What Is High-Functioning Anxiety?

At first glance, someone with high-functioning anxiety might look like they have everything together: a good job, strong social connections, and a calendar full of accomplishments. But beneath the surface, they’re often managing a constant state of internal stress.

“High-functioning anxiety isn’t an official diagnosis,” says Dr. Amanda Reyes, a licensed psychologist based in New York. “But it’s a useful way to describe a cluster of behaviors where anxiety manifests as overworking, overthinking, and over-preparing—often to the point of burnout.”

Common Signs

People with high-functioning anxiety may appear calm and competent. But they often experience:

• Racing thoughts
• Trouble sleeping
• Constant over-preparation or planning
• Perfectionism
• Irritability or muscle tension
• Fear of failure despite past successes

“You might look like you’re excelling at work,” says Reyes, “but inside, you’re running a never-ending checklist and expecting yourself to fail if you stop for even a moment.”

Why It’s Often Missed

Because high-functioning anxiety can come with external success, it’s frequently overlooked by others—and even by the person experiencing it.

“There’s a cultural bias toward productivity,” explains Dr. Carlos Nguyen, a clinical psychologist and author of The Hidden Cost of Coping. “We often praise people who ‘go the extra mile’ or ‘never miss a deadline,’ without asking whether those behaviors come from healthy motivation or anxiety-driven fear.”

What Causes It?

There’s no single cause, but experts agree that it often stems from a mix of genetic predisposition, early life experiences, and environmental pressure.

“For some, it begins in childhood—maybe they were rewarded only when they achieved or had to manage a chaotic home,” says Reyes. “Over time, anxiety becomes a way to stay in control.”

Coping Strategies That Actually Help

If you recognize signs of high-functioning anxiety in yourself, you’re not alone. And while it’s tempting to push harder to ‘stay ahead,’ real relief often comes from slowing down.

Here’s what mental health professionals recommend:

1. Name It
   Awareness is key. “Just putting a name to what you’re feeling can be validating,” says Nguyen.
2. Set Boundaries with Yourself
   “People with high-functioning anxiety often hold themselves to impossible standards,” says Reyes. “Start by defining what ‘enough’ looks like in your day—and stick to it.”
3. Practice Non-Productive Rest
   This means doing things with no outcome—no checklist, no goal. “Pleasure without productivity is powerful,” says Nguyen.
4. Therapy
   Cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), and mindfulness-based interventions are all commonly used to treat anxiety.
5. Medication
   For some, anti-anxiety or antidepressant medications may be part of the solution. “It’s not about fixing weakness,” Reyes adds. “It’s about calming a system that’s constantly on high alert.”

When to Seek Help

If anxiety is interfering with your sleep, relationships, or daily functioning, it’s time to reach out.

“You don’t have to wait until you’re in crisis to ask for help,” says Nguyen. “Even if things look fine on the outside, your experience matters.”

The Bottom Line

High-functioning anxiety often flies under the radar because it’s wrapped in achievement. But chronic stress—no matter how well-disguised—is still stress.

Recognizing it is the first step. Healing, as always, begins when we stop pushing and start listening.