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A Guide to High-Functioning Anxiety


In the current fast-paced climate and society that celebrates success and excellency, the pressure to perform is constant. The pressure to “be busy” is all around us and thus, we can feel guilt and a feeling of not being worthy if you’re simply…not that busy. Have you ever jam packed your schedule despite feeling tired, lost sleep over delivering a project or a presentation at work, or even socializing at a gathering or party? If so, you may be experiencing high functioning anxiety. High functioning anxiety describes the tendency to effectively be able to manage the stressors and demands of daily life, despite feelings of anxiety. In high functioning anxiety, a person adapts a consistent “fight” response to the anxiety, meaning a philosophy of pushing through the anxiety, working through it, or ignoring it in order to combat it. Commonly, this response can be driven by an overwhelming fear of not meeting expectations or “not doing enough”, which can cripple our self confidence and lead to anxiety, depression, or burnout. In this post, we'll explore the signs, causes, and practical strategies to overcome high functioning anxiety.

Examples of High Functioning Anxiety: 

Imagine standing in front of a packed conference room, your heart racing, palms sweaty, as you prepare to give a crucial presentation. Or picture yourself working overtime every night, working tirelessly on assignments, projects, and making yourself available 24/7 to anyone and everyone who might send you a request at any point in the day. These are just a couple of scenarios where high functioning anxiety can rear its head, leaving individuals feeling paralyzed by fear and self-doubt. In everyday life, high functioning anxiety can manifest in a variety of ways, such as:

  • Academic Pressure: Students facing exams or presentations may experience overwhelming anxiety, fearing failure and the consequences it may bring.
  • Career Expectations: Professionals may feel immense pressure to constantly perform at their peak, leading to stress and burnout. This can be exacerbated especially if you are seeking career advancement.
  • Social Situations: Meeting new people or attending social events can trigger anxiety for individuals who fear judgment or rejection.
  • Creative Pursuits: Artists, writers, and performers may struggle with perfectionism, fearing criticism or failure to meet their own or critics’ standards.

These examples illustrate how high functioning anxiety can infiltrate different aspects of life, hindering personal growth and fulfillment.

Exploring Roots of High Expectations: 

High functioning anxiety can affect anyone and certain factors such as culture, gender, and family history can influence susceptibility. Women are more likely to suffer from anxiety than men due to certain societal pressures and norms. Cultural factors can also have an impact–this is a common problem I see in my Asian American clients. If you are from a family that valued academia, you may have begun to tie your worth and value to academic success at a young age which later continued in adulthood and into career success. Additionally, if your caregivers were prone to anxious behaviors, it’s possible this was a learned behavior and/or you have a genetic predisposition to anxiety. 

Effects of High Functioning Anxiety: 

High functioning anxiety can often help people find success and reach their goals. Maybe you got that promotion you always wanted, achieved that test score by staying up all night studying, or finally achieved your fitness goals after months of rigorous training. On the outside, high functioning people are often very successful and look like they have it all together, but they often have anxiety and other symptoms brewing on the inside. Some physical symptoms may include frequent headaches, lightheadedness, muscle tension, low quality sleep, and racing heartbeat. Below the surface, they may struggle with persistent self doubt, fear of disappointing others, inability to relax, overthinking, double/triple checking their work, isolation, irritability, and/or significant stress that impedes their daily ability to function healthily (lack of quality sleep, diet, and exercise). When the pressure to perform is prominent, you may put aside other important commitments and rituals, including self care. This can also cumulate and result in burnout, something we may all be familiar with. 

Strategies to Overcome High Functioning Anxiety: 

  1. Therapy: You can work with your therapist on many strategies to challenge your high functioning beliefs. Therapy can focus on altering core beliefs that were set in childhood, such as “I need to excel at all times” or “I need to be perfect”. These sorts of core beliefs can be harmful because they leave little space to be human: to make mistakes and have off days due to forces outside of your control. Working in therapy can help you identify what your core beliefs are, specifically, what unconscious rules might be driving your behavior to perform at the expense of yourself and your health. Over time, you can work to replace these core beliefs with healthier and more realistic goals. 
  2. Realistic Goal Setting: Rethinking goal setting is another method to help overcome this anxiety. Goals should be realistic and attainable. Read here about SMART goals which can help provide a realistic guideline to measurable goals.
  3. Reexamine Personal Values: What are your main values, or guiding principles in life? These are what you are putting into practice everyday, such as friendship, compassion, fun, travel, etc. Often, just one or two core values are related to career, success, and work. Work with your therapist to draw a values map and see what other principles in life are just as important to you, but haven’t been nurtured due to high functioning anxiety. Take a look at this list to start. 
  4. Schedule Breaks: High functioning anxiety can result in a “go-go-go” mindset, leaving little room for rest and relaxation. Schedule in breaks if needed or times for mindfulness and meditation. Schedule phone calls to check in with friends or a yoga class. At first, it will be hard to pick up these new habits, so scheduling it in your calendar is a great way to start to set some time aside for yourself and shows that you are prioritizing yourself!


High performance anxiety is a common challenge that many individuals face, but it is never too late to take a step back and make some healthier changes to your lifestyle. By implementing mindfulness techniques, challenging negative thoughts, and seeking support when needed, you can overcome the anxious symptoms and regain control in your daily life. Talk to your therapist about the symptoms that resonate with you and come up with steps together to challenge and cope with high functioning anxiety!