There are so many joys a person can experience in life, but many of those same joys also come with stresses. For example, you may be happy to see your kids’ smiling faces when you pick them up from school (joy) but to get them, you have to rush and wait in a long line to pick them up (stresses).
Many people have a level of stress (arousal) that they can tolerate where it won’t interfere with their functioning. They can handle stresses, difficulties, noises/sounds, and more while still being mentally present, feeling all their emotions, and otherwise able to stay emotionally regulated.
One term for this is the “Window of Tolerance” – the amount of space someone has that allows for psychological comfort and flexibility. It’s not necessarily about happiness, but it is about being able to function despite what’s going on around them.
Those with mental health challenges, however, typically have a much smaller window of tolerance. Stresses and difficulties end up putting them above or below the window:
Above the Window – This is called the “hyperarousal” zone. It is more common for people with anxiety. It is where their bodies react with excess energy, like nervousness and agitation, when the stresses do not fit into their window of tolerance.
Below the Window – This is known as the “hypoarousal” zone. It is more common in those with depression. It is where a person’s response to issues not fitting in their window is to shut down, become numb, and give up.
Note: Admittedly, one of the limitations of the “Window of Tolerance” analogy is that it doesn’t explain why some people go “above the window” and some people go “below” other than an individual’s mental health. But the window of tolerance itself does help beneficially describe what a person can handle, and why it differs from one person to the next.
The Shrinking Window of Tolerance with Depression
When a person has depression, they have a smaller window of tolerance. That means that there are fewer things that they can handle before their window becomes full and overwhelmed. For example, a light criticism from a coworker becomes a head on collision, because their window is full and nothing else can fit through before it spills out below the window.
But why does this window shrink?
Low Battery – Depression is exhausting, so a person with depression often has a low battery that is less capable of handling multiple tasks before being depleted.
High Threat Systems – Those with both depression and anxiety have a higher than active threat detector, which misinterprets neutral or only mild threats as more significant threats.
Minimal Backup – When your mental health is functioning, you have mechanisms in place to keep you “in your window.” Not so with chronic stress and depression, where the systems that usually calm us, like neurotransmitters, are not able to do their job.
The smaller the window, the less a person feels like they can handle. So our role as therapists is to try to get the window bigger.
How Do We Increase the Size of the Window of Tolerance?
Improving the size of the Window of Tolerance is something we do indirectly in therapy, by teaching coping tools and stress reduction mechanisms that allow us to stay grounded, present, and reduce negative critical thoughts.
If you feel like you may be struggling with a smaller window of tolerance and want help addressing your depression, please reach out to Flourish Psychology, today.
We often talk about social anxiety by referring to its effects on relationships. Yet, what make social anxiety so challenging and so problematic is that it affects us even when we are not engaging in social activities. Like other forms of anxiety, social anxiety is ongoing and constant, and it is in our best interests to make sure that we are addressing this anxiety so that we can improve not only our social life, but the rest of our decision making as well.
The Ways Social Anxiety Shapes Decision Making
Remember, social anxiety is always there. It does not just appear when you’re in a party or a meeting. It, like most forms of anxiety, touches everything that you do.
That means that it can also guide choices that you make throughout the day. It affects decisions you make about work, school, dating, marriage, and much more.
Many people living with social anxiety make decisions based on fear of judgment rather than personal preference or practical benefit. This can influence everything from small routines to major life paths.
Avoiding Opportunities – A person with social anxiety may decline a job interview, pass on a promotion, or avoid signing up for a class because they anticipate embarrassment or fear not meeting expectations. These choices limit personal growth.
Over-Preparation and Perfectionism – Decisions can become slowed by the need to prepare excessively. Writing an email, submitting work, or even posting online may require multiple drafts because of concern about how others might perceive mistakes.
Choosing Convenience Over Preference – Something as simple as deciding where to shop or which restaurant to order from may be shaped by which option feels less likely to involve social stress, even if it is not the person’s preferred choice.
Difficulty Saying “No” – Fear of disappointing others or being seen negatively can lead to agreeing to commitments that do not align with personal goals or comfort.
Withdrawing from Conflict – When facing disagreements, the decision may be to avoid confrontation entirely, even at the expense of personal needs or fairness.
