Do people often tell you that you seem calm, capable, and successful—while inside, you feel overwhelmed or like you're barely holding it together? Do you find yourself constantly second-guessing, checking and rechecking things, or worrying about making even the smallest mistake? How much of your energy goes into managing how others see you, afraid of being judged or letting someone down?

Sure, you’re accomplished. You meet your goals. On the outside, you have it all together. But internally, it’s a different story. You often feel on edge, constantly scanning for what might go wrong. You lie awake at night with racing thoughts, worrying about everything from work to relationships to things you said three days ago. That’s what is referred to as high-functioning anxiety.

What Is High-Functioning Anxiety?

High-functioning anxiety is a form of anxiety that hides in plain sight. It’s often masked by achievement, productivity, and a polished appearance. From the outside, you—or someone you care about—might look organized, composed, and thriving. But underneath, there's a relentless current of self-doubt, fear of failure, and pressure to be perfect.

Interestingly, this kind of anxiety can sometimes fuel success. It pushes people to work harder, achieve more, and stay on top of every detail. But the driving force isn’t confidence—it’s fear. Fear of not being good enough, fear of letting others down, and the constant sense of being an impostor.

The problem is, no level of success ever truly eases the anxiety. The inner worry and emotional strain don’t go away just because everything looks good from the outside. If left unaddressed, the pressure keeps building—leading to burnout, emotional exhaustion, and a constant sense of dissatisfaction.

That’s why it’s so important to work through the underlying beliefs and patterns that fuel high-functioning anxiety. Because without addressing what’s beneath the surface, no amount of external achievement will bring lasting peace or fulfillment.

Who Struggles with High-Functioning Anxiety?

Anyone can. It often shows up in high achievers—professionals, entrepreneurs, students, caregivers, perfectionists—people who appear to have it all together but feel far from it inside. If this resonates with you, know that you’re not alone—and support is available to help you find calm beneath the chaos.

It’s not uncommon for high-performing professionals in high-stress fields—such as physicians, mental health providers, attorneys, and others—to quietly struggle with this form of anxiety. Maybe this sounds like you: on paper, you’ve built a successful career and achieved what others might admire. But internally, you feel persistently anxious, overwhelmed, and unfulfilled.

You tend to overanalyze conversations and social interactions, constantly second-guessing how you came across. There’s a pressure to maintain a polished appearance and present yourself a certain way, especially in public or professional settings. This often makes it difficult to relax, be present, or build genuine connections with others.

The challenge becomes more serious when anxiety begins to interfere with your overall quality of life. For many professionals with high-functioning anxiety, this shows up as chronic overthinking, rumination, and an ongoing worry about mistakes or how others perceive them.

You might notice certain behavioral patterns, such as:

• A need for constant reassurance
• A strong urge to please others and avoid conflict
• Always being early and overly prepared
• Becoming emotionally reactive or irritable when plans go off course
• Difficulty setting boundaries or saying no
• Harsh self-criticism over even minor mistakes
• Nervous habits or compulsive behaviors

These habits, while often masked as “being responsible” or “on top of things,” are actually signs of inner distress. When anxiety is driving your behavior behind the scenes, it becomes harder to feel calm, confident, or truly satisfied with your life—even when everything looks successful from the outside.

Generalized Anxiety Disorder (GAD)

At some point, you may have been diagnosed with Generalized Anxiety Disorder—or maybe you haven’t received a formal diagnosis but recognize the signs in yourself. The clinical symptoms of GAD include restlessness, fatigue, trouble focusing, irritability, muscle tension, sleep disturbances, and persistent, intrusive worrying. Interestingly, these are also common in individuals experiencing high-functioning anxiety.

Whether the term “GAD” feels validating to you or you’re resistant to labels altogether, what matters most is addressing the anxiety itself—finding effective ways to manage it, not just naming it.

You’ve long assumed that the key to feeling calmer was to simply do more—work harder, achieve more, earn praise, build financial security, or reach the next professional milestone. Somewhere along the way, your self-worth became tied to accomplishments and external validation. Slowing down, taking breaks, or resting doesn’t bring relief—it often makes things worse. Even during downtime, your mind continues racing.

In many ways, success became your coping mechanism. The more you achieved, the more you hoped it would quiet the anxiety. But when you're not chasing the next goal or staying busy, the discomfort only grows. You're left with thoughts and feelings you’ve worked hard to outrun—emptiness, self-doubt, and a constant hum of unease. So, you stay busy to avoid facing them.

Friends or loved ones may encourage you to “just relax” or “take time for yourself,” not realizing that slowing down actually intensifies your stress. Over time, the nonstop pace can leave your body and mind completely depleted—leading to chronic fatigue, sleep issues, and eventually, feelings of burnout or depression.

This cycle is exhausting, but it can be broken. With the right support, you can learn how to quiet your mind, feel more present, and reconnect with a sense of peace that isn’t dependent on productivity or performance.

Treatment for High Functioning Anxiety

When you begin therapy for anxiety, I will start by getting to know you through a comprehensive mental health assessment. This includes exploring your unique experience with anxiety, your mental health history, and how it's currently affecting different areas of your life. From there, we’ll work together to create a personalized treatment plan that’s tailored to your needs and goals.

That might sound a bit broad, so you may still be wondering—what does anxiety treatment actually look like? In our work together, I commonly draw from evidence-based approaches like Cognitive Behavioral Therapy (CBT) and mindfulness practices. We’ll work on identifying your anxiety triggers, developing coping strategies, and learning how to stay grounded in the present moment. I’ll help you build skills to manage discomfort when it arises, using tools such as relaxation techniques, meditation, and mindfulness to slow down your racing thoughts.

Therapy will also give you space to explore and begin shifting some of the deeply ingrained perfectionistic beliefs that often fuel anxiety. If you're constantly feeling like an impostor—worried that your success isn’t real or fearing that one mistake will expose you—you’re not alone. These thoughts are common among high-achieving individuals.

You don’t have to keep pushing through anxiety just to maintain appearances. You can find calm without sacrificing ambition, and you can live with confidence that isn’t rooted in fear. If you're ready to stop letting anxiety run the show, reach out today. Let’s work together to help you reclaim your peace.

Overcoming Barriers to Seeking Support as A Professional

Admitting that you need support can be especially challenging—particularly if you're in a helping profession yourself. Many high-achieving professionals push through stress and exhaustion until they hit a breaking point, often delaying care until burnout feels unavoidable. That’s why it’s so important to work with a therapist who truly understands the unique demands, responsibilities, and pressure that come with your profession.

Reaching out early, before things spiral, is one of the most effective ways to protect your well-being and sustain your ability to thrive both personally and professionally. If you're considering therapy, I invite you to contact me for a confidential consultation to see if we’d be a good fit.

And of course, your privacy is a top priority. As with all therapeutic services, I strictly follow the highest standards of confidentiality. No information will be shared without your explicit, written consent—unless required by law.

Getting Started

I understand that it is hard to find time for yourself and that you want some relief, too.  Let us work together to find time for you to get the help you deserve and support you want.  Please contact me to set up your first appointment to get started on your healing journey.

Other Counseling Services Kathleen Provides

I am happy to offer in-person and online individual therapy services for adults.  I have practiced in the mental health field for 25+ years and have developed an expertise and passion for working with clients. I specialize in providing counseling for anxiety, chronic illness, chronic pain, depression, stress management, trauma and PTSD and more.  I also provide support for busy professionals.  I use CBT therapy, DBT therapy and EMDR therapy with great success.  If you don’t see the issue you are looking for listed, please contact me to ask if I can help you with your unique situation.  I look forward to helping you live your best life possible!