High-functioning anxiety is peculiar in that it doesn’t resemble anxiety at all. It resembles the coworker you’re envious of. The person who remembers everyone’s birthday, responds to emails before eight in the morning, and manages to fit in a half-marathon on the weekends. She appears to be a model of competence from the other side of the room. She has rewritten the same Slack message four times, and up close, her hands tremble a little when she puts down her coffee.
This type of anxiety is so easy to overlook because of the discrepancy between what people perceive and what is truly occurring. Although it isn’t a formal diagnosis in the DSM, therapists have been discussing it more candidly in recent years. It’s more of a description, a way to give a name to something that has been lurking for years in family group chats and offices. Seldom do those who have it call in sick. They arrive early. They prepare too much. And they pay for it in ways that no one can see.
Performing wellness can lead to a particular type of fatigue. If you observe someone doing it for a sufficient amount of time, you begin to pick up on the subtle clues. The laugh was a little too fast. how they express regret for things that weren’t their fault. They find it difficult to watch a movie without checking their phones—not because they’re bored, but rather because they feel uncomfortable being still. It’s possible that what appears to be ambition is actually more akin to fear of wearing a blazer.
According to one therapist I encountered, it’s anxiety with a paycheck. I was struck by that phrase. One of the things that keeps high-functioning anxiety in check is the reward system surrounding it. Overworkers receive praise from their bosses. Friends depend on the planner. The responsible person is trusted by family members. Thus, at some point, the person carrying it all discovers that their value is dependent on never showing signs of weakness. It begins to feel more like a professional risk than a personal one when the mask slips.
But the body is not deceived. The record is quieter. tension that persists for years in the jaw. An upset stomach before each Monday meeting. Sleep that arrives in two-hour fragments, broken up by 3 a.m. spirals about an email sent last Tuesday. Doctors often see these patients long before therapists do, treating the migraines and the IBS without ever asking about what’s underneath. Someone has typically been operating on fumes for ten years by the time they finally make the connection.
It’s more difficult to discuss how lonely it becomes. Since you’re doing well on paper, you can’t really complain. The promotion went to you. The dinner was hosted by you. Technically, you’re all right. Saying otherwise seems self-indulgent, almost embarrassing, like pleading for undeserved sympathy. Thus, the majority of people remain silent. They simply carry on in the hopes that it will pass or that a peaceful weekend will resolve the issue. Usually, it doesn’t.
Observing this in friendships and workplaces gives me the impression that we have created a culture that rewards the very thing that is causing harm to people. We commend the grinder. We honor those who are always accessible. It’s worthwhile to consider whether the individuals we look up to for maintaining their composure are genuinely alright or if they’ve simply become adept at acting. Sometimes the bravest thing isn’t doing more. It’s acknowledging your fatigue at last.