Trouble Analyzing Others – Negative self talk may cause people to misunderstand social media posts, texts, and more, as they assume that other people do not see the world the way they do, leading to worse decisions.
Any decision that is fueled by anxiety is one that may not be right for the person experiencing it. Instead of going through life in such a way that they’re able to make decisions that benefit them, they may be choosing things not just based on the anxiety itself, but on the way it shapes their opinions.
The Ongoing Effects of Social Phobia
Another factor to consider is the way that social anxiety reinforces its own behaviors. When you make small decisions in the moment based on your social anxiety, you create patterns that reinforce avoidance behaviors and problematic thinking.
This both:
Causes you to have more social anxiety and allow it to control you further.
Leads to situations where you’re in a job, relationship, or something else you do not want, leading to more unhappiness and, ultimately, more anxiety about life.
This is one reason why social anxiety is never limited to social experiences. When you have social anxiety, it quietly influences everyday decisions, leaving less space for spontaneity, growth, or authenticity.
Moving Toward Healthier Decision Making
Addressing social anxiety means more than reducing fear in social events. It involves building awareness of how anxiety guides decisions and working to shift the decision-making process back toward personal goals rather than avoidance.
Even if you feel like your social anxiety is manageable – maybe you have a few close friends, or you’re in a good relationship, or you’ve accepted this anxiety as a part of yourself – it’s always touching the decisions you make and the behaviors you do.
Treat social anxiety instead. You’ll find that you’re happier and more fulfilled when your anxiety is in your control.
Society’s attitudes towards mental health have changed considerably from where they were even a few decades ago. Seeking therapy, especially in places like New York City, is considered normal and encouraged.
Still, many people have trouble asking for help. Not just with mental health, but with anything. They don’t like asking their friends to help them move. They have trouble asking their family for advice or emotional support. They feel uncomfortable asking coworkers to take on parts of their projects.
They believe that they NEED to handle things on their own. It’s a part of their upbringing, almost like an identity.
It’s hard to seek help from a therapist when you have this mindset. Yet, it’s important to also take a moment to show you seeking a therapist is NOT asking for help. At least not the way you’re thinking about it.
In fact, seeing a therapist is exactly the behavior that you expect from someone that is handling things on their own.
Let’s talk about what we mean.
Are You Asking for Help When You See a Doctor?
Imagine your leg got a cut with a painful infection. What would you do?
You would call the doctor. Obviously.
Is that “asking for help?” No. It’s actually handling things on your own. You had a problem, a doctor can solve it, so you called the doctor. You didn’t need help from anyone to do that. Calling a doctor was the way to handle it on your own.
What would happen if your car broke down?
You would call a mechanic, or a towing company. You would not be “asking others to help” you do that. You would be the one “handling it” by calling the towing company and getting your car repaired.
You get the idea here.
So what happens when you have trouble with your mental health?
You’re not “asking for help” by reaching out to a therapist. You are doing the logical step – GETTING help from the person that is most qualified to provide that help. You’re then paying that person to do their job by helping you improve your mental health.
All of this IS handling things yourself, because you are the one, all on your own, seeking the solution to your challenges.
The Psychological Effects Behind Asking for Help
In addition, depending on what you feel you are struggling with, the difficulty asking for help may be a symptom – or even a cause – of the condition.
For example, there are those that struggle with what’s known as “functional anxiety.” This is a term that refers to individuals that tend to overachieve. Anxiety almost becomes fuel that pushes them to accept more projects, work harder, work extra, and be perfectionists in everything they do. These individuals struggle with asking for help because their anxiety pushes them to accept everything that comes their way.
There are also those that take on too much because they feel it’s their responsibility to care for others. These individuals tend to have considerable problems “asking for help” because they were raised to be the caregivers of the family, or the person responsible for keeping things together. This can cause a person to feel overwhelmed, burnt out, and anxious. In this case, the person’s tendency to feel responsible for others is a possible cause of their anxiety, and thus something that needs to be addressed.
Find a Therapist for Your Mental Health
As you can see, the challenges people have asking for help can cause (or be caused by) a person’s mental health, and – if you think deeply about it – contacting a therapist is doing things on your own anyway. It is not a sign of weakness, it is not leaning on others, it is not inconveniencing anyone. It is seeking a problem (“I need help”) and solving it.
