This Is What High-Functioning Anxiety Feels Like

It just comes. It doesn’t need an invitation. It just invites itself in, and suddenly your heart is beating faster. Your hands are shaking. Your bones feel weakened, jelly-ish. You’re afraid to raise your eyes, and when you do, it’s there staring you in the face: the reason your anxiety kicked into high gear.

And you have to breathe deep in order to catch your breath. You have to tense up those muscles, compensate for the jiggly-bone feeling. You must continue to force yourself to breathe normally. You might cross your toes over and over, hard enough it almost hurts. You might pick your cuticles, and you don’t notice you’re doing it until it does hurt. You may bite your lip, or chew your tongue, or catch the inside of your lip between your teeth.

But you do whatever it is that has scared you and made your anxiety peak. You step into the car and turn the ignition. You walk into that meeting. You knock on that door. You pick up that phone and dial the number.

This is the acute phase of high-functioning anxiety. No one sees your jelly bones. They probably don’t notice your shaking hands. And if you don’t tell them, they have no idea you’re legitimately terrified to get into the car or make that call or knock on the door.

In my case, I’m terrified to go to the post office. I don’t know why. I have things to mail. I need to mail them. But the idea of the post office puts a lump in my throat and a vicious nausea in my gut, and my heart races.

But high-functioning anxiety isn’t just the terror of the immediate. It also happens in the slow burn of the everyday. You don’t want to go home from work because you know if you go home from work, you have dishes to do. You fixate on those dishes, obsess over them, worry about them like a terrier with a bone, unable to let them go. They ruin your whole day.

Or you have a party that evening, a party you don’t really want to go to. You think about it obsessively. What to wear, what you’ll say, how long you have to stay without seeming rude. None of these things are that bad. None of these things will break you. It doesn’t matter. You can’t help obsessing miserably over them anyway. I do this with my riding my exercise bike. I like it, even enjoy it, once I’m up there. But the anticipation of it makes me feel sick to my stomach, makes me obsess, and can ruin my day.

High-functioning anxiety also includes the most banal of worries, like social anxiety. You worry that everything you say is stupid. You constantly feel like an imposter. You become convinced that everyone hates you, and even if they don’t hate you, that they think you’re stupid and uninteresting. I’ve known people for years, known them fairly well, and still was stuck in this stage. Their presence is enough to send me stammering and spouting nonsense in the midst of my terror. Which makes me look stupid. Which is a self-fulfilling prophecy.

Then there’s the mammoth worries. Everyone with high-functioning anxiety has them, and no one talks about them because we’d sound like we should be driven directly to the nearest emergency room. We might worry that we’ll drive off a bridge — not because we’re suicidal, but just because we thought about it and that thought is enough to make it happen. The French call it “l’appel du vide,” or loosely, “the call of the void” — the urge to jump from high places. We might be terrified that someone’s finger will slip and suddenly — oops! — nuclear war! Then nuclear winter. Then we’re all suddenly eating each other and living Cormac McCarthy’s bleakest of bleak novels, The Road.

We may be terrified of car crashes, just because we know how often they happen, and we figure our number has to come up one day. Will we die? Will we live on in paralysis? Do we have a will, both living and otherwise? We worry about hurricanes in June and snowstorms in January. Global warming and the death of bees. Syrian refugees and the Muslim ban. The plight of public schools. There is no end to what our mind can seize on and run with until we’ve reached death or apocalypse.

But most of our worries are more prosaic, just numerous and frequent. We worry that our kids are watching too much TV, that our 5-year-old isn’t reading enough, that our dog might have cancer. We worry our friends will think the house isn’t clean enough. We worry our friends will think the house is too clean. We worry about the far-off — vacations to come, Christmas, the end of the summer — and the close-up — tooth decay, germs in the kitchen, leaky faucets. Everyone worries about these things sometimes. We worry about these things a lot.

To have high-functioning anxiety is to always be worrying, but to mask that worry with a smile. Just beneath the surface, we’re freaking out about three different things. But above it, we’re smooth, unruffled. We look like we’re okay, but we’re just hanging on tight. Oh sure, things will slip out. But until you know us very well, you might not have any idea that we have a problem. We probably didn’t. We probably thought everyone lived like us for a long, long time.

Medication — SSRIs like Zoloft, or benzodiazepines Xanax or Klonopin — might help us out and keep us from our worst visions of nuclear apocalypse. But it can’t take everything away. We’re still worried about that faucet. And the tooth decay. And our dog. And nuclear winter. And driving off that bridge.

We start to shake again. And we clamp down, set our jaws, and keep going. This is what it is like, after all, to live with anxiety.