The Silent Struggle

In a world that celebrates academic and extracurricular success, many teens quietly battle a condition that often goes unnoticed until they reach a breaking point—high-functioning anxiety.

Pushing to the limit

High-functioning anxiety is a condition where individuals perform well in their daily activities despite feeling anxious. Unlike individuals with typical anxiety disorders, teens with high-functioning anxiety maintain high academic performance, excel in sports, and appear confident. “They tend to be a lot more driven and organized. They are motivated individuals that are setting high expectations for themselves,” says Kristin Wagner, LSCW-C, a therapist at Sheppard Pratt’s Center for OCD and Anxiety. However, beneath this successful exterior lies a constant state of worry and self-doubt—with anxiety pushing them to succeed at a significant cost to their mental health.

The impact on school-age kids

High-functioning anxiety can manifest in various ways, such as high academic performance and participating in numerous extracurricular activities, but it can negatively affect their social lives. Many teens isolate themselves, fearing failure or judgment from their peers. Teens may experience physical symptoms such as stomachaches, headaches, and repetitive physical behaviors like nail biting or skin picking. Older teens may exhibit emotional symptoms like irritability, restlessness, and excessive worry, Wagner explains. High-functioning anxiety often coexists with other mental health disorders like depression, obsessive-compulsive disorder (OCD), and attention-deficit/hyperactivity disorder (ADHD), complicating diagnosis and treatment.

Causes of high-functioning anxiety

The causes of high-functioning anxiety are multifaceted, involving genetic and environmental factors like family history or trauma. Teens with a family history of anxiety or other mental health conditions may be more susceptible to developing high-functioning anxiety, according to Wagner. Perfectionism, a common trait among these teens, can further exacerbate their anxiety.

How can parents help?

The first step in helping your teen is recognizing the signs of high-functioning anxiety. “Noticing changes in behavior is important,” Wagner says. “It’s also crucial to educate kids about stress and help them develop coping skills to manage it, such as exercising mindfulness and prioritizing self-care.” Wagner suggests treating mindfulness as focus training and ensuring teens carve out time for joyful activities to rejuvenate. Knowing how and when to focus your energy can help you better manage stress and anxiety.

If you’re concerned about your teen’s anxiety, help is available. Mental health professionals who specialize in working with adolescents can help your teen develop coping strategies. You can also look for a provider who specializes in cognitive behavioral therapy (CBT), which is proven to be effective in treating anxiety disorders.