What High-Functioning Anxiety Looks Like (And Why It's Often Missed)

We often correlate anxiety as panic attacks, nervousness with trembling hands or avoidance of everyday life. For countless high-achieving adults especially women balancing careers, family, and personal goals, the anxiety hides behind their successes, increased productivity, and a very polished professional appearance. Like a perfect model or employee. We hide our anxiety well but inside we are a ball of nerves, overthinking and worrying. Ladies and gents, this is what we call high-functioning anxiety and because it looks different from stereotypes, it goes unnoticed, invalidated and untreated! 

We often see so many of these high-functioning professionals in our practice and many feels no one understands or experiences the pressures of corporate world especially those at the top and end up often overcompensating. They usually look calm and capable on the outside, but inside with racing thoughts, stomach feels tight, and your mind refuses to shut down. These symptoms are easily dismissed or celebrated as driven or successful, high-functioning anxiety often goes unrecognized and untreated. 

What High-Functioning Anxiety Looks Like

Many of my clients that are high functioning with anxiety may appear as “put together”, but internally their minds rarely rests. Here are some common outward and inward signs:

• Perfectionism disguised as excellence

            People with high-functioning anxiety often have a drive to succeed, always meeting

            stringent deadlines and appear competent fueled by their fear of failure. Mistakes are

            feared more than anything else. 

• Overthinking, Overpreparation and Racing Thoughts

            They spend many hours planning, rehearsing or replaying conversations, and second

            guessing their every decision. Preparing for every “what if” scenarios which leaves them

            in a constant mental loop of exhaustion. Yet, to their colleagues, friends or family it looks

            like being thorough and dependable. 

• Constant busyness

            People with high-functioning anxiety tend to keep their calendars full to avoid quiet

            moments that bring up worry in a form of restlessness.

• A polished image

            ”Holding it together” in public, smiling, while feeling very restless or exhausted privately

            because it took so much energy out of you.  Many masters the art of looking like they

            have it all together and put on a mask daily to hide their anxiety. 

• Physical symptoms of anxiety 

            Believe it or not, anxiety carries physical symptoms such as muscle tension, stomach

            upset, headaches, nausea or vomiting, and trouble sleeping. These physical signs are

            often experienced by many however brushed off as stress or “just part of the grind.”

Why It’s Often Missed

1.     Success masks our struggle

When someone is excelling in school, work, or personal life, it’s easy to assume they are 

fine and make it hard to believe that anxiety is at play.  Society equates achievement 

with wellness. 

2.     Anxiety looks “productive”

Many traits of high-functioning anxiety are rewarded in the workplace, school, and in

relationships. Perfectionism, over-preparation and realizability are a few worth

mentioning. 

3.     Stigma and Silence

Many professionals and high-functioning adults minimize their struggles because they

don’t want to be seen as “weak” or inadequate and fear that admitting it will damage 

their reputation and career. 

4.     Lack of Awareness, even among providers

           Many clinicians, teachers, friends and family members may miss and overlook the   

           signs because high-functioning individuals do not exhibit dramatic symptoms of

           anxiety outwardly.

The Cost of Being Overlooked

If left untreated or unrecognized, high-functioning anxiety can lead to the following:

• Burnout from constant overdrive and the need to be perfect. 

• Strained relationship caused by irritability, withdrawal and isolation

• Physical health issues like insomnia, digestive issues, and chronic tension

• Increased risk for depression or panic disorders when anxiety goes untreated

What looks like success from the outside often comes at the price of inner peace and well-being. 

A Holistic Approaching to Healing

Recognizing high-functioning anxiety is the first step toward healing and feeling better. At Monarch Holistic & Wellness Services, I take an integrative approach that looks beyond symptoms to support the whole person. 

• Mind-body practices: mindfulness, various breathing strategies, yoga or meditation to calm our nervous system and reduce racing thoughts. 

• Lifestyle changes: improving sleep hygiene, nutrition, and increasing physical activities can directly influence and support brain health and stress response. Small changes make a big difference.

• Therapy and coaching: Work on setting boundaries, working through perfectionism, and reshaping anxious thought patterns can provide lasting relief.  

• Medication and/or nutraceuticals: For some people, traditional means of medications or supplements may help restore balance and reduce symptoms.

This approach isn’t about silencing who you are, it’s about helping high-functioning individuals with anxiety thrive without the constant undercurrent of worry. 

You’re Not Alone

If you’re thinking that this resonates with you or someone you love, know that high-functioning anxiety is very real, valid and treatable. 

Seeking out help does to mean that you are “weak” or failing. It means you’re investing in a healthier and more sustainable way of living. Healing begins when you give yourself permission to acknowledge what’s happening and reach out for help.

At Monarch Holistic & Wellness Services, I specialize in helping high-functioning adults, women in life transitions, and Black and Brown professions find balance and peace. Together, we can build a treatment plan that blends both science and holistic healing, so you can succeed and feel whole.