functioning anxiety often go unnoticed because people seem to “have it together.”
How High-Functioning Anxiety Affects Daily Life
If you have high-functioning anxiety, you might be juggling a lot while quietly dealing with:
- Sleepless nights. You’re tired but can’t seem to switch your mind off.
- Emotional burnout. Keeping everything “perfect” leaves little energy for yourself.
- Strained relationships. Always putting others first or needing everything to be flawless can create tension with loved ones.
- Missed chances for help. Because you appear fine, others might not realise how much you’re struggling—or you might feel guilty asking for help.
What Can Help?
If you think you’re dealing with high-functioning anxiety, there are ways to manage it:
- Take a breather. Mindfulness exercises like deep breathing, meditation, or journaling can help calm a busy mind.
- Set boundaries. It’s okay to say “no” or ask for help. You don’t have to carry everything alone.
- Challenge negative thoughts. Notice when you’re being overly critical of yourself and try to reframe those thoughts.
- Talk to someone. A trusted friend, a counsellor, or a therapist can provide support.
- Consider professional help. Therapy, like cognitive-behavioural therapy (CBT), can help you understand and manage anxiety.
Where to Find Support in South Africa
There’s no need to face anxiety alone. Here are some helpful resources:
- The South African Depression and Anxiety Group (SADAG): Offers support groups and a 24/7 helpline. Visit www.sadag.org.
- Mental Matters Directory: Browse our directory for therapists, counsellors and other mental health professionals near you.
- Lifeline South Africa: Free and confidential support by phone, 24/7. Call 0861 322 322
Final Thoughts
High-functioning anxiety is often invisible, but that doesn’t mean it’s any less real. If you’ve been feeling this way, know you’re not alone—and that there’s no shame in reaching out for help. Taking even small steps to understand and manage your anxiety can make a big difference in your daily life and well-being.
Mental Matters is a resource and information platform. We do not provide medical advice, diagnosis, or treatment. While the information on our website is for general awareness and support, it should not replace professional advice. For any mental health concerns, please consult a qualified healthcare or mental health professional.