See what therapy can do for you. If you’re in New York, reach out to Flourish Psychology and let’s begin the process of getting you the support that your mental health needs.
We’re not getting enough sleep. Most of us are sleep deprived, and rarely, if ever, get a full night’s sleep more than one day in a row.
There are many issues that lead to these difficulties, and addressing them can take time as we determine why they’re occurring and work individually with how to solve them. Yet some of the potential causes of sleep difficulties, including racing thoughts, metal to due lists, and emotional residue from the day can interfere with the onset and quality of sleep.
Sleep hygiene practices are, at least theoretically, designed to address this. By giving yourself a habit/routine to help you fall asleep, you should be able to calm your mind and ease off easier than if you simply go straight to bed with your phone in your hands.
But, of course, sleep is more complicated than that, and there are plenty of times when our brains stay highly active and we have too much on our minds to relax.
Why the Brain Struggles to Transition to Sleep
Before examining journaling, it’s important to understand why sleep onset is disrupted. One of the most well-documented factors is heightened cognitive arousal – essentially, excessive mental activity in the pre-sleep period. This can include:
Persistent planning or problem-solving thoughts
Unresolved emotional tension from daytime experiences
Anticipatory anxiety about the following day
New ideas you want to remember or to-dos that you would like to prioritize
Research shows that these thought patterns correlate with activity in the default mode network (DMN), a neural system associated with self-referential thinking. High DMN activity at bedtime is associated with longer sleep onset latency and lighter sleep cycles.
Because journaling externalizes internal dialogue, it has the potential to reduce DMN activity and shift the brain toward a state more conducive to sleep.
The Power of Sleep Journaling
In these situations, you may want to consider keeping a sleep journal next to your bed.
Sleep journals are, essentially, journals where you can write down anything and everything that is on your mind when you are trying to go to sleep at night. It doesn’t necessarily matter what you write down, and you never need to force yourself to write down anything if you’re feeling tired (it differs from a gratitude journal in this way, as those types of journals are designed to be completed daily).
Rather, it’s a place for you to put your thoughts on paper in order to get them out of your head.
Journaling at night can reduce mental overactivity and create psychological closure that supports sleep onset. This practice is not simply about venting thoughts onto paper. The type of journaling, the structure, and even the timing all contribute to how journaling interacts with the brain’s sleep-regulating systems.
What Happens When You Journal Before Bed
Journaling operates at the intersection of cognitive restructuring and emotional regulation. Several peer-reviewed studies have found that the right form of journaling can measurably affect key variables tied to sleep, including sleep latency (how long it takes to fall asleep) and overall sleep quality. For example:
A 2018 study published in Journal of Experimental Psychology found that individuals who wrote out specific tasks they needed to complete the next day fell asleep significantly faster than those who journaled about completed tasks.
Another study published in Behavioral Sleep Medicine showed that expressive writing – where individuals write about their thoughts and feelings – reduced symptoms of sleep-onset insomnia in people with anxiety.
Keep in mind these are examples of *different* benefits. The first study looked at something called “cognitive offloading” where moving thoughts out of your mind (your working memory) and onto paper basically tells your brain “don’t worry, you can’t forget, it’s written down on paper” which frees up additional resources and helps the brain disengage from active processing.
The second study showed that writing out our emotions and feelings is a form of processing. Anxieties and stresses often occur when emotions feel unresolved, or when they’re bouncing around in mind without being fully processed. Writing out these emotions help us process them, allowing us to have some closure and, eventually, sleep.
Remember, these thoughts may not all be stressful. Imagine you’re someone that loves writing, and – when you’re supposed to go to sleep – you have this great idea for a story. Your mind can’t relax if you’re worried that you may forget the idea. If you write it down, your brain knows you can’t forget it, and you can hopefully relax better and ease yourself into sleep.
Addressing Sleep for Mental Health
Sleep may not be directly responsible for the entirety of our mental health, but it becomes extraordinarily difficult to cope with stress and address our psychological challenges if we’re not also prioritizing sleep. Journaling may not solve all your issues, but if an active mind is keeping you awake, consider taking out a journal and testing out those benefits.
