All treatment providers we recommend are regulated by the Care Quality Commission (CQC) or Care Inspectorate.
Generalised anxiety disorder (GAD) is a mental health condition characterised by constant and (usually) irrational worries. Those with anxiety struggle to control anxious thoughts and habits, which manifest both physically and mentally.
The DSM-5 defined generalised anxiety disorder and symptoms of anxiety: 
This persistent anxiety is characterised by uncontrollable worry for a long period of time. Commonly associated with alcohol abuse, substance use, and other health problems, anxiety presents with a list of treatable complications.
‘High functioning anxiety’ occurs in individuals that suffer from anxiety but are still able to meet the demands and responsibilities of daily life. People often keep their fears and worries internal, seeming confident and fearless on the outside.
This is not the same as general anxiety disorder, and it isn’t recognised by the DSM as a diagnosable disorder. The difference between general anxiety and high-functioning anxiety lies in the person’s emotional and physical response to the stimuli causing anxiety.
People who experience general anxiety fear certain situations and often avoid them. People with high-functioning anxiety will often push themselves regardless of the anxiety they are feeling. 
It is difficult to diagnose high functioning anxiety, but certain factors may contribute to its presence:
It is challenging to know exactly how many people suffer from high-functioning anxiety, as it can often be mistaken for constant feelings of ‘fight or flight’. 
Those with high-functioning anxiety use their fears to push them towards uncomfortable feelings, propelling them into situations and experiences rather than holding them back. How people appear on the outside is the opposite of how they feel on the inside. So, what does it look like?
Positive Characteristics of High Functioning Anxiety: 
Negative Characteristics of High-Functioning Anxiety:
Those with high-functioning anxiety are often seen as hard workers and over-achievers. This perception can add unnecessary stress to individuals already struggling internally, aiming to please and confirm the high expectations set by others.
However, this perception fails to take into account the internal struggle and the constant deep-rooted worrying that is required to uphold such positive external facades.
This form of anxiety hides people’s true feelings, which can impact their quality of life.
There are different levels of anxiety and different types of anxiety. Severe high-functioning anxiety engages a false persona, as people with this form of anxiety will lead productive lives on the outside but battle constant fears and worry on the inside.
Inside, people with high-functioning anxiety may suffer from:
Mental health became stigmatised as early as the Middle Ages. Those who were mentally ill were said to be possessed by demons and devils in need of a priest.
These negative attitudes persisted into the next Centuries, which led to the confinement and imprisonment of the mentally ill.
WHO, The World Health Organisation states that stigma is ‘a mark of shame, disgrace or disapproval which results in an individual being rejected, discriminated against, and excluded from participating in a number of different areas of society‘. 
The National Survey of Mental Health Literacy and Stigma states that the biggest misconception about anxiety is that it is viewed as a weakness. It is also common for people to believe that anxiety is not a ‘real’ medical illness, and that they should just ‘calm down and relax’.
Stigmatising anxiety leads to reduced self-worth and a lack of confidence.
This can lead people to disconnect from those who aren’t being supportive and others. Fear of being negatively labelled often prevents people from seeking the medical care they need as they feel embarrassed asking for help.
Anxiety, or ‘claiming anxiety’, is commonly seen as an excuse. The difference between generalised anxiety and high-functioning anxiety is that internal worries do not prevent people from functioning, instead the anxiety is used to keep going.
To many people, this does not ‘appear’ like anxiety, as it manifests differently on the outside. Despite these negative attitudes, high-functioning anxiety can be as damaging as a generalised anxiety disorder.
Mental health professionals can help with high-functioning anxiety through behavioural therapy. Anxiety is a mental health disorder that can affect our daily lives.
An anxiety disorder diagnosis may seem scary and overwhelming, but it is treatable. Feelings of anxiety are often irrational, but these deep-rooted fears can be managed by changing our mindset and outlook.
CBT is a short-term treatment that focuses on skills to aid emotional responses to irrational thoughts. This changes the way patients think, modifying behaviour. By addressing underlying negative thoughts, CBT alters maladaptive emotional responses. 
Exposure therapy is commonly used in CBT methods for treating anxiety.  Exposure treatment comes from the theory of emotional processing; fear is represented by cognitive networks that retain information about the feared stimulus and response.
For example, your brain will remember that the last time you got in an elevator you felt an increase in heart rate and started sweating. When the environmental stimulus that activates fear is encountered, brain networks activate the fear structure.
The relationship with the stimuli and responses are often irrational and maintained by avoiding the feared stimuli.
Exposure therapy aims to modify the fear structure. By activating it in a safe environment, the brain then provides new information to the structure to disconfirm the associations we usually make.
Amongst other forms of therapy, medication is also available from your GP to help your anxiety. Medication for anxiety has been developed for both long-term and short-term use depending on the nature of your anxiety.
The first type of medication you may be prescribed is selective serotonin reuptake inhibitors, also called SSRIs. This is likely to be the first medication you are offered, working to increase the levels of serotonin in your brain.
Sertraline is a common type of SSRI, used to treat depression, OCD, panic attacks and PTSD. This starts to work after four weeks of the first tablet, although positive effects can be felt after the first week.
Common side effects of sertraline:
Escitalopram and paroxetine are used to treat similar conditions, such as depression, anxiety, OCD and panic attacks. They also have parallel side effects as sertraline.
Serotonin and noradrenaline reuptake inhibitors called SNRIs may be prescribed to help ease feelings of anxiety if SSRIs don’t seem to help.
This medication increases the levels of serotonin and noradrenaline in the brain. Venlafaxine and duloxetine are two forms of medication under the SNRI bracket, with these side effects:
If SSRIs and SNRIs aren’t applicable to you, the GP may suggest pregabalin. This anticonvulsant is used to treat epilepsy, but research has shown that pregabalin helps levels of anxiety.
This medication is less likely to cause low sex drive and sickness than the others (SSRI and SNRI).
Before you go to the GP and seek medical help, make sure you are doing all you can to help your anxiety using natural coping mechanisms.
Constantly living with anxiety can prove to be challenging, so try to implement the following into your daily routine:
 American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed. Arlington, VA: American Psychiatric Association, 2013.
 The South African College of Applied Psychology. What is high functioning anxiety and is it real?
 National Institutes of Mental Health (NIMH), The National Institute of Mental Health Information Resource Center. Any Anxiety Disorder.
 AH Clark, Clark Psychology Group. 9 Surprising Symptoms of High Functioning Anxiety.
 HansE.HillerW.A meta-analysis of nonrandomized effectiveness studies on outpatient cognitive behavioral therapy for adult anxiety disorders.Clin Psychol Rev.20133395496423988455
 FoaEB.KozakM.Emotional processing of fear: Exposure to corrective information.Psychol Bull.19869920352871574
If you’re living with problematic or addictive substance use, at some point someone will mention counselling. You might have heard of it in relation to treating stress, mental health conditions, …