Living With High-Functioning Anxiety: What It's Like & What Helps

As someone with significant anxiety who is also high-functioning, I understand what it’s like to live with an invisible struggle every day. High-functioning anxiety is often described as a subtype of generalized anxiety, an “unofficial diagnosis,” yet it’s far more common than most people realize.

On the outside, people with high-functioning anxiety tend to look like they’re doing well. They meet deadlines, show up for others, stay productive, and appear steady and capable. Many are labeled as Type A, perfectionistic, or overachievers. And while some of those traits may be accurate, they don’t tell the full story.

The Invisible Side of High-Functioning Anxiety

What often goes unnoticed is the internal experience—because it rarely matches what others see. High-functioning anxiety is easy to overlook for several reasons:

• Masking anxious feelings

• Explaining symptoms away as being “busy” or “overwhelmed”

• Functioning well externally despite struggling internally

These patterns often get reinforced because they’re praised by others and even rewarded internally (“If I am productive, maybe the anxiety will stay quiet.”). 

Meanwhile, under the surface, people with high-functioning anxiety may experience:

• Constant mental chatter and overthinking

• Persistent self-doubt or fear of disappointing others

• Feeling on edge or tense throughout the day

• A sense of never doing “enough,” no matter how much they accomplish

• Difficulty slowing down or relaxing

• Physical symptoms like tight muscles, shakiness, stomach discomfort, fatigue, headaches

Despite seeming successful or put-together, the internal emotional load can be heavy.

My Experience With High-Functioning Anxiety

As a child, I saw myself as Type A, perfectionistic, and high-achieving — labels that were reflected back to me by teachers, family, and peers. I pushed myself intensely in school and extracurriculars, carrying pressure I placed on myself.

For a long time, I didn’t believe I had anxiety at a clinical level. In my mind, anxious people were visibly restless, externally nervous, or talked openly about their worries. I didn’t fit that image, so I assumed I wasn’t really anxious.

As I learned more about anxiety, and learned more about myself, I realized how much I was holding inside. With support from family and mental health professionals, I began to understand that I didn’t have to live with that much pressure or rigidity. It was possible to feel lighter. It was possible to manage stress and soften perfectionism.

My personal experience has shaped the way I show up as a therapist. I work with many clients who experience anxiety and panic in different forms. I feel called to share what I’ve learned, normalize their experiences, and help them build strategies that genuinely work for them. No one should have to struggle in silence.

Strategies That Have Helped Me (and My Clients)

Here are tools that have been meaningful in my own life and in my work with clients:

Planning & Organization

• Creating schedules and plans that are flexible

• Writing lists in pencil or typing them so changes feel easier

• Separating “needs to be done now” from “can be done later”

• Using reminders, sticky notes, or Google Tasks

• Breaking larger tasks into smaller, manageable steps

• Setting realistic goals instead of idealistic ones

Relaxation & Wind-Down Time

• Building in daily relaxation time (I aim for two hours before bed)

• Reading, watching TV, cooking, skincare routines

• Talking with family and friends

Motivation Supports

• Giving myself rewards to boost motivation

• Starting with the harder or less interesting task to build momentum

Emotional Regulation & Mindfulness

• Writing thoughts down (journal, Notes app, or on paper)

• “Tabling” worries—imagining placing them on a mental shelf

• Mindfulness practices like the “leaves on a stream” exercise and using Insight Timer (free app for meditation and mindfulness)

• Taking walks and listening to podcasts

Connection & Support

• Talking with trusted people

• Participating in therapy

  • Using approaches like Cognitive Behavioral Therapy (CBT), acceptance-based strategies, and strengths-based work