High-Functioning Anxiety: What it is and how to manage it holistically

301 million people struggled with anxiety in 2019. Since then, the numbers have only been on the rise—and that’s documented numbers. There are plenty more people who have suffered silently, and still more who struggle without even knowing what exactly is going on. Those who have high-functioning anxiety tend to belong to the latter camps. They are able to push through life, propelled by the fuel of their fear. This can lead to external success, but at a cost: their health and happiness. 

This has been my experience. For the majority of my adolescence, I struggled unconsciously with anxiety. It manifested in plenty of ways. In my school years, it looked like extreme shyness, people-pleasing, constant concerns about my health, endless dissatisfaction with my body, feeling uncertain about my own opinions, etc. In university, it went on to take the shape of shallow breathing, acid reflux, food intolerances, and panic attacks. 

After finding myself in the ER post-severe-panic- attack, I finally learned about anxiety. Over the next few years, I became more and more informed about how the mind can bring on such bodily symptoms, and emotional and behavioural patterns. As I began to apply what I was learning and deep inner work, many of my extreme symptoms began to subside. These days, anxiety still shows up, but in less severe 

fashions, like neck or shoulder tension, bloating, or occasional restlessness. More importantly, when anxiety does pop up, I know now how to address it—how to release the anxious energy, rather than letting it build. This is what I want to share here with you. 

In this post, we’ll chat about how to manage anxiety holistically, so, if you or a loved one is struggling, you have some tools at your disposal. 

Signs of High-Functioning Anxiety

First, let’s review some common signs of high-functioning anxiety. 

Behavioral Symptoms: 

● Overthinking and excessive worry about future events 

● Perfectionism and fear of making mistakes 

● Difficulty saying "no" and overcommitting 

● Procrastination followed by bursts of productivity 

● Seeking reassurance frequently 

● Avoiding social situations despite appearing outgoing 

● Nervous habits (e.g., nail-biting, hair twirling, leg shaking) 

● Trouble relaxing or always needing to stay busy 

Emotional Symptoms:

● Persistent feelings of unease or dread 

● Inner sense of fear, even when things are going well 

● Irritability or frustration 

● Fear of judgment or disappointing others 

● Low self-esteem despite achievements 

Physical Symptoms: 

● Muscle tension, headaches, or jaw clenching 

● Difficulty sleeping or racing thoughts at night 

● Fatigue despite high energy output 

● Digestive issues like nausea or stomach discomfort 

● Increased heart rate or shortness of breath in stressful situations 

The Mind-Body Connection 

It’s worth noting that, as illustrated in my own story, the reason we go on to get physical symptoms of anxiety often comes down to the fact that we’ve been ignoring the subtler symptoms for too long. In my case, I had countless emotional and behavioural symptoms, but as I didn’t pay any attention to them, they progressed into physical symptoms. 

“Unresolved emotions and feelings can cause tremendous chronic physical pain. The brain is a powerful instrument that can suppress these emotions into the subconscious or even the unconscious, but it doesn’t delete them. There may be another event or memory trigger that causes them to resurface, and if they don’t resurface as emotions, they can resurface as physical pain. It’s the body’s way of letting you know something needs to be addressed; something is wrong that needs to heal.” -Leslie Delaney, MD 

A Holistic Approach for Managing Anxiety 

Put simply, if a lack of wellbeing stems from disconnection with ourselves, then wellness is restored through re-connection. 

As I share about frequently, I find there to be purpose in everything. And the purpose in pain is to cue us back to the present. So, once you notice yourself in physical, mental, or emotional distress, know that this is your sign to come into the present moment. Begin to make this a habit. “Oh, I feel off. Okay, let me be with myself. Let me check in with me and see what it is I need.” 

The reactive response is to avoid or complain. We tend to go, “Oh, god, I feel horrible. Why me?” Or, “Ugh, I feel so sick. Ah well, it’s a Monday morning, better get to work.” 

If we can notice the reactive response bubbling up within ourselves, and then consciously choose to move in a more loving direction, toward real nurturing of our precious selves, then we can bring ourselves so much closer to feeling better—sometimes shockingly quickly.

A practice I love is called “Focusing.” You simply notice where in your body you feel off. Even if you feel off emotionally, find a part of your body where you feel this is represented. And then, have a conversation with that part of your body. See if you can be there with it, be there for it. Have no expectations of immediate relief or trying to “fix” it in any way. Instead, just see how it feels to be there with that part of you that feels unwell. Notice what comes up. You may hear your intuition guiding you to some sort of action, or your experience may be purely somatic. For instance, you may notice that just by being with this part of you, there is a dissipation in physical tension or mental worry. 

Whether or not you want to do this, or some other practice you love to come into communion with yourself (yoga, journaling, walking, meditation, etc.), it doesn’t matter. Let yourself move toward the practice that feels most aligned in the moment, trusting that it’s not about the modality, it’s about the connection achieved via the modality. 

When to Seek Support 

If you find it very hard to be present with yourself, know that you’re not broken. Inability to be present is often a sign that you’ve been through something rather challenging, and now there’s a part of you that is protecting you from feeling too deeply. 

If this is the situation you find yourself in, reach out to someone. Structured therapies like CBT and MBSR (Mindfulness-Based Stress Reduction) offer effective, scientifically supported pathways for managing anxiety. Alternatively, coaching may be an avenue for you if you connect more with a forward-focused approach that emphasizes personal growth, actionable strategies, and building your capacity to navigate anxiety in daily life. 

Or, if both of those options feel too overwhelming, reaching out to a trusted loved one is a good first step, too. Remember that you’re not an island. None of us are. We are meant to receive support, to be there for one another.