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5 Reasons People Don't Know I Struggle With 'High-Functioning' Anxiety


If you have spent much time online, it is likely you will have heard of the term “high-functioning.” People talk a lot about “high-functioning” depression, anxiety and chronic fatigue syndrome. But what is it? What does that even mean?

The term “high-functioning” means the person struggling with such a condition performs and functions at a “high level” despite their condition. This means oftentimes no one would know they are struggling. No one would imagine they struggle the way they do because from a glance, they seem fine. In fact they function to a really high standard! Of course, looks can be misleading. What people see rarely ever shows the whole picture.

I have high-functioning anxiety and I want to tell you a few things about that this means and what it looks like.

1. I’m always busy.

Even though I have fibromyalgia, myalgic encephalomyelitis (M.E.)/chronic fatigue syndrome, irritable bowel syndrome and other chronic conditions including chronic pain, I always keep myself busy which often leads to people disbelieving my conditions or the severity of my fatigue and chronic pain. Why? Because my anxiety causes my heart to beat faster, adrenaline to pump through my blood stream and therefore chilling out, resting and being still as my body actually needs, is hard for me. Sometimes being still is impossible. For example, talking on the phone triggers my anxiety. On the very rare occasion I do talk on the phone, I may sound fine on the other end but if you could see me, you would find me pacing all over the house, tapping my fingers, scratching my hand and sweating. My anxiety also causes my emotions to be intensified and I can be very passionate until the surge of anxiety fades and I am left exhausted, numb and depleted.

2. I’m always smiling.

To most people I meet, I am a smiley and happy person. I have been told I am warm and bright. But I know my anxiety makes me nervous and sweat. On the surface I laugh a lot and smile, with a sheen to my skin that appears as a healthy glow and yet within minutes or hours that “shine” turns into a pale, drawn, worn out face. Drained from constant smiling. Drained from constantly trying to hide the battle waging war within me. My coping mechanism used to be to hide. It seems my coping mechanism now, is to smile and laugh my way through it. Maybe sometimes that is the same thing because telling someone “I am anxious” or ”I am having a panic attack” doesn’t feel possible. I Just grin and smile through it instead.

3. I nibble, pick and scratch.

I bite my lips a lot. Sometimes without realizing, sometimes not knowing until I’m sore. I also have dermatillomania, a skin picking disorder commonly caused by anxiety. I have had this condition since I was a teenager, when I first started getting pimples. It developed into a problem. I pick at pores perceiving blemishes. On my face, neck and chest, sometimes my legs and arms as well. When I pick, I feel a release from anxious tension. I visited a doctor once after picking so badly I needed large wound plasters to cover up the damage done. He just laughed and told me to ”just stop.” I wish I could. Anxiety compels me to do it but depression always follows, making me feel ashamed of what I have done to myself. My boyfriend also noticed and brought to my attention lately that when anxious, I scratch a certain point on my head/forehead as though trying to calm or scratch away my nervous feelings.

4. I over-empathize.

I feel everything. I am very sensitive. Sometimes I feel drained after socializing because I feel as though I absorb the emotions of those around me. I find watching the news too much affects me badly and there are certain films or programs or songs I cannot listen to at certain times. I often need to retreat for my own sanity and emotional health. My anxiety causes me to swing between being the most daring outgoing girl full of energy, to the most introverted, shy, self conscious girl who would rather be in my own company.

5. I am a strong person.

As a person who has battled anxiety, fear and depression every day for years, you will find I am one of the strongest people you will ever meet. I have overcome so much. Although I have terrible days and dark moments, I always get back up again. I am a loyal, understanding and non-judgmental friend because I know how it feels to struggle and feel alone. I am always up for deep heavy chats that most would be uncomfortable with, because I have had to go deep in dealing with my own demons and past. I am still a work in progress and my faith gets me through and gives me hope. Anxiety and depression does not scare me because I battle it daily, therefore I can advocate and reach out to others struggling in the same ways. Knowing what it feels like, makes me want to reach out to others who feel alone, to let them know they are not.

I hope this will help you understand your friends and family who struggle with “high-functioning” anxiety because most of the time, I do not feel I am functioning well at all. I hide my anxiety by functioning well because I do not want to be judged. That is what many of us have to do but it does not make our struggles any less worthy of acknowledgement. I hope it helps you not to judge a book by its cover and to be more aware. When you see that friend who tells you they have anxiety and yet they seem so bright and busy, I hope you have compassion and admire their strength rather to assuming they are fine. And if you have “high-functioning” anxiety, I want you to know I see you. You are not alone.

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Thinkstock photo via bruniewska