7 Signs of High Functioning Anxiety and How to Get Over It

If you’ve ever found yourself relentlessly chasing perfection, overthinking decisions, or lying awake at night with racing thoughts, you might be experiencing high-functioning anxiety. Unlike its more overt counterparts, high-functioning anxiety often wears a disguise of achievement and relentless drive. Today, we delve into recognizing 7 signs of high functioning anxiety and some strategies to help you navigate through them with grace and self-compassion.

What is High Functioning Anxiety?

High-functioning anxiety isn’t an official anxiety disorder but rather a term used to describe people who live with anxiety but identify themselves as functioning reasonably well in different aspects of their life. High functioning anxiety refers to individuals can manage to perform well in their jobs, maintain social relationships, and fulfill daily responsibilities despite struggling internally with anxiety symptoms.

People with high-functioning anxiety often appear to be successful, driven, and highly organized who set impossibly high standards fort themselves. They might be the ones who are always early for appointments, excel in their careers, and seem to have a perfect handle on their lives from the outside. However, internally, they may be really struggling with their mental health, battling constant worry, fear, and stress, too much anxiety which propels them to overachieve and overprepare as a way to cope with and attempt to control their anxiety in their daily life.

Despite their ability to function at a high level, individuals with high-functioning anxiety can experience significant emotional distress, including:

  • Excessive worry or feeling that something bad is going to happen
  • Overthinking and planning for all possible outcomes to feel prepared
  • Perfectionism and fear of failure
  • Difficulty saying no due to a fear of letting others down
  • Need for reassurance or approval from others
  • Physical symptoms of anxiety, such as increased heart rate, gastrointestinal issues, muscle tension, and difficulty sleeping.

Because they may not show the typical signs of dysfunction associated with most anxiety disorders, their suffering might go unnoticed by others, including healthcare professionals. This can make it challenging for them to seek help or even recognize that they need support, as they might not fit the conventional picture of someone struggling with anxiety.

Managing high-functioning anxiety often involves learning coping strategies such as mindfulness, relaxation techniques, and cognitive-behavioral therapy to challenge and change anxiety-producing thoughts. Additionally, establishing healthy boundaries, prioritizing mental and physical health and self-care, and seeking support from a therapist can be beneficial steps towards managing the symptoms of high-functioning anxiety.

What Causes High Functioning Anxiety?

Unlike most mental health conditions, high-functioning anxiety is not a clinical diagnosis. It arises from a complex interplay of factors similar to those associated with other anxiety disorders. Understanding these causes can help in managing its symptoms more effectively. The main factors contributing to high-functioning anxiety include:

  1. Genetics: Anxiety disorders can run in families, suggesting a genetic component. Individuals with family members who have had an anxiety disorder may be more predisposed to developing high-functioning anxiety due to inherited traits.
  2. Brain Chemistry: Neurotransmitters, the chemicals in our brain that transmit signals, play a role in anxiety disorders. An imbalance in neurotransmitters like serotonin and dopamine can affect mood and anxiety levels, contributing to the development of high-functioning anxiety and impacting overall mental health.
  3. Personality Traits: Certain personality traits, such as perfectionism or a tendency towards being a people-pleaser, can increase the risk of developing high-functioning anxiety. Individuals with these traits often set extremely high standards for themselves and may constantly worry about meeting these expectations or fear disappointing others.
  4. Life Experiences: Traumatic or stressful life events, such as experiencing a traumatic event, enduring ongoing stress, or even childhood adversity, can trigger anxiety disorders, including high-functioning anxiety. These experiences can impact mental health and lead to a heightened state of anxiety that persists, even in less stressful situations.
  5. Environmental Factors: Factors such as work stress, academic pressure, or relationship issues can contribute to the development of high-functioning anxiety. Individuals in high-pressure environments may be particularly susceptible.
  6. Social Conditioning: Cultural and societal expectations can also play a role. For example, societal pressures to succeed or to present oneself positively on social media can exacerbate feelings of anxiety and inadequacy.
  7. Lifestyle Choices: Lack of physical activity, poor diet, too little sleep, and substance abuse can all contribute to or exacerbate anxiety symptoms. Lifestyle choices play a significant role in maintining physical and mental health.

Understanding that high-functioning anxiety has multifaceted causes can be empowering. It underscores the importance of a comprehensive approach to management and treatment, including lifestyle changes, therapy, and, when necessary, medication, to address the underlying causes and support individuals in leading a balanced and fulfilling life.

7 Signs of High Functioning Anxiety and How to Tackle Them

High-functioning anxiety can manifest in various ways, often hidden behind a facade of achievement and competence. Here are seven common signs that might indicate someone is dealing with high-functioning anxiety:

1. Being an Overachiever:

Constantly pushing for perfection and setting exceedingly high standards for oneself. People with high-functioning anxiety often drive themselves hard in their careers or personal projects, fearing that they are not doing enough, even when they are achieving great success.

2. Chronic Overthinking and Worrying:

If you experience anxiety, you likely spend an excessive amount of time worrying about the future, replaying past events, or obsessing over decisions. This can include imagining worst-case scenarios and planning for all possible outcomes to mitigate anxiety. Negative thoughts might be running rampant in your brain and it can be hard to stop the anxiety spiral.

3. Difficulty Saying No:

A tendency to overcommit or take on too much responsibility because of a fear of letting others down or missing out. This often leads to stress and burnout but is driven by the anxiety of not meeting others’ expectations.

4. Need for Reassurance:

Seeking constant validation and assurance from others about their decisions, work, and relationships. This sign stems from a deep-seated fear of failure or making mistakes, driving individuals to look for external confirmation of their worth.

