Just because I keep it together doesn't mean I'm not a ball of nerves inside

Anxiety disorders are among the most common mental illnesses in the U.S.. The Anxiety and Depression Association of America reports that some 40 million U.S. adults deal with anxiety disorders every year — but that only about 37 percent of those suffering receive treatment. Part of the problem is that there is still lots of stigma around talking about and seeking help for mental health problems.

            Not everyone experiences an anxiety disorder the same way, of course. And many people can be incredibly high-functioning while constantly struggling on the inside. I'm one of those people. It's sometimes hard to explain to loved ones that I can look like I have it together professionally while at the same time, the simplest things in my personal life can make me feel terribly uneasy. A huge part of breaking down stigma, though, is finding the words to describe our experiences. Here are seven things high-functioning people with anxiety want loved ones to understand.

1. We're able to compartmentalize.

Being high-functioning with anxiety can be confusing to friends and loved ones. You may see us enjoying professional success, and it may even seem as though things come easily to us. Internally, however, things are often much more complicated. "People with anxiety are likely to feel more anxious in certain areas of their life, and less anxious in others. For example, someone might experience heightened anxiety at work and an ease in their anxiety when they're with friends. For others, the opposite might be true. As a result, depending on the setting you meet someone in and how their anxiety operates, you may not encounter their anxiety," says Madison McCullough, a therapist based in New York City.

Personally, it can be easy to compartmentalize when it comes to my work: When I sit down at the computer, I feel present and ready to go. But when I'm done for the day, I may feel spent, anxious, and completely lack the drive that helped me function during the workday. Any desire to carry out social plans is overshadowed by anxiety that I've been ignoring from 9 to 5.

2. Canceling plans doesn't mean we don't value our relationships.

We may say yes to plans with every intention of going, but when the actual event comes up, feel too overwhelmed to go through with it. Don't assume that we don't want to see you or that we don't value your time: This has way less to do with our relationships with you than with what's going on internally.

Sometimes, I feel like my anxiety will be so obvious when I show up to something that it'll make it uncomfortable for everyone else. That alone leads me to think I should stay home. Whether or not people would, in fact, feel uncomfortable, the feeling is still there (and valid).

Nicole Woodcox Bolden, a therapist, transformation life coach, and family prep educator based in Chicago, Illinois, says this is dead-on — not only does she speak from the experience of a licensed therapist, she also identifies as someone with high-functioning anxiety. "All day there are so many thoughts going on in our head, and we just can't be 'on' anymore," she explains. Then, when faced with the plans we've made, we worry that we'll be judged. "So, we cancel plans because we are exhausted and we overthink the consequences of going out."

It can seem like folks with anxiety are flaky, or like we always have the energy for some things but not others. The truth is that while it's easy for me to work or see a few very close friends who understand my anxiety, it's much more difficult to put myself in unfamiliar social situations.

3. It's important that you not point to anxiety to explain away our feelings.

When we react to something in a certain way or open up about a concern to you, it can feel invalidating if you assume it's only our anxiety talking. Yes, the anxiety can sometimes be a factor, and it can intensify our emotions, but that doesn't mean there aren't other root feelings beneath it. Take the time to talk to your friends and loved ones and figure out what's going on before shrugging something off as "just" another anxious episode.

Bolden offers another reason to avoid doing this. "Not everything is pathological! Sometimes people are just tired or sad, and that's okay."

4. Our anxiety can sometimes be a mystery, even if we've lived with it for years.

Sometimes, we may know why we're anxious; other times, we may not. In fact, according to McCullough, this can be one of the hardest things to deal with. "The unpredictability of anxiety is one of the most challenging things about living with it. Over time, the unpredictability can result in something called hypervigilance, which is when a person is constantly scanning their environment or themselves for some kind of indication that a threat or anxious trigger might be coming

When something specific triggers my anxiety, I often know exactly what's going on. The other day, though, I had a feeling of dread all day: It felt like something was sitting on my chest, though nothing out of the ordinary had happened. There was no culprit to pinpoint other than my anxiety disorder. It's often harder to deal with when it comes out of nowhere because it can feel like some sort of ominous premonition — like something bad is on the horizon, just out of view.

5. Anxiety isn't always rational or directly connected to what's currently going on.

Intellectually, we understand that our anxieties are sometimes irrational, but that doesn't make it any less difficult to deal with. When we're anxious and confide in you about it, don't tell us it's not a big deal. It might seem like downplaying things would be helpful, but instead, it feels like you're not taking our experiences seriously — which can push us away. It's more helpful to listen to what we have to say and remember that while our emotions may seem out of proportion to you, that doesn't mean they're not real.

About this, Bolden explains that anxieties are often based on something that's happened to us before, even if that exact situation isn't currently happening. She says, "Don't try to make us feel ridiculous for feeling anxious over something. Our anxiety is based off our brain trying to protect us. If you really want to help, try to help us find more evidence in our life to remind us that we are safe and can handle whatever happens."

6. There are things you can do to help.

Simply asking what we need is more helpful than you know. It lets us know you care but also gets us thinking about what might help us in the moment of our anxiety. McCullough agrees that asking about needs is important. Additionally, she says, "Avoid giving advice and trying to come up with 'solutions.' Creating a space where a person with anxiety can be heard, and empathized with, is one of the most supportive things you can do."

While it can be counterproductive to tell us what to do (as there's no one-size-fits-all way to work through anxiety), active listening is great. Helping us talk it through and figure out our own needs rather than telling us what you think would work is a better course of action.

7. There may be more than anxiety at play.

Anxiety disorders (like generalized anxiety disorder, or GAD) often occur alongside other mental health issues. Depression and anxiety, for instance, frequently go hand in hand. While not everyone who deals with anxiety is also suffering from depression or another mental health disorder, it's important to consider that someone who's dealing with anxiety might have other things going on, even if they don't divulge everything to you all at once.