Between good mental health and a diagnosable mental health disorder, there is a vast no-man’s land of different mental states. The nature of life means that we will inevitably experience dizzying happiness, desperate sadness and everything in between, including a certain amount of fear, worry and anxiety. In fact, it wouldn’t be normal to never experience negative emotions, but generally speaking we should feel pretty OK most of the time.

This isn’t, however, the case for everyone. Some people find themselves feeling very anxious and worried more often than not, yet to an outside observer they appear completely well. This phenomenon is increasingly becoming known as “high-functioning” anxiety.

High-functioning anxiety isn’t a diagnosable condition, and if you live with it, you appear to cope with life tolerably well. You get up in the morning, look after your children, make your way to work, perform proficiently and push down your feelings of panic and worry. If you are affected by high-functioning anxiety, it can be extremely difficult to distinguish between the normal worry of life, and something which would justify a trip to the doctors — you just know that anxiety and unhappiness is your default state.

This opens up a lot of questions about how we define mental illness, and how much we put down to personality or normal low mood. For example, in the first throes of grief, depression is often seen as natural and therefore not a clinical issue. You might be extremely unhappy, but not diagnosably so.

With high-functioning anxiety, you will experience at least some of the main characteristics of a diagnosable anxiety disorder, but at what’s generally considered “subclinical” levels — especially as your personal and professional lives function as usual.

When Life’s a White-Knuckle Ride

Debra Kissen, PhD, co-chair of the public education committee for the Anxiety and Depression Association of America, says of high-functioning anxiety that, “Many people are walking around with extremely high levels of anxiety that are near meeting the criteria for anxiety disorders, but they’re white-knuckling their way through it.”

If you live with high-functioning anxiety, you may have come to regard a vague sense of dread and headachey worries as a normal part of life — companions that you can’t avoid. The other less well reported but still very evident symptoms of anxiety such as digestive problems, fatigue and muscle aches can also be an issue.

You may rely on emotional crutches such as overeating, smoking or drinking a bit too much — but usually not in a pronounced enough way to stop you from operating as normal. Alternatively, you may be very restrictive in your lifestyle in order to feel in control, embarking on strict diets and assiduously avoiding anything you consider unhealthy, perhaps even exercising excessively.

All in all it can be a stressful, lonely, and exhausting way to live — where anxiety is a major feature of each and every day, but there isn’t any support to help you deal with it. Apart from this, you may also feel that you can’t give yourself the permission to seek help, rest or self-care, because in your own estimation you don’t have a “proper” illness.

How to Cope with Frequent Anxiety

  1. Acknowledge the problem: The first thing to acknowledge with high-functioning anxiety is that, while you may not necessarily be diagnosably unwell, living with fear and worry is not something you have to accept. You may also want to consider that despite functioning capably, these feelings still disrupt your wellbeing enough to warrant a chat with your doctor. They will be in a far better position to judge the extent of your anxiety; particularly if for you, it’s nothing out of the ordinary.
  2. Pay attention to your thoughts and actions: You could also take up journaling to get more of a handle on your feelings. It may transpire that you have developed several coping mechanisms which aren’t immediately obvious either to you or others, and keeping track of your actions and emotions will reveal them to you. For example, you may avoid networking events with colleagues because while you can cope professionally, the idea of socializing with workmates fills you with dread. This kind of insight allows you to assess just how much anxiety is holding you back (if at all), and the influence it has on your relationships and career. This might be less dramatic than with other forms of anxiety, but still a tangible thing. Whatever the outcome, these negative feelings aren’t an inevitability, and you can do things to change them.
  3. Consider various treatments/therapies: Although only your doctor can say for sure, you may not want or need any pharmaceutical intervention to help you live with your anxiety. However, talking therapy can benefit many people and your doctor (as well as online resources) can help you find professionals that will be able to assist you.
  4. Make lifestyle changes to improve your general wellbeing: Meditation is often cited as an anxiety-reliever, and you may find a group meditation class led by a experienced teacher provides you with both the space to relax, and a support group who understand your experiences. If applicable, cutting down on your alcohol consumption will help you avoid its depressive after-effects, and creating a good work/life balance can also make a difference. For example, instead of working through lunch, ensure you take a walk in order to wind down, and turn off your email notifications on your personal phone.

The most important thing, however, is to give yourself the permission and time to enact self-care. Prioritize your own wellbeing, and anxiety needn’t be a such a prominent feature in your life.