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High functioning anxiety is not recognized in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as a mental health diagnosis. The term ‘high functioning anxiety’ is currently used as a broad, umbrella term that includes individuals who live with anxiety but are not overtly debilitated by its symptoms. According to the Mayo Clinic, having occasional feelings of anxiety is a normal part of life. Further, Psychology Today asserts “anxiety is built into our primate origins as a warning system,” and that there are several benefits to experiencing occasional anxiety. Anxiety can help an individual avoid danger as its presence elicits a heightened state of alertness which in turn can help to detect and attend to potential threats. Anxiety can help an individual further develop his or her empathy. Situational anxiety can contribute to enhancing one’s motivation and increasing performance levels. While there may be benefits to anxiety, experiencing persistent, debilitating anxiety is not healthy.

The medical definition of anxiety provided in the Merriam-Webster Dictionary is “an abnormal and overwhelming sense of apprehension and fear often marked by physical signs (such as tension, sweating, and increased pulse rate), by doubt concerning the reality and nature of the threat, and by self-doubt about one’s capacity to cope with it.” Individuals with high functioning anxiety often appear perfectly healthy to others, but are likely internally suffering from many of the same symptoms that accompany a diagnosable anxiety disorder. Fortunately, there are a plethora of treatment options available for individuals who are struggling with high functioning anxiety. 

Dialectical Behavior Therapy 

Psychologist Marsha M. Linehan developed dialectical behavior therapy (DBT) in the late 1980s as a more effective therapeutic method to treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD). It is a form of evidence-based psychotherapy that is founded on the principals of cognitive behavioral therapy (CBT) and blends Eastern mindfulness techniques (e.g., awareness, mindfulness and attentiveness to current situations and emotional experiences) to encourage acceptance and change. Dialectical behavior therapy consists of four primary behavioral skill modules, which include: core mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. Dialectical behavior therapy is comprised of three distinct therapeutic settings, including weekly individual psychotherapy (one-on-one therapy) sessions; weekly DBT skills group sessions, and access to twenty-four hour support between sessions via phone coaching, when needed.

High Functioning Anxiety and DBT

Every individual is different and will have a unique set of needs when it comes to the treatment of a mental health condition. Many mental health practitioners develop tailored treatment plans that cater to the nuanced needs of the individual. The development of DBT was intended to assist individuals diagnosed with BPD in managing emotion dysregulation and social difficulties. May individuals with high functioning anxiety often present with a false persona and typically struggle with cultivating meaningful relationships. DBT can be a highly effective method of treatment for individuals with high functioning anxiety. 


The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health.  As such, please do not use any material provided above as a means to disregard professional advice or delay seeking treatment. 

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