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We’ve all seen denial in action.

Most of us, I assume, by the time we stretch our way out of adolescence, have experienced the uncle who can stop drinking “anytime he wants,” the friend with the boyfriend who’s “not usually like that,” or the sister who just “tried weed once.” We see it, and we can’t help but roll our eyes.

Some of us, though, get to witness “profound denial.” That is altogether different. I saw it once with a high school friend who was with me during the very same experience and would not only refuse to admit it but would predictably change the subject whenever I brought it up. It was spooky but also a little fascinating.

Personally, I’m beginning to question how far my own denial has been in play lately. I’ve been told by doctors in the past that I suffer from “silent anxiety.” It’s an anxiety that presents more sneakily than the garden variety made for television shaking or sweating.

When my friends have asked me how I am doing since my breakup, I was not overtly untruthful when I said, “Fine.” As far as what I felt like on a conscious level, things were going smoothly (besides inexplicable insomnia that started right when the relationship crashed down around me a couple of weeks ago).

It’s more than a little curious when I think of how there could very well be a whole universe unfolding in my subconscious that I’m utterly unaware of.

Psychology is a trip.

When you do the proper research, you will find that insomnia is only one of the ways that “silent anxiety” will manifest. There are almost a dozen different behaviors that we may normalize as idiosyncrasies or personality quirks but might, more accurately, be hidden anxiety.

A high-functioning anxiety sufferer, much like a high-functioning addict, may have developed the skills necessary to carry on enough of a charade to manage survival from day-to-day. But—as I can certainly attest after numerous sleepless nights—that doesn’t mean they aren’t at least somewhat debilitated.

The following are a list of potential symptoms of this malady known as “silent anxiety”:

1. Insomnia

Of course, there are many different reasons why a person may suffer from insomnia—too much caffeine or regular ol’ life problems could take the blame just as easily. When the issue becomes chronic, it’s something to consider.

2. Restlessness

This is the unexplainable feeling of not being able to still your mind or body. It can be leg shaking, restless leg syndrome, or even an overall feeling of an impending threat.

3. Constant Worry

Have you ever spoken to, say, someone in the same job as yourself and realized that not everyone rushes around like a maniac trying to do everything perfectly? This has happened to me in the past. Conversations like that are so important because one of the most human errors we tend to make is assuming we move through life much the same as everyone else. Personally, it always blows my mind when I realize most people don’t take everything as a life-or-death situation all the time. In fact, that “life and death” thing? Yup, most of the time, it’s anxiety.

4. Difficulty Concentrating

This is not always something that people associate with anxiety, but if you are the type of person who already illustrates other symptoms, this could be one as well. I know, for myself, it is almost impossible to read written words at times. Thank God for Audible.

5. Irritability

I have an interesting story about this. After a scary road-rage incident that could’ve gone really bad, I had a session with one of our more accomplished Elephant Journal writers, Galina Singer. After a little poking and prodding, I broke down emotionally and realized that was terrible anxiety was hidden underneath all of that anger. As a commercial truck driver in a world of distracted drivers on their phones, the ever-present threat of a serious accident seems to follow me from morning ’til night—every day. This is generally translated into irritability and anger because I feel more “in control” wielding those emotions than fear and anxiety. But make no mistake, that’s where it originates.

6. Sadness

This can be tricky because the sadness associated with anxiety is somewhat different from the sadness that accompanies depression. But, if nothing else, they are siblings. Dr.Carla Marie Manly spoke about this extensively with Bustle, but the gist of it was that anxiety sadness is exhibited more along the lines of frustration than “weepiness.”

7. Feeling Pressured

It doesn’t take too much imagination to understand that this symptom can frequently coincide with the perceived need to become a people pleaser. Whether in social situations or at work, the pressure that exists with anxiety makes setting proper boundaries more difficult than usual.

8. Incurable Dissatisfaction

While this is not strictly a hurdle related to anxiety, we need to be aware of anything that becomes extreme. Most people wrestle a little with the “hedonic cycle“—the phenomenon by which we always seem to return to our baseline of life satisfaction after both desired and undesired circumstances. However, when we simply do not possess the ability to remain in any state of satisfaction for any length of time, this could be a symptom of silent anxiety.

9. Inability To Feel Joy

The emotion referred to as “joy” is quite specific and often confused with other positive emotions. Joy is when you look into a child’s eyes as they eat an ice cream cone and you are able to be fully present and aware of the moment’s grace. Anxiety will usually take us out of the moment and make joy more elusive.

10. Physical Manifestations

Oh, boy! So this can range from Crohn’s Disease, Fibromyalgia, to back problems (seriously, just about anything). There is ample proof that anxiety presents as varied physical ailments, and it seems it worsens in relation to how much the anxiety is repressed.

So that is a comprehensive list of what “silent anxiety” can look like.

My only hope is that someone may get a clearer understanding of how pervasive anxiety can be—even if it looks nothing like what we assume it’s supposed to look like.