In the mental health world, the term “obsessions” has a very different meaning than it does in casual conversation. In casual conversation, “obsessions” are things you want or desire. They’re things you’re happy to think about often, or things that you like to do.
In the mental health world, “obsessions” are very different. They are typically thoughts that you *do not want* that “intrude” your mind over and over again. Most of the time, these thoughts also cause distress, as they’re often on topics and subjects that a person finds upsetting.
One of the challenges of obtrusive thoughts is how hard they are to control. The more you try to push them away, the more they come back. This is actually by design. Our brain is, in some ways, specifically designed to make sure that the more you try to stop a thought, the more often the thought will occur.
Why Can’t We Stop Intrusive Thoughts?
Psychological studies have shown that it takes a lot of mental energy to avoid thinking about something. So much energy, in fact, that your brain needs to remind you of it in order to remember not to think about it. There are different terms for this, but one of the most popular is called the “Pink Elephant Problem.”
What is the Pink Elephant Problem?
The Pink Elephant Problem is a study that shows that if you tell half a group of people to think about a pink elephant, and half a group of people not to think about a pink elephant, the group told not to think about it ends up thinking about it more than the other group. It takes so much energy to avoid thinking about a topic, that you end up thinking about it more.
What Does the Pink Elephant Problem Have to Do With OCD?
Imagine you have an intrusive thought that causes you distress. Because it causes you so much stress and anxiety, you try to push it away. You try your best not to think about it. Suddenly, you’re running into the pink elephant problem. Your brain spends so much energy trying not to think about it that it ends up thinking about it more and more often.
How Do You Break This Cycle?
Part of overcoming these intrusive thoughts is breaking this cycle and making it so that you *can* forget. To do that, you have to actually embrace the thought. Remind yourself that your intrusive thoughts do not define you. Remind yourself that pushing the thought away does not work. You may even want to think about the thought on purpose in order to make it something that you no longer obsess on.
Is That All There is To It?
No, addressing OCD does take a lot more energy and effort. You may have to address the initial causes of the obsessions, the compulsions, what causes you the most distress, and even forgiving yourself for your thoughts. Those all take time and energy, and benefit from working with a therapist.
But if you stop attempting to push down those thoughts, accept that you have them, and focus on moving forward, then the thoughts not only should occur less – they should also cause less distress when they do occur.
Ready for OCD Help?
If you are someone that struggles with obsessive compulsive disorder or intrusive thoughts, reach out to a therapist today. Through therapy, you can gain more understanding of the cause of these thoughts and develop cognitive tools to help you control them. Contact us today to learn more.
We talk about anxiety as though it is always a debilitating disorder – one that people struggle with *immensely*. Certainly, some people do have anxiety that makes it difficult to function, unable to leave the house or experience a happy and productive life.
But for others, anxiety is not a debilitating condition. It is a manageable one. Their anxiety affects their life, but it doesn’t control them, and so a person with anxiety can still manage relationships, work, parent, and perform normal tasks.
The thing is, that itself can be a problem.
When a person has this type of anxiety, they may be hesitant to treat it. Why see a therapist when you are still married, or you still work, or you have friends that you see regularly?
Yet, we know a few things to be true:
Everyone deserves to live their best, happiest life, and that is often not possible when a person has anxiety.
Someone that has more manageable anxiety now may not have manageable anxiety later. Untreated anxiety is at risk for getting worse over time.
Anxiety may seem manageable because your life seems normal, but if you didn’t have anxiety, your life would be very different.
Individuals with this type of anxiety are sometimes referred to as having “high functioning” anxiety or being “high functioning.”
High functioning anxiety is not a clinical diagnosis, but rather a term used to describe individuals who appear outwardly successful, organized, and composed, while internally experiencing persistent worry, self-doubt, and emotional distress. These individuals often meet personal, academic, or professional expectations while privately struggling with anxiety symptoms that are either unrecognized or dismissed due to their high level of daily functioning.
This form of anxiety can be difficult to detect because it doesn’t disrupt responsibilities in obvious ways. In fact, it can drive people to be more detail-oriented, more dependable, or more productive. But beneath the surface, the emotional toll can be significant.
