High-functioning anxiety is not a medical diagnosis, but it is an increasingly common issue that’s being talked about by Forbes, US News & World Report, the Cleveland Clinic, and even the meditation app Headspace. 

So, what is high-functioning anxiety? How would you know if you have it?

There are 2 sides to high-functioning anxiety: confidence and success on the outside, with constant fear and worry on the inside. 

On the outside, a person might appear to have it all together all the time. To others, they show up as:

  • High-Achieving
  • Perfectionistic
  • Busy & In Control
  • Meeting Deadlines
  • Detail Oriented
  • Organized & Productive
  • People Pleasing 
  • Seemingly Confident

But  the outward success comes at a cost of inner turmoil:

  • Constant Worry
  • Overthinking
  • Harshly Self-Critical
  • Restless & Irritable 
  • Fear the Worst will Happen
  • Feeling Stressed 
  • Overextended
  • Can’t say No
  • Mental & Physical Fatigue

So, is high-functioning anxiety worth it?

Even though a little bit of anxiety can drive action and success, too much can take a toll on the body and mind. 

That’s why people with high-functioning anxiety struggle not only with constant worry but also things like insomnia, muscle tension, racing heartbeat, exhaustion, and mood swings. 

The thing about high-functioning anxiety is that it is very much an INNER struggle. Nobody would ever know on the outside, and the symptoms don’t meet the criteria for an anxiety diagnosis. 

Keep reading, because we’re going to look at some underlying causes of high-functioning anxiety and some tips for easing the inner angst (while still staying productive and successful).

Root Causes of High-Functioning Anxiety

For anyone experiencing high-functioning anxiety, it can feel like a normal way to be—as if it’s necessary to be in a constant state of stress just to keep up with life’s demands. 

But what if it’s not actually normal? 

What if it could be possible to stay organized, productive, and goal-oriented without compromising your inner peace? 

The first step to breaking the cycle of high-functioning anxiety is to look at where it’s coming from. So, here are 5 potential root causes of high-functioning anxiety:

  1. PersonalityHigh-functioning anxiety might just feel like who you are, based on your personality. It is more common in people who tend to be shy or nervous in new situations or those who have a tendency to worry. 
  2. Stressful Life EventsAny experience that your body perceives as traumatic can create a stress response in the body that cascades into anxiousness. Even if we compensate by overachieving, the stress builds up on the inside.  
  3. Alcohol Use or AbuseIt’s common for those with high-functioning anxiety to have a cocktail or glass or wine to calm the nerves or relieve the anxiety. The problem is that it’s a short-term fix. Drinking alcohol can lead to sleep problems, fatigue, and worse anxiety the next day. 
  4. Thyroid ImbalanceThyroid hormones regulate your metabolism but also influence mood. Both an overactive (hyper) and underactive (hypo) thyroid can lead to nervousness and anxiousness. Routine labs don’t usually evaluate a complete thyroid panel, so it’s possible to have thyroid imbalance even if you’ve been told your labs are normal. 
  5. Sympathetic OverdriveYour sympathetic nervous system activates in response to stress, releasing a cascade of chemical messengers (like adrenaline) and hormones (like cortisol). With ongoing stress, your sympathetic response can overpower the more calming parasympathetic response. That creates agitation, anxiousness, muscle tension, sleep problems, and more. 

It can be tricky to unravel what’s really at the root of high-functioning anxiety on your own. If this is something you can relate to, we would love to help. 

Our functional medicine approach means we look past the routine labs and screenings to find more subtle patterns (like thyroid imbalance or disrupted stress hormones) underneath the symptoms. 

Then we create a personalized plan to help you feel as calm and confident on the INSIDE as you appear to everybody else on the OUTSIDE. 

Now let’s take a look at some options for nutritional support.

Nutritional Support for High-Functioning Anxiety 

People with high-functioning anxiety often feel the need to just need to keep on pushing through, but there are ways to lessen the stress and anxiousness by nourishing the body and brain with targeted nutrients. 

Here are 5 supplements to lessen the anxious feelings and increase stress resilience:

  1. ProbioticsProbiotic blends of Lactobacillus and Bifidobacterium strains show promise for supporting stress and anxiety. They work by supporting the gut-brain axis and modulating inflammation in the body and brain.  
  2. MagnesiumMagnesium is needed to produce several neurotransmitters in the brain that affect anxiety and mood. It has a relaxing effect, calming the nervous system as well as tense muscles.  
  3. Vitamin B6Vitamin B6 works together with magnesium in supporting neurotransmitter production in the brain. Other B vitamins (like B12 and folic acid) may also be beneficial, so one option is to take a B Complex or multivitamins providing the entire family of B vitamins. 
  4. AshwagandhaAshwagandha is considered an adaptogenic herb because it supports the body’s stress response (the hypothalamic-pituitary-adrenal axis). It can be helpful for relieving anxiety, calming the nerves, and supporting better sleep. 
  5. St. John’s WortLots of people think of St. John’s Wort when they think of depression, but it works by supporting healthy levels of neurotransmitters (like serotonin) in the brain and can therefore also be very useful to alleviate anxiousness and stress. 

Nutritional and herbal supplements will not put an end to high-functioning anxiety on their own, but they can nourish the body from the inside out to be more resilient to stress. 

Now, are you ready to learn a quick but powerful way to stop anxiety in its tracks? 

Vagal Toning for High-Functioning Anxiety

With all the overthinking, overachieving, perfectionism, and people-pleasing, high-functioning anxiety is enough to keep anybody’s nervous system in overdrive. That’s why it can be helpful to intentionally calm the nervous system every day and throughout the day. 

One way to do that is with vagal toning exercises.  

The vagus nerve is at the center of your parasympathetic nervous system—the arm of the nervous system that puts you into rest and relaxation. 

Better vagal tone means the body can relax faster after experiencing stress. 

Vagal toning exercises can be practiced as part of an everyday routine AND used in the moment for immediate stress relief. 

Here are 3 quick ways to activate and tone the vagus nerve:

  1. Deep BreathingSlow and deep belly breathing is a powerful way to tone the vagus nerve. You can do this anytime and anywhere. One way to make a practice of deep breathing is to try an app that will alert you with reminders and guide you through quick breathing exercises. 
  2. HummingThe vagus nerve connects to the vocal cords, so the act of humming stimulates the nerve. Other ways to use the vocal cords to stimulate the vagal nerve include singing, laughter, or chanting. 
  3. Cold Water SplashExposure to cold is known to activate the vagus nerve. You can make a routine of this by ending your showers on cold. If you need a quick cold exposure in the moment, try splashing your face with cold water. 

Over time, other ways to tone the vagus nerve include yoga, meditation, exercise, and eating a healthy diet filled with foods like fruits, veggies, and fermented (probiotic-rich) foods. 

How to Get Help for High-Functioning Anxiety

If you can relate to the information we’ve shared in this post on high-functioning anxiety and are ready to break the pattern to achieve a greater sense of calm, we can help. 

Through highly personalized naturopathic care, we will get to the root cause and get you on a plan for anxiety relief. Learn about our 1:1 program, Thrive Tribe, here.   

How to regulate your nervous system, Natural nervous system support, Stress resilience and nervous system balance, Somatic healing and vagus nerve activation, Nutritional and Hormonal Links to Nervous System Health, Nutritional and Hormonal Links to Nervous System Health

Disclaimer: These statements have not been evaluated by the Food and Drug Administration. This post is not meant to treat, cure, prevent, or diagnose conditions or diseases and is meant for educational purposes. As always, please consult your doctor before trying any new treatments or supplements. 

Dr Jenny Abercrombie, ND