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While mental health disorders encompass a huge range of symptoms and differentiated conditions, more people struggle with anxiety than any other type of mental disorder. Anxiety disorders are one of the most common mental health issues diagnosed in teens. But not all forms of anxiety are debilitating or disabling, such as high functioning anxiety.

High functioning anxiety describes symptoms of anxiety in people who are otherwise still high achievers among their peers, whether it’s at school, work, or even home (through household tasks and life skills). Anxiety does not preclude hard work or success – but success does not indicate happiness or good mental health, and a capacity for stress is not always a useful indication of a person’s mental wellbeing.

We know from research that anxiety has a detrimental effect on academic performance and cognition. Teens are less likely to internalize lessons and more likely to forget the facts if they’re preoccupied with anxious thoughts and have a harder time focusing.

In adolescents especially, fear of failure and overly high expectations (often self-generated) can lead to excessive academic stress and pressure. This attitude is self-destructive, especially for young adults facing the oncoming pressures and stressors of adulthood.

But kids with high grades can still struggle with anxiety. A study of 500 school children showed that as many as 3.9 percent of students with very good grades scored high on anxiety tests. Lower than their peers with poor grades (14.1 percent), but still significant. Knowing what high functioning anxiety looks like and how it sets itself apart from debilitating anxiety can help us gain a better understanding of how to help teens struggling with high functioning anxiety.

High Functioning Anxiety vs. Other Anxiety Disorders

First and foremost, high functioning anxiety is not a disorder. There are no clinical criteria for it. It is not listed in the DSM-5 or other resources for diagnostic criteria in psychiatry. However, “high-functioning” is a common descriptor for cases of mental health problems where a patient effectively copes with their condition, albeit in an unhealthy way, or continues to function in spite of their diagnosis. A diagnosis of high functioning anxiety usually falls under Persistent Depressive Disorder (PDD).

Difficult to Identify

One of the primary characteristics of any mental disorder is that a patient is struggling with their condition, meaning it has a material and tangible effect on their life, such as the threat of self-harm, relationship problems, or trouble at school, work, or home.

High functioning anxiety can be difficult to identify because a teen with high functioning anxiety can mask their symptoms and continue to achieve great things. In many cases, teens with high functioning anxiety are doing well at school and in their extracurriculars but still feel overwhelmed from time to time by anxious thoughts or unwanted thinking.

Masking Symptoms

In other, more dangerous cases, high functioning anxious teens might be masking their symptoms through effective yet potentially destructive short-term coping mechanisms.

These are coping mechanisms with long-term consequences, whether it’s something as simple as bottling up a traumatic experience or using drugs like alcohol and marijuana to regularly combat anxious thoughts and continue to “function.”

Teens who feel anxious from time to time might not need professional treatment now but could still benefit from learning how to address and cope with these thoughts before they interfere and turn into a greater, debilitating issue in the future.

Meanwhile, teens who rely on short-term yet destructive coping mechanisms to deal with their anxious thoughts and continue functioning may end up paying the price sooner rather than later, especially in cases of substance abuse.

Recognizing High Functioning Anxiety in Teens

If high functioning anxiety does not keep someone from doing well at school or their job, how can it be identified? By looking for other telltale signs of anxiety. These include:

  • Physical symptoms such as unexplained pains, sudden shortness of breath, and random chest pains.
  • Physical tics, like teeth grinding, clenched jaws and associated jaw pain, scratch marks, shortened nails/nail loss (from biting), and hair loss (from pulling).
  • Rising substance use, including nicotine, alcohol, and illegal substances such as prescription medication (including recreational use of ADHD medication).
  • Avoiding friends and family, isolating more often.
  • Tendency to drift away and not be “present” in the moment.
  • Losing track of time often (consistently too late/too early).
  • Becoming emotionally distant or unreachable.
  • And more.

These symptoms of anxiety might not reach a point in a teen’s life where they become candidates for a diagnosis of an anxiety disorder. However, they may be a sign that your teen is potentially at greater risk of anxiety issues, substance use, or depressive problems in the near future, especially if they have a personality that causes them to be harder on themselves, even after failure.

Furthermore, helping a teen with high functioning anxiety learn to identify and develop healthy, strong coping skills against their symptoms and thoughts can help them build resilience and preemptively prevent a future diagnosis. In this case, it’s preventative medicine rather than a cure.

Treating High Functioning Anxiety

High functioning anxiety is addressed in teens like most other anxiety disorders: by talking with a professional. Talk therapy or psychotherapy is the most effective treatment for an anxiety condition, usually in combination with other forms of therapy, including experiential therapy and medication (especially when comorbid conditions are involved, such as depression or substance use).

In teens with high functioning anxiety, taking the opportunity to discuss these fears and anxious thoughts with a professional gives them the chance to nip things in the bud by learning to differentiate between signs of potentially disordered anxious thinking and a healthy amount of self-awareness and doubt.

Modalities like cognitive behavioral therapy also help teens learn to apply lessons from therapy in their day-to-day life and utilize their thinking to affect their emotional and mental health.

Addressing High Functioning Anxiety at Home

In addition to a treatment plan, another important component of long-term emotional and mental health is support at home and within the community.

Parents, siblings, and friends alike can help teens with high functioning anxiety by encouraging them to take breaks from time to time, to stick to healthy physical habits such as a strict sleep schedule, less caffeine, a better diet, and to bring them along on social activities to keep them from isolating themselves.

Staying Consistent

Some days and weeks feel harder than others, but consistency can help overcome and eliminate most anxious episodes and help teens find a better balance in their life.

For more information about anxiety treatment for teens, contact us today. Our team of professionals will be glad to speak to you.