Anxiety is a complex set of reactions designed to keep us safe. In the days of saber toothed tigers, the “fight or flight
response” was, literally, a lifesaver. When a person faced a dangerous situation, a series of physical and mental events
occurred: the heart raced, attention focused on the threat, blood flow changed to allow extra energy for the muscles.
Blood pressure rose and the brain tried to anticipate what would happen next. There was a rapid calculation – should I fight for my life…or run for it? In caveman days, this was as much decision-making as was needed And these two options covered most situations.
Things were simpler back then. Anxiety about giving a presentation for school or work does not allow for either fight or
flight. You just have to get through it.Being anxious about being unprepared for your geometry test also doesn’t allow for
flight or fight (unless you can squeeze in a sick day). In the extreme, anxiety can become panic – with racing heart, clouded mind, and sense of doom. There is an urge to flee the situation. Because fleeing the situation makes the anxiety less, the behavior gets reinforced. People tend to avoid similar situations in the future. Life can feel like it is all about avoiding anxiety.
Anxiety is the single most frequent reason people choose to begin therapy. And, treatment for anxiety has the highest rate of success. It has been estimated that 18% of the population over 18 years of age will experience an anxiety disorder. Despite the fact that anxiety disorders are treatable, only 1 person in 3 seeks treatment. Everyone experiences anxiety. It draws our attention to potential danger and focuses us. But, like a car alarm that keeps going off even when no one is around – sometimes anxiety is a distracting, or even debilitating, false alarm.
Recently, “high functioning anxiety” has been getting attention in the media. In 2014, Scott Stossel wrote in The Atlantic
that he had struggled with severe anxiety despite being a successful magazine editor. Asked by a doctor how many episodes of anxiety he had, his answer was, “One, my whole life.” With high functioning anxiety (HFA), the individual suffers with anxiety, but somehow is able to do what they need to do. People with HFA may be very successful.
Often, the suffering is not apparent to others. But, inside, it can feel like torment.
Despite their success, people with HFA may doubt the adequacy of what they do. They may worry for days about something they said, or did, or something that was said to them. Decisions can be difficult because of fear of making the wrong one. Sufferers may seem angry or irritable since they feel like they are constantly on the verge of being overwhelmed. A problem at work may feel like a catastrophe. At home, frantic activity or social avoidance may be how these individuals try to regain equilibrium.
For adolescents, anxiety may focus on appearance in addition to competency. Selfconsciousness is commonly the main concern.Feeling too fat, or too thin, too tall or short may plague the most seemingly-successful teens. For teens with high functioning anxiety, perfectionism is the goal, and the enemy. Teens are social creatures, and there is much social learning to be done in high school and college. Fearful withdrawal can limit a teen’s chance to grow. Sports, academics, friendships, romantic relationships, college applications and the need to choose a vocation all can be anxiety provoking
and all can be fuel for HFA. HFA teens perform, but with much struggle. Anxious teens often have physical complaints – headaches and stomach aches are the most common. These physical symptoms may take the place of feeling anxious, and may take on a life of their own.
The worries can seem endless. Each promotion, or success, can bring fears of being “found out” as incompetent (the imposter syndrome). Some of these fears can become self-fulfilling prophecies. If these problems sound familiar, they are. Everyone struggles with these issues to some extent.Those with HFA suffer more and more often. Too much anxiety can rob people of the experience of joy in their lives, and satisfaction with themselves.
Likely, no one will suggest they get help – only a few people very close to people with HFA know how hard it is for them. But, if the private battle interferes with wellbeing, perhaps it is time to talk with someone who can help.
Dr. Douglas Haymaker is a licensed clinical psychologist with over 20 years of clinical experience. He is presently a partner at Haymaker and Haymaker Psychological Services, a private practice setting where your confidentiality is assured, in Bridgewater, NJ. He attended college at Brown University and graduate school at the University of Florida in Gainesville, FL. Areas of specialization include relationship issues, coping with transitions such as loss and divorce, and the assessment and treatment of AD/HD, anxiety, depression and PTSD. He also performs psychological, neuropsychological and educational evaluations.