5 ways anxiety hides and goes untreated

Anxiety affects everyone differently, specifically those with symptoms of “high functioning” anxiety. This group tends to use fear to propel them forward in life, rather than hold them back, making it more difficult to diagnose.

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Dec 23, 2021 UPDATED
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There are clear criteria that help mental health therapists diagnose anxiety disorders with relative certainty, but the way anxiety shows up in every client is different. 

Anxiety disorder is the most common mental health disorder in the U.S., affecting more women than men. According to the National Institute of Mental Health (NIMH), 31% of U.S. adults will experience an anxiety disorder at some point in their lives. 

In other words, there are a lot of folks walking around out there who have anxiety so badly that it negatively impacts their day-to-day functioning.

I personally am a high-achieving stress ball, and despite specializing in the treatment of anxiety, had a hard time identifying it in myself.

From the outside, I look hard-working and organized. On the inside, I experience all the symptoms of anxiety disorder, including intense feelings of impending doom, fear of failure, anxiety, a racing heart, etc.

Although it's not listed in the DSM-5, the standard classification used when diagnosing mental disorders, it's often referred to as "high functioning" anxiety.

Sometimes, signs and symptoms of anxiety can be sneaky and disguise themselves as characteristics or traits that are often praised and, therefore, go unnoticed. 

Below are five ways anxiety hides and goes untreated. 

1. You struggle to truly relax

Self-care has been a hot topic in the past few years, and I strongly believe that it is an absolute necessity. 

The problem is that it can be easy to sit down with a book and a glass of wine and call that relaxing. Sorry, it’s not. I mean, not always

For those of us who live with anxiety on a daily basis, it requires genuine effort and focus to slow the sympathetic nervous system (fight or flight) and shift into the parasympathetic (calming nervous system). 

Overplanning isn’t bad. However, it can be problematic when it causes one to feel drained, overwhelmed, or exhausted. 

A tool of mindfulness that I’ve used myself and teach my clients is that when you sit down to relax, take a couple of minutes to do a full mental scan of your body. What do you notice?

body scan

In order to experience the physical benefits of downtime, your nervous system must recognize that you are safe and calm. If your heart is racing, you have trouble slowing your thoughts, or feel fidgety, you might not be relaxed at all. 

2. You snack when you get stressed

No, there’s nothing wrong with snacking. As a mindfulness therapist, I help clients raise their self-awareness and become clear on why they are reaching for food.

Going through this process myself, I noticed anytime I experience acute stress, I immediately look for a treat: sitting in traffic–eat Oreos; pay bills–eat chips; work deadline–string cheese…You get the point. 

Through the lens of anxiety, one might notice that food is not what they truly want or need in a stressful, irritable moment. Instead, it serves as a distraction and lets them slow down momentarily. It is a maladaptive coping mechanism for anxiety that easily gets mistreated.

3. You’re known for obsessively overplanning

If I had a dollar for every time someone said to me “Wow, you planned for everything, didn’t you?” I would sip coconut water on the beach for the rest of my days. 

As a young person, I was praised for being responsible. As a mom, I am praised for being prepared, and as a clinician I am congratulated for having a plan for almost any client scenario. 

The emotional toll and mental energy that having "high functioning anxiety" requires, though, is exhausting. 

My tendency to go above and beyond when planning ahead is purely to calm the fear of the unknown, and to control outcomes as much as possible, thereby reducing my anxiety. 

Overplanning isn’t bad. However, it can be problematic when it causes one to feel drained, overwhelmed, or exhausted. 

If you notice you lose interest in doing things because of how much work it is just to leave the house, then your overplanning might be a maladaptive, self-soothing tool, rather than a productive trait. 

4. You have trouble taking your workout to the next level

This one is super duper sneaky, and it took me quite a while to nail down what was happening. In my 20s, I ran half marathons and distance races with friends. Three kids and one chronic illness later, I assumed my running days were over. 

My workouts felt terrible. I hit a wall at 2 miles and couldn’t seem to get past it. 

As I addressed my anxiety symptoms, I noticed a shift in the gym. My stride became longer, and I was less sore after my workouts. I regained control of my breathing and could focus on body mechanics as I ran instead of fighting incessant negative thoughts mile after mile. 

When anxiety peaks, people often describe feeling paralyzed and not being able to muster up the energy to even begin to clean the house or go grocery shopping.

The less worry and tension I held, the more I allowed my body to move like the runner I used to be. 

Almost any athlete will tell you that mindset is half the battle. For those of us with anxiety, your racing thoughts don’t just stop when you hit the gym. 

If you notice that your workouts have plateaued and you live with anxiety, it would be worth it to find a therapist who can support you in achieving your zone of optimal performance, where muscles relax, breath becomes steady and you can release ruminating thoughts. 

5. You have a tendency to “give up” when overwhelmed

Giving up is sometimes coded in our minds as a “lazy behavior”, but in many cases, this is not true. When anxiety peaks, people often describe feeling paralyzed and not being able to muster up the energy to even begin to clean the house or go grocery shopping. 

Anxiety is debilitating, it’s “fight or flight”. When people become flooded or overwhelmed, the thinking brain shuts down, just like a switch was flipped. 

It may feel counterintuitive, but if the thought of doing household chores, completing a work task, or even socializing seems impossible, let yourself give up. When the stressor is released, sometimes a more clear path appears, or motivation returns and then the activity doesn’t seem so impossible.

There can be an incredible freedom that comes with identifying and naming anxiety as it shows up for you. You don’t have to suffer through untreated symptoms. There are many viable treatment options available. 

My personal favorite is mindfulness. It can be an incredibly gentle way to manage symptoms that otherwise take over your life and stop you from living with ease and achieving your goals. 

high functioning anxiety

Mindfulness resources for beginners

Interested in dipping your toe in the mindfulness pond, but don’t know where to begin? Check out these resources to get started. 

Guided meditations

Mobile apps

Anxiety quiz

To help you determine if you have symptoms of an anxiety disorder, take Monarch’s 2-minute, free anxiety quiz.

Article originally published Dec 6, 2021. Updated Dec 23, 2021.

U.S. Department of Health and Human Services. (2017). Any anxiety disorder. Retrieved from National Institute of Mental Health (NIMH) website: https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder 

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