It's time to stop calling yourself "high functioning"
Putting this term to bed, once and for all
I have been back and forth on this week’s newsletter topic for a long time. In fact, this topic has sat in my drafts for months. I know it will probably ruffle some feathers, so I hope to word it in a way that makes sense of such a complex topic.
Here it goes.
I think we should stop talking about ‘high functioning’ in terms of mental health. Or at least reframe what it means and why it matters (or doesn’t).
High functioning is often used to describe someone with a mental health condition who is able to operate at a ‘high level’ - but what does that even mean?
It infers that a person with high-functioning anxiety, for example, is able to carry out normal daily tasks in spite of their condition. In fact, some might take it even further and say that their condition is what makes them high-functioning (more on that later).
Before I dive into my issues with the term ‘high functioning’, I want to say that I am aware that this term has been used historically to describe autistic people, and that’s not my field of expertise at all.
My husband is ND, but that doesn’t give me the right to speculate on what terms are acceptable or useful for the ND community. If you want to learn more about the problematic nature of high-functioning autism, you can read this really insightful piece by
on how this term can be damaging to the autistic community and the individuals given this label.So, back to the subject of ‘high functioning’ as a general mental health term. I must admit, I’ve used it in the past to describe myself.
Sure, I have anxiety, but I am also still getting shit done.
But the more I think about it, the less comfortable I feel about the label being used at all. Calling myself, or someone else, ‘high functioning’ does two things:
It implies that there are ‘low-functioning’ people
Most significantly, to me, it infers that it’s okay to have a mental health condition as long as you are still useful to society, i.e. able to function at the same level as everyone else.
It’s extremely dangerous (although very typical of our capitalist society) to say that people only have worth if they contribute to society in the way that we want them to.
A high-functioning person can work; therefore, they are paying into the economy. They can socialise, exercise, perform domestic tasks and myriad other activities associated with daily life. By saying I am high-functioning, I unintentionally add value to my condition. Sure, I’m anxious as shit, but at least I can do this.
And, with that attitude comes a slippery slope of the moral hierarchy associated with our inherent value as human beings. If we aren’t able to function in the way society wants us to, what’s the point? Are we worth less? Not a great question for people with depression, for example, to be asking themselves.
I’ve written in the past about how depression simply isn’t cool, and this is an extension of that issue. It’s hard to admit you have depression or an illness founded on depression because the symptoms of depression are so heavily associated with being ‘low functioning.’
Depression manifests itself differently for every person, but common symptoms include oversleeping, low motivation, difficulty with personal care, problems working, and so on. It’s safe to say none of this list could be prefaced with ‘high functioning’.
Anxiety is another kettle of fish, and one that is often described as ‘high functioning’ due to its very nature. Back to the point I touched on earlier about how you might actually be ‘high functioning’ because of your condition, this is another area that I think we have to be wary of for more reasons than those I’ve already mentioned about personal and social value.
Back in my corporate days, my anxiety was very, very bad. I would say it was debilitating, but that would imply I wasn’t able to do my job. In fact, I was really bloody good at my job. I worked long hours and delivered high-quality work, and I was even promoted within 11 months of starting at the company and given three direct reports. All because I was ‘high-functioning.’
To be honest, the more “high functioning” I became, the more anxious I was.
Playing into the fact that I was ‘high functioning’ allowed me to work myself into the ground. Sure, I was anxious, but I was good at it. I got stuff done - not in spite of my anxiety, but because of it.
And, obviously, this tower of cards was bound to fall. Because by allowing my anxiety to take the driving seat, I let my own health suffer. I became very ill with digestive problems and had regular migraines, my moods were erratic, and I suffered from very, very dark Sunday Scaries that would overshadow any semblance of a weekend I tried to enjoy.
I was constantly in flight-or-flight mode. So, from the outside, I was smashing it but, on the inside, I was falling apart.
Labels like ‘high functioning’ can do more harm than good, especially for anxious folks. They assign moral value to our conditions and allow us to continue engaging in dangerous behaviours like overworking and overthinking while justifying those things to ourselves as necessary for achieving our goals.
So, I guess there are two points to be made here…
The first is that if we’re not useful, then we have no value. This isn’t true. The whole existence of the phrase ‘high functioning’ to describe a mental health condition is damaging to the overall cause of getting society to accept and give worth to everyone, regardless of their mental health diagnoses.
The second is slightly more complex, and hopefully, I have articulated it above. By giving ourselves labels like ‘high-functioning’, we are telling ourselves (and others) that our output is the most important thing we do, even if that means our health suffers as a result.
I’m curious to hear what you think about the term ‘high functioning’ and if you have ever used it to describe yourself or someone else. I am particularly interested in hearing from ND people about this, as I know it’s a whole other beast to untangle and one that I can only try to understand through the voice of those with lived experience.
This week has been a rough one, if I’m honest. It was Mother’s Day on Sunday, so obviously that was really hard for me as a motherless mother. However, Craig did take me, Miri and his mam out for a delicious lunch on Saturday, so that definitely lightened the load.
Here are some other things I’ve enjoyed this week:
🎥 Dune 2 (IMAX) - OH LORDY, the second instalment in Denis Villeneuve’s Dune series, did not disappoint. What an epic 2.5 hours. I loved every single second of this film, and we’re already planning a trip to see it again soon.
🎮 Plate Up! - As avid fans of the co-op Playstation game Overcooked, Craig and I were delighted to start playing Plate Up!, which is a similar concept but definitely harder and more complex. I highly recommend it if you and your partner are looking for a fun game and want to argue every single night.
📖 Heartstopper Vol. 5 - I’ve had this on my shelf since Christmas and finally picked it up as expected the latest instalment in Oseman’s series is fantastic. I was also pleased to see a few more appearances from Tori and Michael from Radio Silence (my favourite of Oseman’s books).
That’s all from me this week,
See you next week for more of the same!
Ellen x