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Living With High Functioning Anxiety or Depression

What is High Functioning Anxiety and High Functioning Depression?

High functioning Anxiety does not look like how we expect anxiety to look. High functioning Depression does not look like how we expect depression to look. That’s because our stereotypes are based on people that are disabled by their symptoms, that are unable to function, that can’t manage the basics of life. Depressed people that can’t get out of bed, anxious people who can’t leave the house.

On the contrary someone who is high functioning is exactly that – functioning at a high level. They are able to work, maintain relationships, engage in hobbies, engage in social activities. On the outside everything seems great. No-one would suspect a problem. But just because everything ‘appears’ a certain way doesn’t mean it is. We regularly see examples in the press of celebrities who seemingly have it all and then have a breakdown, suffer addiction, or commit suicide.

For these people, the suffering is very hidden. If they told those around them they were depressed or anxious, they’d likely hear “I’d never have known, you seem to have it all together”.

Recognising the problem

Depression and Anxiety isn’t about what’s on the outside, it’s about what’s on the inside. We can seemingly be succeeding yet feel like a complete failure. We can be seen by others as intelligent yet see ourselves as stupid. We could have lots of friends and loved ones around us yet believe that no-one likes us and feel alone. We can be exhausting ourselves doing so much for others, yet still feel like it’s not enough. There are many more examples of these contradictions between the reality on the outside, and how we feel on the inside.

A lot of people describe it as feeling as if they are existing, but not really living. There’s a lack of pleasure, a lack of feeling connected, a lack of feeling proud or satisfied.

Imposter syndrome

Imposter syndrome is common with those with high functioning depression and high functioning anxiety. They feel like at any time they will be ‘found out’. That they have been ‘lucky’ so far that people haven’t realised what they are really like. This can apply both at work and in our personal life. If we don’t feel good enough, then we won’t believe that others could think positive things about us. For those that are high-functioning sufferers there is never enough that can be done to calm those fears and worries no matter how much they accomplish.

It’s common for there to be moving goal posts – this means you set a goal for yourself, achieve it, but rather than celebrating and revelling in this, you’ve already set yourself the next goal to keep pushing forwards, because nothing ever feels enough. It can also be common to see over-compensating and reassurance seeking, both in relationships and at work.

The irony of course with imposter syndrome, is that often those that feel like imposters are quite the opposite. Some of the most successful people in the world feel this way, Adele for example has spoken repeatedly about her fears of being ‘found out’.

Recognising High Functioning Anxiety and Depression

If you are wondering if you are experiencing either of these problems, take a look at the list of symptoms below. How many do you recognise?

Symptoms of High-Functioning Anxiety

  • Constant overthinking
  • Pushing for perfection
  • Unable to relax or switch off
  • The need to be in control
  • Excessive planning, preparing and list making
  • Worry about “what if …?”
  • Shifting goalposts
  • Exhaustion
  • Feels of stress and overwhelm

Symptoms of High-Functioning Depression

  • Reduced interest
  • Lack of enjoyment and pleasure
  • No motivation
  • General feelings of apathy
  • Feeling disconnected
  • Increased destructive behaviours (comfort eating, drinking etc)
  • Thoughts of “What’s the point?”
  • Withdrawal from none essential activities
  • Conversation and social interactions feeling more draining


The vicious cycle of depression and anxiety is the same whether we are high or low functioning – it is fed by unhelpful thoughts, incorrect beliefs, and bad behaviour habits. Treatment will help you to recognise where your issues lie, and how to overcome them, to help you to learn how to experience a happy and stress-free future.

At Hannah Paskin Therapy I am experienced in working with High Functioning Anxiety and High Functioning Depression.
Book your appointment here: Book Now | Hannah Paskin (

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