As we continue to recognize World Mental Health Day on October 10th, the latest data analysis from ComPsych analysis shows that anxiety has skyrocketed to the number one presenting issue among American workers—topping depression, stress, partner/relationship issues, family issues and addiction and grief among other topics people sought help for.
Results of the American Psychiatric Association’s (APA) show that in 2024, almost half (43%) of the American population say they feel more anxious than they did the previous year, up from 37% in 2023 and 32% in 2022. On a global scale, the APA study finds that Americans are anxious about current events (70%), the economy (77%), the upcoming United States presidential election (73%) and gun violence (69%).
Other anxiety provoking issues weighing on the American workforce are global conflict, racism and political conflicts, mass shootings, climate-related disasters and a turbulent economy. I described an easy and useful tool to mitigate anxiety in a recent piece for Forbes.com.
In addition, there’s evidence that 80% of workers have lower well-being due to “productivity anxiety.” But how much of the reported anxiety is Type-A behaviors and how much is “high-functioning” anxiety that’s affecting your career? Anxiety disorders are the most common mental illness in the U.S., affecting 40M adults.
Earlier this year #highfunctionalanxiety trended on TikTok with over 180M views. Yet, it remains unrecognized as a formal diagnosis. Many people may experience anxiety while still functioning well in their daily lives, often without realizing they have “high-functioning” anxiety.
‘High Functioning’ Anxiety Versus Type A Personality
I spoke by email with Michael Louwers, M.D., associate medical director at Reset Medical and Wellness Center. I asked him how employees can distinguish between “high-functioning anxiety” and Type A personality.
“Distinguishing the difference may seem straightforward, but it is often murky,” Louwers told me. “Firstly, people with Type A personalities are not suffering from a psychiatric disorder. Type A individuals share characteristics such as competitiveness, drive, ambition, organization and perfectionism. In the right setting, these traits can be helpful and foster success in school and business, making them natural leaders.”
Louwers adds that unfortunately, Type A personalities can also be impatient, hyper-vigilant, quick to temper and sensitive to criticism. “These toxic traits can quickly break down family, social and work relationships and may allow the pursuit of unrealistic expectations to consume their life, leading to severe anxiety,” he explains. “These individuals are often high functioning, holding successful positions and higher socioeconomic status, such as doctors, lawyers, engineers, politicians or business executives. They may appear functional from the outside but may be struggling. People with ‘high functioning’ anxiety can quickly develop severe anxiety and depression, which leads to high rates of burnout and even suicide. The stress will also impact physical health, contributing to a compromised immune system, insomnia and cardiovascular disease.”
5 Signs Indicating ‘High Functioning’ Anxiety
Understanding how to utilize the positive traits of the Type A personality and limit the negative characteristics requires maintaining balance and using stress management techniques. “Type A personalities often overwork themselves, striving to achieve perfection, which leads to ‘high-functioning anxiety,’” according to Louwers. He identifies five subtle signs that this could be occurring:
- You may overreact to triggers or seek out unhealthy coping strategies.
- You might be considered impatient, hot-headed and difficult to work with.
- You could be a perfectionist, reluctant to delegate tasks, not trusting others’ judgment, resulting in others never measuring up to your unrealistic standards.
- You are regarded as a workaholic and struggle with an unhealthy balance of work and family life, which leads to disputes and the breakdown of social relationships.
- You could feel guilt or shame in the shadow of even minor failures and often resort to unhealthy coping mechanisms like alcohol or drugs.
Triggers That Heighten ‘High Functioning’ Anxiety
Louwers points out that many triggers in our everyday lives can set off anxiety like a minor change in routine that throws off a well-planned schedule and heightens anxiety. That can include traffic to work or spilled coffee before a meeting, he says. “People who fear failure, especially perfectionists, often struggle with the stress of new responsibilities, competitive work environments and strict deadlines,” he notes, suggesting that, “When these triggers occur, remember to take a deep breath. Life will continue, so try to make the best of it.”
Employees with an anxiety disorder experience a heightened fight-or-flight response—a physiologic reaction to triggers that can be difficult to control that includes a racing heart, adrenaline surge or a sense of panic. Louwers says the first step is to utilize healthy coping strategies and seek guidance from a professional.
5 Tips To Manage ‘High Functioning’ Anxiety
Louwers lists five additional strategies to manage anxiety:
- Practice mindfulness. “Dedicate at least 30 minutes daily to focus on yourself. Put down the electronics and live in the moment. Eat healthily, exercise and consider meditation. Deep breathing exercises are a daily ritual for me!”
- Improve social interactions. “Set aside time for healthy social interactions. Spend more time with family or friends and improve your work-life balance. Remember to be a good role model.”
- Practice good sleep hygiene. “Strive for seven to nine hours of sleep nightly. By following a consistent sleep schedule, limiting caffeine, and avoiding late-night food or exercise, you can significantly improve ‘restorative sleep.’ Waking up refreshed is critical to starting your day right.”
- Avoid unhealthy coping. “Don’t smoke or use alcohol to manage stress. Avoid emotional eating. Challenge negative thoughts, and remember that stress is not always harmful. Use stress to motivate, but don’t allow it to overwhelm.”
- Identify if there is a problem. “If you can relate to these signs or symptoms and you’re struggling to cope, it’s important to know that you’re not alone and that resources are available to help.”
If traditional treatments like medications or counseling are not enough, Louwers proposes another option that may be available. Originally used for pain management, the stellate ganglion block is an anesthetic injection he has found to be effective in treating anxiety and PTSD. This evidence-based treatment is used at Reset Medical and Wellness Center to calm a hyperactive fight-or-flight response.
Louwers describes the Neurosympathetic Reset (NSR) as a 15-minute, safe, and well-tolerated procedure done under ultrasound guidance. “The NSR has shown compelling results, with around 80% of patients with anxiety disorders experiencing clinically significant improvements lasting months to years,” he concludes.