5. Physical Symptoms:

Experiencing physical manifestations of anxiety, such as gastrointestinal issues, headaches, muscle tension, fatigue, or trouble sleeping, despite maintaining a facade of control and composure.

6. Procrastination Mixed with Perfectionism:

Difficulty concentrating, procrastination and perfectionism can all be signs you struggle with high functioning anxiety. Delaying the start or completion of tasks due to a fear that the outcome will not be perfect, coupled with periods of intense productivity. This can create a cycle of stress and urgency, often leading to burnout.

Avoidance of Social Situations:

While some individuals with high-functioning anxiety may appear socially active, they might internally feel anxious about social interactions, leading to avoidance or distress during social activities. This avoidance is often due to a fear of being judged, saying the wrong thing, or not living up to perceived social expectations.

Identifying these signs can be the first step towards seeking help and developing healthier coping mechanisms. It’s important to remember that despite the challenges of high-functioning anxiety, effective strategies and support are available to manage and alleviate these symptoms.

How to Treat High Functioning Anxiety?

As an anxiety therapist, I work with so many women who struggle with high functioning anxiety and are looking for ways to reduce anxiety and lead happy fulfilling lives. Treating high-functioning anxiety involves a combination of strategies designed to manage anxiety symptoms and improve overall well-being. While high-functioning anxiety isn’t a formal diagnosis, the methods used to address it are similar to those for other anxiety disorders. Here are some effective approaches:


Engaging in therapy can be highly effective. I’m a big fan of incorporating evidence based strategies like cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT) and Mindfulness based therapy. CBT helps individuals identify and challenge negative thought patterns and behaviors associated with anxiety, teaching them healthier coping mechanisms. Other therapeutic approaches, such as mindfulness-based therapy or acceptance and commitment therapy (ACT), can also be beneficial.


In some cases, medication may be recommended to manage symptoms of anxiety. Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), are commonly prescribed. It’s important to discuss the benefits and potential side effects of medication with a healthcare provider.

Lifestyle Changes

Incorporating regular physical activity, ensuring adequate sleep, and maintaining a balanced diet can significantly impact anxiety levels. Exercise, in particular, is known to reduce stress and improve mood.

Stress Management Techniques

Learning and practicing stress management techniques such as deep breathing exercises, meditation, yoga for anxiety, or progressive muscle relaxation can help reduce anxiety when you’re feeling anxious. I’ve got a ton of blog posts on this that you can read, if you want to learn more strategies. 

Setting Boundaries

Learning to say no and setting healthy boundaries in personal and professional life can prevent overcommitment and reduce stress levels, which is crucial for individuals with high-functioning anxiety who often take on too much.

Time Management

Developing effective time management skills can help reduce the feeling of being overwhelmed. This includes prioritizing tasks, breaking them into manageable steps, and scheduling breaks to avoid burnout.

Mindfulness and Grounding Techniques

Practicing mindfulness and grounding techniques can help manage moments of anxiety. These practices encourage living in the present moment and can reduce overthinking and worry.

Build a Support System

Sharing feelings and experiences with trusted friends, family, or support groups can provide emotional support and reduce feelings of isolation.

Limit Stimulants

Reducing the intake of caffeine and other stimulants can decrease symptoms of anxiety, as these substances can exacerbate feelings of nervousness and agitation.

Sleep Hygiene 

Prioritizing sleep and having good sleep hygiene can make a big difference. This might include limiting screen time before bed, reducing caffeine intake, and so much more. You can learn some more strategies about sleep hygiene here. 

Professional Help

For some, the symptoms of high-functioning anxiety can be severe and interfere with daily life. In these cases, seeking help from a mental health professional is essential. This can include psychologists, therapists, psychiatrists, or other mental health providers who can offer specialized treatment plans for high functioning anxiety.

It’s important for individuals experiencing high-functioning anxiety to remember that seeking help is a sign of strength, not weakness. Treatment and management strategies can significantly improve quality of life, allowing individuals to harness their strengths in a healthier, more balanced way.

What is the difference between anxiety and high-functioning anxiety?

High-functioning anxiety is not a clinically recognized condition but rather a descriptive term. It refers to individuals who experience anxiety symptoms but are still able to perform well in various aspects of their lives, including work, school, and relationships. People with high-functioning anxiety often appear successful on the outside, masking their struggle with anxiety.

The primary difference between general anxiety and high-functioning anxiety lies in how individuals cope with their symptoms and the impact on their daily functioning. Those with general anxiety may have more visible struggles with daily tasks and may recognize the need for help. In contrast, individuals with high-functioning anxiety often maintain a high level of functioning and may not seek help because they or others perceive them as being successful or having everything together.

It’s important to note that both forms of anxiety can cause significant distress and deserve compassion and understanding. Regardless of whether anxiety is impacting an individual’s ability to function, seeking support from mental health professionals can provide strategies to manage symptoms and improve quality of life.

Wrapping Up

If you find yourself resonating with the signs and symptoms of high-functioning anxiety, or if the daily coping strategies feel like a band-aid to a deeper issue, it may be time to consider professional help. An anxiety therapist can work with you to create a tailored approach that addresses your individual needs, helping you to navigate the complexities of anxiety with confidence and self-compassion.

Remember, seeking help is a sign of strength and a step towards reclaiming your peace of mind. You don’t have to walk this path alone. If you’re ready to explore the transformative power of therapy and take the next step in your journey to feel less anxious, you can reach out to me here, I would love to connect. Together, we can work towards creating a more balanced life, where anxiety is no longer controlling you. Your journey towards healing and growth is just a conversation away—take that step today.

That's So Well Therapist Arielle

It's me, Arielle!

Holistic Therapist, Nutritional Therapy Practitioner and Yoga Instructor in Elk Grove, California.

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