Understanding and managing high-functioning anxiety involves recognising its hidden nature and applying effective strategies to improve mental health and productivity.
Meet Rachel. She’s a corporate lawyer at one of the top law firms in the city, known for her professionalism, her ability to get through an unbelievable amount of legal documents during a day and her ability to manage multiple projects and also a team. To anyone looking at her, she comes across as perfect, too good to be true.
Rachel's inner world however is one where she has no control over her racing thoughts and constant undercurrent of worry. She never talks about it. Why would she? She doesn’t seem anxious. She’s excelling. Her relationships seem to be working. And most of all, Rachel’s anxiety propels her forward. However while she feels compelled to keep going, she is starting to feel the exhaustion in her late 30s. This is the reality of high-functioning anxiety.
Many people like Rachel live with high-functioning anxiety—a form of anxiety that, instead of causing outward panic, manifests as overachievement, perfectionism, and constant self-criticism. Unlike typical anxiety disorders, high-functioning anxiety is invisible to the outside world because it’s often masked by success and productivity.
While someone with high-functioning anxiety might seem to have it all together, the emotional toll beneath the surface can be overwhelming. Here’s a deeper dive into what high-functioning anxiety really is, and how you can spot it—even if it’s happening to you.
High-functioning anxiety isn’t an official diagnosis in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), but it’s a term often used to describe individuals who meet the demands of life and appear calm and competent, yet inside, they are struggling with constant anxiety.
It’s characterised by an internal drive to be perfect, a fear of failure, and the compulsive need to stay busy—often resulting in outward success but inner turmoil. While others may view this anxious energy as ambition or dedication, the person experiencing it feels trapped in a cycle of never-ending self-doubt and worry.
Though high-functioning anxiety doesn’t manifest with the paralysing panic attacks or debilitating fear associated with other anxiety disorders, the inner experience can be just as distressing. Some common traits include:
Overachievement and Perfectionism: A drive to constantly achieve more, fuelled by the fear of not being good enough.
Overthinking: Racing thoughts, replaying conversations, and second-guessing decisions—even long after they’ve been made.
Difficulty Relaxing: Rest doesn’t come easily. There’s always a sense of guilt or restlessness when not working or being productive.
Fear of Failure: A relentless fear that mistakes could have catastrophic consequences.
Procrastination Masked by Productivity: Constantly staying busy as a way to avoid dealing with deeper fears and insecurities.
People-Pleasing: The need for external validation and fear of disappointing others.
People with high-functioning anxiety often mask these traits by overcompensating, leading to successful careers and lives that appear perfect from the outside. But this constant state of tension takes a toll on both mental and physical health.
While high-functioning anxiety can drive achievement, it often comes at a significant personal cost. The inner turmoil can lead to:
Burnout: The body and mind can only function in overdrive for so long before burning out.
Chronic Stress: The never-ending pressure can lead to health issues like insomnia, headaches, digestive problems, and a weakened immune system.
Emotional Exhaustion: The emotional strain of constantly holding it together, never letting anyone see the anxiety, leads to deep emotional fatigue.
If you’re reading this and some of these traits feel familiar, you might be wondering, Is this me? While it’s natural to feel stress in challenging situations, living with high-functioning anxiety feels like constant pressure—even when everything is going right. You may find yourself always planning for the worst, obsessing over your work, or never feeling like you’re enough. And yet, you may not talk about it because, on the surface, things look fine.
Acknowledge Your Anxiety: The first step is understanding that this type of anxiety, even though it’s hidden, is real and deserves attention.
Challenge Perfectionism: Allow yourself to make mistakes without spiralling into self-criticism. Progress, not perfection, should be your goal.
Practice Mindfulness and Relaxation: Incorporating mindfulness techniques like meditation or breathing exercises can help slow your racing thoughts and allow you to focus on the present.
Set Boundaries: High-functioning anxiety often leads to people-pleasing and overcommitting. Learning to say "no" and prioritise your well-being is crucial.
Seek Professional Help: Cognitive-behavioural therapy (CBT), mindfulness practices and hypnotherapy can be incredibly effective in helping you manage anxiety while maintaining balance.
High-functioning anxiety is a paradox. It pushes people to succeed, but it leaves them feeling empty and exhausted. It’s a battle fought in silence, behind a façade of success. For people like Rachel—and maybe even for you—acknowledging this struggle is the first step toward finding peace. You don’t have to sacrifice your mental well-being for your achievements. With awareness, support, and the right tools, you can learn to manage high-functioning anxiety while leading a fulfilling, balanced life.
If you recognise yourself or someone you know in this story, remember—you don’t have to fight this alone.