Anxiety does not have a single look. Some people have outward manifestations. They look stressed and jittery. Their hands can be sweaty. Others, however, do not look like they have any issues at all. They appear confident. They are calm. More importantly, they go about their day doing what they need to do without any issues. Despite these huge differences, it is possible for both to still have anxiety. It is just that high-functioning anxiety can show differently; and this is something I often support clients with through anxiety therapy in Dubai.
There are various factors that can influence anxiety and how it shows. For example, a study on Emirati female students showed that family pressures contribute greatly to their mental health. Other factors are societal expectations and cultural norms.1 Another study focusing on children named gender, the number of children in the family, polygamy, and socioeconomic status as some culture-specific risks for mental health in children living in Dubai.2
What is high-functioning anxiety?
Anxiety is a condition in which a person feels dread or fear that is not proportionate to a given situation. Everybody feels worried about something. But someone with anxiety can feel it constantly, even when there is no threat at all.
Anxiety occurs on a spectrum. In fact, there are different types.3 One example is Generalized Anxiety Disorder (GAD). A person with GAD feels worry excessively to the point that it becomes unmanageable. There are also anxiety disorders that are more specific, such as phobias. In these cases, a person feels scared of a particular thing or event. Social anxiety disorder is another type. This refers to the fear of being judged or thought of negatively by others. The main point is this: anxiety has different symptoms and has varying degrees of intensity.
People with high-functioning anxiety do not get this specific diagnosis. Instead, they are usually diagnosed with GAD. In these cases, people are able to function in their day-to-day lives without interruption. Outsiders often see them as successful or in control. However, these people struggle internally. They have all the other symptoms of anxiety, except that these do not disrupt their routines.
How can you tell if a person has high-functioning anxiety?
GAD can be a challenge to diagnose because somatic, or physical symptoms, are more common than psychological ones. These can present as shortness of breath, palpitations, or dry mouth.4 Health practitioners often conduct a physical examination to rule out illnesses or conditions of the body before landing on an anxiety diagnosis.
According to Johns Hopkins Medicine, a criterion for a GAD diagnosis is that it must be persistent. The feeling of dread and worry should be present most days and for at least six months. More importantly, a health practitioner should be the one providing the diagnosis.
High-functioning anxiety reflects many of these symptoms. However, there are some signs that are more pronounced than others. Examples of these are self-criticism, fear of embarrassing themselves in front of others, and worry that they are inadequate. People with this condition also tend to experience more stress.5
They tend to over-function, or do more than what is expected. They also have unrealistic expectations of themselves. While it can seem that they are successful or delivering results, this can lead to burnout and health problems.
High-functioning anxiety has a tricky aspect to note. One of the criteria of an anxiety disorder diagnosis is impairment in certain areas of functioning.6 Doctors have to be sensitive to the fact that one of the characteristics of a person with high-functioning anxiety is that their daily lives do not appear disturbed. It is important to have a complete picture of a person to get an accurate diagnosis.
How can you address high-functioning anxiety?
A person with anxiety can take the important step of seeking counseling or therapy. These can be crucial tools to help manage symptoms. For example, cognitive behavioral therapy can teach a person to reframe their thoughts. They can change the behaviors that fuel their anxiety. Support groups or group therapy can also provide insight from others who are in the same boat.
Symptoms can also improve through mindfulness, which is the practice of paying attention to the specific feelings that are happening at the moment. It can help alleviate stress and anxiety by reducing reactivity to emotions. People with high-functioning anxiety can use meditation or deep breathing to ground themselves when they start feeling overwhelmed.
Conclusion: Dubai’s Culture as a Contributing Factor to High-Functioning Anxiety
Dubai is a success-driven society. A large part of it is influenced by its economic situation. There are also societal or familial pressures to succeed. While there are undoubtedly a lot of advantages to these, people can feel a lot of pressure to keep up with the pace. While stress can act as a motivator, it can also lead to negative effects.
In the cases of those with high-functioning anxiety, they can keep up with the routines but suffer on the inside. This can have real-world effects, too. Not only can it lead to burnout and loss of productivity, but it can also have an economic impact. In the UAE, it is expected that the economic costs of mental health issues will double by the year 2030.7
Life is always full of high-pressure situations. These can feel magnified if the place you live in values success and achievement. In Dubai, it is important to recognize that anxiety does not always mean a low-performance lifestyle. Some people with anxiety look like they have things under control. It is important to note that just because symptoms are more subtle, it does not mean that they do not exist. In these cases, therapy and other management techniques are still essential.
Cited Sources:
- Jogia J, Anwahi F, Aburehaima S, Sharif A, Kumari V. Understanding Mental Health Needs and Predictors of Anxiety in Emirati Female Students in Higher Education. OBM Neurobiology 2024; 8(2): 220; doi:10.21926/obm.neurobiol.2402220. ↩︎
- Mental Health Problems Among Schoolchildren in United Arab Emirates: Prevalence and Risk Factors
EAPEN, VALSAMMA et al.
Journal of the American Academy of Child & Adolescent Psychiatry, Volume 37, Issue 8, 880 – 886 ↩︎ - Chand SP, Marwaha R. Anxiety. [Updated 2023 Apr 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470361 ↩︎
- Munir S, Takov V. Generalized Anxiety Disorder. [Updated 2022 Oct 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441870/ ↩︎
- Hubbard, L. (n.d.). Managing high-functioning anxiety. Mayo Clinic Health System. Retrieved July 20, 2025, from https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/managing-high-functioning-anxiety ↩︎
- American Psychiatric Association, DSM-5 Task Force. (2013). Diagnostic and statistical manual of mental disorders: DSM-5™ (5th ed.). American Psychiatric Publishing, Inc.. https://doi.org/10.1176/appi.books.9780890425596 ↩︎
- Trautmann S, Rehm J, Wittchen HU. The economic costs of mental disorders: Do our societies react appropriately to the burden of mental disorders? EMBO Rep. 2016; 17: 1245-1249 ↩︎