Anxiety, under normal circumstances, can be an advantage. Senses tell us what is going on around us. Information is fed to the brain stem (amigdala). On to the motor system for, hopefully, an appropriate response (the 4 fs – fighting, fleeing, feeding, making babies). It gives energy and drive to achieving an objective. Yet when in overload it can be debilitating and fighting becomes stress.

There is a new kid on the block. Daisy Goodwin and Jean Claud Chalmet, the Times, Oct 29th 2022.  High-functioning anxiety: calm on the surface but secretly stressed. Daisy admits to outer serenity and inner insecurity, anxiety and dread. Always busy and hasn’t slept for years. A successful journalist. High-achiever, public speaker, relaxed at parties; nagged by doubts about family, self-esteem and daily life which are much worse in the middle of the night.

‘People with happy carefree childhoods do not spend their lives imagining the worst’. She wishes she was one, but ‘no amount of alcohol, infrared saunas, mindfulness apps or hot stone massages will do it for me’. She knows that the nagging doubts are not going away.

So, a strong association with early life. Searching for acceptance. Having to prove oneself over and over. Never good enough. Not a recipe for self-esteem. Then the lifelong living with all this. Can’t relax, full of nervous energy, lists of things to do. Can’t fail, must be in control. Endless worrying and overthinking. Learned in childhood, a nagging critical inner voice as an adult.

Unsurprisingly sleepless nights are in the mix. ‘Mind like a hamster running on a wheel.’Along with constant state of alertness resulting in back and neck aches and pains, made worse by extreme exercise.

What to do? As with many of these mental health issues, knowledge and self-knowledge help you be the master and not the victim. Jean Claud suggests mild exercise, being with friends, meditating, deep breathing, singing. Anything that keeps you in the present.

Face the fear; the world won’t fall apart if you relax. Speak kindly to yourself. Get out of flight/fight mode – not everybody is a threat. Enjoy – you can’t hide forever.

Rachel Carlyle, The Times, ‘Perfection’, May 27th, agrees. High standards underpinned by insecurity is a recipe for anxiety and other mental health problems. Partially inherited and partially learned from parents. Mostly upper echelons of society. Women more than men. And it is not an advantage as searching for perfection promotes inefficient over-striving.

Yes to fail is normal. Yes lots of stuff are not under our control. Yes we are good enough.