Seemingly successful at everything you do, but worried, nervous, and panicky along the way? Get the scoop on what’s going on.

WHILE HIGH-FUNCTIONING ANXIETY isn’t an official medical diagnosis, it’s an increasingly common term used to describe a collection of anxiety-related symptoms that very well may be indicative of a diagnosable condition.

Why the surge in popularity? As far as mental health conditions go, it sounds somewhat “appealing,” according to Elizabeth Cohen, PhD, a New York City–based clinical psychologist. More often than not, people would prefer to be considered “high-functioning” rather than just “generally anxious,” she explains, half-jokingly adding that people like “to have a disorder that makes them sound good.”

In a way, this is somewhat of a Trojan horse; it can lead those who wouldn’t normally check in with their mental health to look inward. Because there’s still so much stigma shrouding all forms of mental health diagnoses, the desire to distance oneself from these conditions could impede inner reflection and access to necessary mental health care, Cohen says. But, on the other hand, the label of “high-functioning” may provide a friendlier access point, due in part to the way this condition is framed.

That doesn’t mean, however, that there is “low-functioning” anxiety or that any other forms of anxiety are lesser-functioning. So what is high-functioning anxiety, exactly? Ahead, experts break down everything you need to know about the condidion, from signs and symptoms to effective treatment.

What Is High-Functioning Anxiety?

High-functioning anxiety is not an official medical diagnosis recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM), the catalog of psychological conditions widely used by clinicians to diagnose patients. It is, however, generally recognized by many mental health practitioners as a subset of generalized anxiety disorder (GAD), says Cohen. GAD is an anxiety disorder characterized by chronic anxiety, extreme worry, and exaggerated tension, even when there’s little or nothing to provoke it, according to the National Institute of Mental Health. That’s because high-functioning anxiety is essentially a “blend of different anxiety-related conditions,” Cohen explains. “It has the people-pleasing that usually comes with social anxiety, the physical responses and ‘waiting for the other shoe to drop’ component of GAD, and the rumination of obsessive-compulsive disorder.”

In essence, high-functioning anxiety is a form of anxiety that drives someone to be hyper-productive or hyper-perfectionistic, thereby yielding seemingly “good” results (in the material and social world). But this comes at somewhat of a mental cost: As they work harder and harder to achieve a metaphorical A-plus, they’re simultaneously overcompensating for the fears (e.g., failure, abandonment, rejection) that are fueling the fire, explains Cohen. Still, it might be hard to pinpoint when a person is struggling with high-functioning anxiety—so much so, in fact, that it’s frequently referred to as “hidden anxiety,” according to experts. This is due largely to the “high-performance” part of high-functioning anxiety, which people don’t typically associate with mental illness or mental health challenges. (Although, friendly reminder: Mental health is varied, and these conditions don’t look the same for everyone.)

“Often, people with high-functioning anxiety look like rock stars and show outward trappings of success,” says clinical psychologist Alfiee Breland-Noble, PhD, director of the AAKOMA Project, a nonprofit dedicated to mental health care and research. In other words, their public, outward life is often marked by a prolific career, high achievement in multiple areas, and/or a polished family and home life—all of which is typically fueled by fear rather than passion. “A fear of not comparing to others, a fear of falling behind, or a fear of getting older,” explains Cohen. These are the people who tend to “have it all” on the surface, but it’s kind of like Instagram in human form—you’re only seeing the highlights.

Society tends to reward those with high-functioning anxiety, thereby perpetuating this success-no-matter-the-stress mentality. Take, for instance, someone who, out of anxiety or fear that they’re not doing enough to please their boss, spends the whole weekend working on a particular project. They then return to work on Monday completely depleted and strung out. Still, they’re likely praised by their boss and colleagues, called a “team player,” and lauded as someone for whom no task is too big nor too small. There’s a heap of positive reinforcement for this anxiety-fueled behavior that’s not necessarily healthy or sound. And because of it, someone with high-functioning anxiety will likely assume that their overworking, perfectionist tendencies are responsible for their success, Cohen says: “But in reality, this behavior leaves them and their nervous system feeling frazzled, on edge, and in a heightened state of anxiety.” Kind of like burnout.

“When you figure out what behaviors work, you repeat them. You want to survive, ultimately, and if you believe it helps your survival, you do it more,” Cohen explains. “Behaviors associated with high-functioning anxiety get really, really reinforced by the world around you.”

So perfectionism, people-pleasing, overachieving, and overworking—no matter the negative mental health impact—are understandably all signs of high-functioning anxiety. Of course, that’s just the short list of the possible symptoms of the condition. For example, you might also be guilty of constantly apologizing, says Cohen. “Saying ‘I’m so sorry’ or ‘I’m so sorry I’m late’ gets seen as conscientiousness—but in reality, you’re putting extra pressure on yourself,” she points out.

What Are the Signs of High-Functioning Anxiety?

Still, high-functioning anxiety isn’t the easiest to identify. “The average person cannot typically see how high-functioning anxiety impairs the person living with it,” says Breland-Noble, who adds that even for an expert, it can take a few sessions before being able to identify the magnitude of a patient’s anxiety if it’s high-functioning.

What’s more, high-functioning anxiety can and often does look different depending on the patient and other variables, such as their culture. This is due largely to the fact that high-functioning anxiety isn’t an official medical diagnosis, and also because of the lack of BIPOC in mental health studies, explains Breland-Noble, who started the AAKOMA Project for that very reason. “Overall, I’m not certain that we as mental health professionals have a deep understanding of the full range of presentation styles as they relate to anxiety in general and high-functioning anxiety specifically,” she says.

That said, both experts say that there are some general symptoms of high-functioning anxiety. Emotional symptoms include irritability, restlessness, fear, and trouble concentrating. Physical symptoms include sleep issues, fatigue, chronic headaches, and nausea.

Is There Treatment for High-Functioning Anxiety?

This type of mental health challenge can definitely be managed, and rewiring your behaviors or habits is absolutely achievable. “Working on lessening high-functioning anxiety and bettering yourself, however, is a daily process, and it’s hard; it’s like each time you have the opportunity to fall into behavior, you have to do the opposite action,” says Cohen. One step to coping with high-functioning anxiety is giving it a name and normalizing it. In Breland-Noble’s practice, she works to “reduce stigma by naming and normalizing” anxiety, including high-functioning anxiety. “I want my patients to understand that they are not alone, that a lot of people live with this, and there’s a healthier way to live—but only if you name and acknowledge what you’re dealing with.”

Additionally, while many people living with anixety have the constant sense that they aren’t doing enough about it, it could actually help to focus on doing less. “Less self-flagellation, less responding to emails and texts immediately all the time, less apologizing. Do less by taking a sacred pause, and stop optimizing—unless it’s optimizing for joy or for ease,” Cohen suggests.

Sure, that’s easier said than done, especially when you’ve gotten into the habit of being constantly available. Start by waiting 24 hours before responding to a given email or text. “Otherwise people expect instant responses from you,” which perpetuates this unhealthy cycle of high-functioning anxiety, Cohen says. “Make it clear that you want good results, not fast results—that you know there’s a benefit to reflecting and taking time,” she adds.