How High Functioning Anxiety Differs from Other Anxiety Presentations
Typically, a person that is high functioning with anxiety are still touched by the condition. Generalized anxiety disorder, for example, causes people to feel anxious more generally, without necessary a specific fear or issue. At work, they may feel anxious about meetings, but they’re still *at work* and doing their job, and to others they may just appear a bit more shy, or their heartbeat goes up a lot but they are otherwise able to manage their experiences. When dating, they may have more fears about “screwing up” a date, but they may otherwise be able to go on dates and just feel high stress and high anxiety throughout the time – possibly overthinking later.
Yet even though they’re functioning, they’re still being affected by their anxiety. They may, for example, be less likely to ask for a raise at work. Or they may be less likely to act confident on a date. Or they may be overly worried about their child running into a street. Their anxiety still touches everything they do in some form.
Compensatory Behaviors
Some people with high functioning anxiety go a step further. Unlike generalized anxiety disorder (GAD), which may interfere visibly with day-to-day functioning, high functioning anxiety may be marked by compensatory behaviors that mask internal distress. People with high functioning anxiety may manage their anxiety through over-preparation, perfectionism, and rigid routines – behaviors that may be socially rewarded but are mentally and emotionally draining.
They are often described as:
Responsible
Ambitious
Reliable
Detail-focused
Self-motivated
But internally, they may also feel:
Constantly worried or tense
Afraid of failure or disapproval
Overwhelmed by routine decisions
Exhausted from overthinking or over-planning
Anxious even during rest or downtime
While the outward appearance may suggest control and capability, internal symptoms often include:
Racing thoughts or chronic overthinking
Difficulty relaxing or feeling “off duty”
Irritability or restlessness, especially when unproductive
Fear of disappointing others or being judged
Over-scheduling or trouble saying no to requests
Perfectionism and fear of making mistakes
Sleep disturbances, especially trouble falling asleep due to mental activity
Physical symptoms such as muscle tension, headaches, or gastrointestinal discomfort
These symptoms may not be severe enough to stop the person from functioning, but they can contribute to long-term stress, burnout, or emotional fatigue.
Why It Often Goes Unnoticed
High functioning anxiety often goes unrecognized for several reasons:
The behaviors it drives – such as punctuality, attention to detail, and overachievement – are socially reinforced.
The person may not describe their experience as “anxiety” because they are not having panic attacks or visibly falling apart.
Friends, family, and coworkers may see them as capable or calm, unaware of the internal pressure they are constantly managing.
In many cases, individuals don’t seek help because they believe their anxiety is simply part of their personality. They’re used to it. And because their life feels fairly normal, at least in the eyes of society, then they do not feel like they are in need of additional help.
Risks of Leaving High Functioning Anxiety Unaddressed
When high functioning anxiety goes unrecognized or untreated, it can lead to long-term complications such as:
Chronic stress or burnout
Increased risk of depression
Relationship strain due to emotional unavailability or irritability
Avoidance of rest or difficulty enjoying downtime
Difficulty adjusting to failure, change, or reduced productivity
Even if your anxiety feels manageable, it does not need to be. Your life will often feel more fulfilling and energizing when your anxiety is under control.
Treatment and Support
Even when anxiety does not appear to interfere with work or responsibilities, it is still valid and treatable. High functioning anxiety responds well to several approaches:
Cognitive Behavioral Therapy (CBT) to challenge perfectionistic or anxious thought patterns
Mindfulness-based practices to promote rest and present-moment awareness
Behavioral techniques to reduce compulsive planning or avoidance
Medication in some cases, for generalized symptoms that don’t respond to therapy alone
Stress reduction strategies to support sustainable routines without over-reliance on anxiety as a motivator
Support from a therapist can help individuals develop healthier ways to manage pressure without sacrificing well-being.
Get Therapy for Anxiety Today
Having high functioning anxiety means living with a constant undercurrent of fear or worry, even when everything appears to be in order. It often looks like success from the outside but feels like survival on the inside.
Awareness is the first step toward change. With the right support, individuals can learn to function not from fear, but from a place of clarity and balance – still achieving, but with far less cost to their emotional and physical health.
For more information, reach out to Flourish Psychology, today.
Location: 300 Cadman Plaza West Floor 12 - Brooklyn, NY 11201
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