Lonely woman

Why high-functioning anxiety is hard to see

Mental illness is largely invisible. Perhaps none more so than high-functioning anxiety. What exactly does it mean to be high-functioning and why it is important that, as a society, we do not ignore it?

High-functioning and low-functioning

There are two types of anxiety sufferers: those who are high-functioning and those who are low-functioning.

The term "functioning" refers to how well people function in everyday life. Low-functioning refers to people who struggle with this: if you find it difficult to get out of bed in the morning, hold down a job, conduct proper self-care and follow personal hygiene routines, this is considered low-functioning.

In contrast, high-functioning refers to people who can function in everyday life. They can look after themselves, hold down a job, maintain a strong social network and generally get on in life. However, they are still wracked with anxiety.

Hidden in plain sight

Because people with high-functioning anxiety can perform well in most situations, it is even harder to spot than other forms of mental health difficulties.

Such individuals are often success and achieve at a high level. In part, their constant stress and worry can be one of the things that drive them. It causes much suffering internally, while externally they look like they are doing well.

It sounds like high-functioning is better, though?

It is. If you are given a choice between being high-functioning and low-functioning, high-functioning would be the obvious choice.

However, it does come with its own set of difficulties.

Being high-functioning makes it harder to get help. This is because there is a sense of guilt: even though it may be ruining your life, you may feel that other people, such as low-functioning people, deserve the help more.

Or, you may worry that people will not take you seriously because everything seems to be okay on the outside.

As good as it seems to be to be a high-achiever, this is, in fact, a hollow victory. What many people may consider a worthwhile achievement is often viewed as another failure by people who are constantly holding themselves to an impossibly high standard.

Why is it important for sufferers?

For those suffering from high-functioning anxiety, it is important to seek help. This is because maintaining this level of worry may be unsustainable. It may lead to burning out and becoming low-functioning later down the line.

When you hold yourself to an impossible-to-reach standard, you are setting yourself up for a lifetime of failure. When things do go wrong, this can have a significant impact on people who tie their self-esteem to their achievement.

Everyone has ups and downs in their life, so we will all inevitably run into a rough patch. This can be especially tough if you have been unable to deal with your anxiety issues and rely on external validation to get you through.

While anxiety can be driving force to help you achieve, it can also be a limitation. Worry causes us to procrastinate, to alter our goals and to view the world from a biased perspective in which we see everything in a negative light.

If we can remove these limitations from ourselves, we can perform at an even higher level.

Finally, anxiety causes a lot of unhappiness. It can ruin our life. Even if we are successful, what is that worth when we are unhappy?

Why is it important for society?

Tackling anxiety, even in high-functioning individuals is important for three reasons.

First, untreated anxiety may seem to be okay right now but can lead to being low-functioning later down the line. This then causes difficulty for society later down the line. Anxiety is easier to treat when someone is high-functioning, so acting early is the best strategy.

Second, anxiety is a limitation. We might think that high-functioning individuals are doing well and achieving lots. This is often true. But how much more could they contribute to society if they had their anxiety under more control?

Finally, we have a social responsibility. People are suffering. Anxiety makes people unhappy, whether they can function in everyday life or not. Surely that in itself is worth fighting for?


High-functioning anxiety is a particularly hard form of mental illness to spot because high-functioning individuals can cope in everyday life.

However, ignoring the issue can lead to greater problems down the line, both for the individual and for society. It also puts limitations on what people can do and causes lots of suffering. Therefore, it is important to make treatment as accessible as possible.


Published 30 October 2017. Written by Chris Worfolk.

Want more content like this?

Subscribe to our newsletter to get more great content emailed to you directly. Plus, we'll send you some chapters from our books for free. We never share your details and you can unsubscribe at any time.