“Helping you gain control over the things you want to change”

Fiona Nicolson

High functioning anxiety explained

Posted on 05 June 2019

Even very successful people can be anxious. I come across this every day I work with clients. Much of the work I do to help conquer anxiety is based in Harley Street, I am working in the middle of one of the most affluent cities in the world and in a street with a world-famous reputation for top of the range medical practice. So, it’s no surprise that many of the clients who come through my door asking for cognitive techniques to help combat anxiety are very successful professionals at the top of their game. Some are even famous in their chosen field. If you saw some of my clients on the street, one thought which would not run through your head would be: ‘that person seems anxious’.

What this shows is that anxiety is not always easy to spot. And that actually can make it harder to live with.

How to identify high-functioning anxiety

My experience of working with anxiety has taught me to distrust first impressions.

I am telling you this today for two reasons.

Firstly, you may know someone who is suffering from very high levels of anxiety and you may not even be aware of it. It could be a family member, or it could be a work colleague who is under tremendous pressure but they are not showing it. Understanding that a person can appear to be OK but actually be very anxious can be an invaluable help to that individual. You may be able to support them and make their life easier if you have an appreciation of what they are going through.

The second reason I want mention this is even more important. It is about you. Again, I base this on my professional experience in my anxiety clinics. Often clients will arrive with a presenting problem but when we start to unpick what is going on we can discover a high level of anxiety. This often surprises the client, but it can be the first step to improving things.

Signs of high functioning anxiety

I thought it would be worth mentioning some of the signs of anxiety, so you can be better informed for your own mental health and the mental health of those around you.

Anxious people who seem to get through life and fulfil everything they need to do are sometimes described as suffering from high functioning anxiety. This is becoming a better-known term and that is good, because it is very useful in identifying the problem. People suffering from high-functioning anxiety can appear happy, competent and achieving on the outside. However, there are often signs that all is not well. Here are a few:

I cannot concentrate enough to do routine tasks. Does this mean I have anxiety?

Do you ever find that concentration and some routine tasks feel impossible and you have to force yourself to do them? Things such as shopping, paying bills, going to the gym can feel like impossible mountains to climb if you are anxious. It can help to look for a recurring pattern. For example, failing to do things which you normally enjoy. Also look out for an unpleasant physical response to the task. These can be early warning signs that there is a problem.

How do I know if a physical feeling is a sign of anxiety?

Some physical symptoms can have a physical cause and others may be rooted in anxiety. Headaches and stomach ache, muscle pain and sore throats are common examples.

If you have a physical symptom, then the first thing to do is to get it checked out by a GP. Eliminate the possibility of a physical cause first. Once you have done that and you think you might be suffering from anxiety, it could be worth investigating if anxiety is the cause of a physical problem. Seeing a professional therapist can help you uncover how your mental state may be affecting your physical well-being.

It is also worth being aware of the close link between the mental and the physical. If you are anxious and also have a strained muscle, for example, it may feel much worse then if you were calm.

Often simple relaxation techniques, especially those which are directed to the relevant area of the body, can start to help.

Is it best to share my anxious feelings or should I keep them to myself?

In the past any mental health issue was regarded as a bit shameful and people used to keep any problems, such as anxiety, a secret. Thank goodness things are changing and we have a much more open culture now. But it can still be a big step to share the fact that you suffer from anxiety.

Sharing feelings of anxiety at work

I sometimes encourage my clients to share at work if they are in an environment where that is possible and appropriate. When they do, other people often come forward to say they have a similar problem. In a work environment this can be invaluable. It could be that there is some aspect of work which is causing anxiety across the workforce. Common culprits can be lack of flexibility, very long hours and pointless competition. Sometimes co-operation can make all the difference and make more sense.

Employers these days are more aware of their obligations to look after mental health and often these things can be altered for the benefit of everyone.

Should I share my feelings of anxiety with my family?

At home and with families the situation can be difficult. Some people feel guilty or worried about upsetting others and and try to hide their anxiety from loved ones. This can lead to frustration and distance.

I often spend time with clients who are dealing with anxiety to work out how they can include their partners, relatives and friends in their recovery.

I encourage my clients to do something which people who suffer with anxiety rarely do. Put themselves first and don’t apologise or downplay their feelings.

What lies behind a fear of disclosing anxiety?

If a client who is suffering feels they have to hide the fact that they are anxious, I always ask ‘why’? The answer can often lies in low self-esteem, a fear that a loved one will withdraw love or an important person will withdraw approval unless the anxious person is perfect. This is often part of a belief system which the client perceives that their feelings are not that important. As one of my clients said: ‘it’s my mind telling me I’m not worth it.’

I always say to my clients, ‘yes, that’s a belief and it is a belief which you created. So, you can create another more useful belief.’ Once a client is used to this idea a whole new world can open up.

Beating anxiety means taking control

My hypnotherapy clinic in Harley Street is a place to work out what the client needs and then to take action to make the changes to help free them from that anxiety. Pinpointing, addressing and positively changing the root cause of their anxiety by making cognitive changes to their belief system and their experiences in life.

An additional step to beating anxiety is to work with the client to define what they need to have a happier and more balanced life and then giving them the confidence and the resilience to achieve it. This often means building a healthy everyday routine around what the client needs. For example, quiet time to be alone and re-charge; time outside in nature to relax and unwind; or a regime which addresses physical needs, such as exercise.

Another aspect can be to learn to say how you feel. Many people with anxiety, especially those high functioning outwardly successful people do not show their feelings, even to their nearest and dearest. Disclosing feelings often has to be learned, it can become a habit and is generally a healthy one.

Cognitive hypnotherapy for anxiety in Harley Street

If this article strikes a chord with you then do contact me. At my clinic in Harley Street I use a variety of cognitive techniques, including hypnotherapy, to help people overcome anxiety. I have great success rates and I am sure I can help you.

Call me on
07920 054292
or to email me or send me your details:

Attended a lecture by the eminent Prof Ernesto Spinelli earlier today.

I had the opportunity to reflect on and expand my understanding of '#existential anxiety'.

Fabulously insightful. Highly ... recommend.

#existentialism #angst #existentialtherapy #Psychotherapy #philosophy

Great initiative from the London Mayor. @MayorofLondon
Why can't all businesses who make money from women's patronage set up such schemes? Keeping your customers safe seems a ... good business practice to me.

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