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Could your child have high-functioning anxiety?

The telltale signs of high-functioning anxiety in children range from ambition and perfectionism to insomnia and extreme fear of failure.

Did you know that more than 9% of children aged three to 17 worldwide suffer from anxiety? According to the Centers for Disease Control and Prevention, that equates to one in three children. 

The symptoms of anxiety differ between children and adults. For example, toddlers typically complain of physical ailments such as stomachaches and headaches, whereas older children typically experience angst, apprehension, irritability, and difficulty concentrating. There are also different types of anxiety disorders, including high-functioning anxiety.

What exactly is high-functioning anxiety? 

According to Dr Rachel Delany, a child and adolescent psychiatrist, high-functioning anxiety is a term used to describe individuals who experience high levels of internal anxiety but come across as successful and high-achieving. 

“Their anxiety is mostly internal and does not manifest through avoidance or excessive coping behaviours. On the surface, these people appear to be confident, poised, and professional, and they are frequently at the ‘top’ of their class or respective fields,” she said.

Signs of high-functioning anxiety in children

Common symptoms of high-functioning anxiety in children include:

  • Overthinking and overanalysing 
  • Dwelling on mistakes made in the past
  • Irritability 
  • Insomnia and fatigue 
  • Extreme fear of failure
  • Difficulties saying “no”
  • Nervous habits and tics (nail biting, skin picking, leg bouncing, and so on) 
  • Excessive worry
  • Physical symptoms such as upset stomachs or headaches

However, many of these symptoms are not visible. 

High-functioning anxiety differs from more severe or limiting anxiety in that the child continues to perform well in daily activities. A tween or teen with high-functioning anxiety may exhibit externally perfectionistic characteristics such as good organisation skills, punctuality and good planning. They may appear ambitious and hardworking as well. Children who suffer from high-functioning anxiety are typically high achievers and well-prepared.

What causes high-functioning anxiety?

The causes of high-functioning anxiety vary greatly. For example, a family history of anxiety may predispose a child to the disorder. Anxiety can also be triggered by negative or stressful life events, medical conditions, and environmental stressors.

How is high-functioning anxiety in children treated?

It’s best to always consult with your child’s doctor or a health care provider if you believe your child suffers anxiety. Your provider may refer you to a child psychologist or psychiatrist.

Anxiety can be treated in a variety of ways. Talk therapy can help some parents and children manage symptoms together. Speaking with a therapist or counsellor can help you as a parent understand your child’s anxiety and can help teach your child techniques for coping with it. For other children, medication may be an option. In other cases, a doctor may suggest a combination of therapy and medication for your child.

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I'm an experienced writer, sub-editor, and media & public relations specialist with a demonstrated history of working in the media industry – across digital, print, TV, and radio. I earned a diploma in Journalism and Print Media from leading institution, Damelin College, with distinctions (Journalism And Print Media, Media Studies, Technical English And Communications, South African Studies, African & International Studies, Technology in Journalism, Journalism II & Practical Journalism). I also hold a qualification in Investigative Journalism from Print Media SA, First Aid Training from St John’s Ambulance, as well as certificates in Learning to Write Marketing Copy, Planning a Career in User Experience, and Writing a Compelling Blog Post.
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