High Functioning Anxiety and Self-Medication


It’s normal for everyone to have occasional anxiety, but a person with an anxiety disorder will experience intense, ongoing worry and a sense of fear about everyday situations.

Some people with anxiety disorders will also have panic attacks. Panic attacks are a terror that peaks in a few minutes and come with many physical symptoms.

When you have an anxiety disorder, one of the defining features that set it apart from normal anxiety is that it affects your daily functionality. Your sense of fear or worry is out of proportion to what’s actually happening.

Specific types of anxiety include:

  • Agoraphobia—a type of anxiety where you’re afraid of public places or worried about being embarrassed, helpless, or trapped in certain situations.
  • Generalized Anxiety Disorder—GAD is among the most common types of anxiety. Characteristics of GAD include excessive worry about even routine things in life. 
  • Panic Disorder—symptoms of panic disorder include repeated episodes where you feel extreme terror. You may feel chest pain or tightening, heart palpitations, and shortness of breath.
  • Social Anxiety Disorder—also known as social phobia, you may experience high levels of fear regarding social situations. You might feel self-conscious or worried you’ll be embarrassed or viewed negatively by other people.


What is High-Functioning Anxiety?

High functioning anxiety isn’t independently recognized as a diagnosis in mental health. Instead, it’s an all-encompassing term for people who live with the effects and symptoms of anxiety but can function at a reasonably normal level.

If you have this form of anxiety, you may find it a driver for you. Externally, you appear to be put together and thriving. This is often what we see in those people who have a Type A personality. You may perform well in nearly all areas of your life. Below the surface, you feel very different than what people see.

Someone with high functioning anxiety may be motivated and always “going” or busy.

Below this exterior, you may be filled with nervous energy, afraid to disappoint people, and have intense fears of failure. 

Positive and negative aspects can come with highly functional anxiety, at least as far as others can see. However, the toll it’s taking on you internally without treatment can lead to complications.

Some of the positive traits that tend to be associated with a high functioning level of anxiety are:

  • An outgoing personality in your daily life
  • Being proactive and planning for all potential scenarios and outcomes
  • Punctuality or arriving early
  • Organized, often making calendars and lists
  • Detail-oriented can be a common symptom of this type of anxiety 
  • Tidy
  • Helpful
  • Loyal
  • Passionate

Unfortunately, below those positives can lie your struggle. Things you may experience in your day-to-day life that can be indicative of anxiety symptoms include:

  • You’re a people pleaser
  • You talk out of nervousness or have nervous habits
  • There could be repetitive behaviors
  • You experience overthinking and racing mind on a regular basis 
  • Losing time because you’re always arriving early
  • An ongoing need for reassurance
  • Rumination and dwelling on negative things
  • Intense nighttime stress leading to insomnia and sleep deprivation 
  • Not much of a social life
  • You can’t enjoy the moment
  • The future scares or intimidates you
  • You don’t feel like you can say no
  • Physical and mental fatigue
  • Often comparing yourself to others
  • You’re loyal in relationships to the point it can become a problem

Another thing we often see in high performers with underlying anxiety is an increased risk of developing a drug or alcohol problem as a coping mechanism.


Screen Shot 2022 01 21 at 18.37.48


Anxiety and Substance Abuse

No matter the specifics of the type of anxiety disorder you have, anxiety is in and of itself highly related to substance abuse and addiction.

According to the Anxiety and Depression Association of America, around 20% of people with an anxiety disorder also have a mental health diagnosis of a substance abuse disorder.

When you’re someone who’s a high-performer and who’s always “on” because of your underlying chronic anxiety, you might drink or use other substances to reduce that stress at the end of the day.

Along with alcohol, benzodiazepines are medicines that can temporarily calm anxiety but are addictive.

The more often you turn to substances to cope, the higher the risk you’ll become addicted and dependent.

Using substances like drugs and alcohol can feel better at the moment but end up negatively affecting your brain chemicals, worsening your levels of concern. 


Getting Help

While there are effective treatments for high functioning anxiety, it can be tricky. There are reasons intertwined with your anxiety that may prevent you from getting help. 

Barriers to treatment include:

  • There’s a tendency to think that as long as you’re achieving, you don’t need any help.
  • It’s common to think everyone feels like you do.
  • You might worry about the stigma of reaching out for help.

You may have a preconceived idea of what an anxiety diagnosis means. You could see it as being debilitating. You might envision someone who can’t work and struggles to leave the house, but the truth is that it can look different for everyone. You might also be in denial about what you’re going through.


What Are the Treatment Options?

The good news is that treatments are available and can be highly effective. If you’re someone who’s simultaneously struggling with addiction, you should seek specialized treatment. When you have an anxiety disorder and a substance use disorder, they’re co-occurring disorders requiring dual diagnosis treatment.

Treatment for anxiety disorders and addiction are similar, but the approach needs to be specialized.

Regardless, if you haven’t previously been diagnosed with an anxiety disorder, a good starting point is to speak with your doctor.

From there, your doctor can help you determine the next best step.

If you only have a diagnosis of anxiety, your treatment plan will likely include behavioral therapy and counseling, such as cognitive-behavioral therapy. You might also receive medication.

If you have a co-occurring substance use disorder, you’ll likely need more intensive treatment, such as inpatient rehab.

Substance use and anxiety complicate one another and make treatment more complex. If you just treat your anxiety, the substance abuse disorder will make a recovery nearly impossible, and the same is true if you only treat the addiction. 

You need treatment for both issues at the same time.

You don’t have to suffer from high-functioning anxiety, nor do you have to self-medicate in an attempt to deal with your symptoms whether you experience them all the time or you just have worry at night. 

Contact Opus Health by calling 855-953-1345 to learn about dual diagnosis treatment that will help you retain the things you love about yourself while feeling like your underlying mental health issues are healing. 

More To Explore

Help Is Here

Don’t wait for tomorrow to start the journey of recovery. Make that call today and take back control of your life!

Begin Your Path to Recovery

Speak with our dedicated Recovery Advocates to find the right personalized treatment approach for you.

All calls are 100% free and confidential

A photo of the Opus Health Rehab Detox Center logo.