Has ‘High-Functioning Anxiety’ Been Blown Out Of Proportion?

If you look in the medical textbooks, you’re not likely to come across this phrase. That’s because it is not recognised as a medical term.

Yet, ‘High-Functioning Anxiety’ is entering the vernacular in the conversation around mental health. Healf explores what sparked the origin of this unorthodox term, and what it could mean for millions, if not billions of people worldwide.

We are talking about mental health more these days. In the last decade it has really taken off as a viral topic. And, many would argue this is societal progression in its most sincere form. Being able to open up about personal struggles and seek the help you need when you need it most, it’s saving lives, and it is deepening our connection and understanding of one another.

But, in a tidal wave of content now concerning mental health issues, there is also a lot of misinformation out there, or information that is just not that helpful to the untrained eye — leaving room for problems to arise.

What is 'High-Functioning Anxiety'?

According to the article and other online sources, common issues associated with high-functioning anxiety are defined as:

• Perfectionism, often setting unrealistic standards
• Overthinking and constant worry
• Difficulty relaxing, even during downtime
• Fear of failure or rejection, leading to over-preparation
• People-pleasing tendencies, struggling to say "no"
• Appearing calm and composed, while feeling anxious inside
• Need for reassurance from others
• Restlessness or fidgeting
• Trouble sleeping or racing thoughts
• Physical symptoms like a racing heart or sweating under stress

The term was popularised through its use as a hashtag. And while the world of scientific research, including research into psychology and psychotherapy, is inherently creative, there may be room for error if things get out of hand. Or into the wrong hands.

Lucy Foulkes, an academic psychologist at Oxford University argues that information being pumped out around ‘High-Functioning Anxiety’ is well intentioned but may be having an unintended side effect on the observers of this content. Foulkes expresses deep concern that the current awareness craze is, ironically, making their mental health worse.

She breaks the process down into three possible stages:

Rising mental health awareness is well-meaning, but often unreliable. Platforms like TikTok spread simplified messages, turning everyday behaviours, be it procrastination or nail-biting, into signs of supposed mental illness. This oversimplification may be blurring the line between normal struggles and real disorders, creating confusion rather than clarity.

This awareness leads to overinterpretation, where common life challenges are mistaken for mental illnesses. Online trends encourage self-diagnosis, making it easy to mislabel everyday stress or anxiety as disorders. The result is that normal emotions can be viewed through the lens of psychiatric terminology.

Believing you have a mental disorder can worsen symptoms, a reverse placebo effect called the nocebo effect. Avoiding stress due to perceived anxiety increases long-term anxiety. Labelling every low mood as depression deepens distress, reinforcing the belief that one is unwell, which fuels the anxiety cycle.

Lucy Foulkes adds that she would like to stress how she is not trying to diminish the very real experiences of many people viewing this content who do have genuine reason for concern about their mental health.

“An individual with high-functioning anxiety may appear calm on the outside but feel very anxious internally. These individuals may try to mask their symptoms.”

Cleveland Clinic on TikTok

Is education around ‘High-Functioning Anxiety’ necessarily a bad thing?

A counterargument to Foulkes' concern could be that increased awareness around mental health is actually empowering people to better understand their struggles, reducing stigma which is damaging to our society at large, while encouraging more people to seek help.

While the sharp incline in conversations about mental health may initially feel overwhelming, it ultimately provides valuable tools and resources that promote self-care, early intervention, and a more informed society. In this view, some might argue the awareness "craze" Foulkes mentioned, may not be the reason mental health cases are on the rise, but rather creating a more open and supportive environment for those affected by it.

To add to that, just because high-functioning anxiety doesn’t have formal recognition in the medical world doesn’t mean the concept of experiencing anxiety while still being able to function, seemingly without difficulty, isn’t a real problem. Many people live with anxiety but manage to maintain their daily responsibilities, even if their internal struggles aren’t outwardly visible.

Should we take ‘High-Functioning Anxiety’ seriously?

Taken out of the context of the ’correct ’medical terminology. The concept and the high uptake of this phrase may suggest there is more to it than meets the eye of the sceptics.

Living with high-functioning anxiety could be a damaging prospect, especially if you choose to ignore the unpleasant symptoms you're experiencing. While you might manage to keep up with your responsibilities, the constant internal struggle can take a toll. And, perhaps achievement isn't the only thing that should be celebrated in one’s life. Over time, this approach of burying your head in the sand may prevent you from truly enjoying life at its fullest, while the anxiety continues to cause disruption below the surface.

Further reading: The Unwanted After-Effects Of Therapy

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