High-functioning anxiety: What it is and how to manage it

Thriving on the outside but falling apart on the inside—understanding high-functioning anxiety can help you balance success with self-love.

On the outside, you’re a boss. The degrees, the career, the connections, you’ve “done it right.” Everyone looks at your life and sees success.

But inside, you’re a wreck, doubting your achievements, afraid to fail, and never feeling good enough. Your life seems like a house of cards that can crumble at any moment.

If you feel this way, you’re not alone. Anxiety, in general, impacts more women than men in the U.S. ¹. Black women, in particular, often have additional cultural and societal pressures that add to the burden. 

This article explores high-functioning anxiety—what it can look like and how to address it—so you don’t have to keep pushing through it.

What is high-functioning anxiety?

High-functioning anxiety often refers to individuals who experience general anxiety symptoms but can still handle their responsibilities and generally appear successful to others.

Instead of struggling to focus or meet work deadlines, women with high-functioning anxiety may overperform—work harder, stay later, and take on more projects. 

What does high-functioning anxiety look like?

Beneath the doing and achieving is constant pressure, and this can make it difficult to relax.

“People experiencing high-functioning anxiety may struggle to turn off their minds at night as they replay the day or worry about the future,” said Dr. Charmain F. Jackman, psychologist and founder of InnoPsych, a mental health tech company. “Even vacations can cause stress. They may plan all aspects of their downtime because it’s so hard to unplug.” 

Fear is often a significant contributor to high-functioning anxiety. Fear of failure, disappointing others, and not measuring up can leave you feeling vulnerable and insecure ².

“Some people may feel self-conscious, constantly thinking others are judging them,” Jackman said. “They may avoid social situations, like networking or speaking up during meetings.”

Many Black women carry this in silence, knowing friends and family won’t understand. But your mind is signaling that something isn’t right, and it’s okay to listen.

>> READ MORE: Signs the burden is too heavy

High-functioning anxiety symptoms

Symptoms of high-functioning anxiety can mimic those of a general anxiety disorder ³. In addition to excessive worry and racing thoughts, you may experience these mental and emotional symptoms ².

• Pressure to be perfect
• Overthinking and overplanning
• Focusing on the worst-case scenario
• Feeling like something bad is always about to happen
• Fear of disappointing others
• Fear of failure and criticism
• Harsh self-criticism
• Feeling like nothing you do is ever enough

You may also experience physical symptoms like the following ^2,4:

• Irritability or feeling on edge
• Restlessness or difficulty relaxing
• Trouble sleeping
• Headaches or migraines
• Muscle tension
• Digestive issues
• Rapid heartbeat

“Fighting through it” takes an emotional toll

It’s easy to overlook or dismiss symptoms of high-functioning anxiety because you’re handling business and showing up for others. But pushing through anxiety day after day can leave you emotionally depleted, dealing with burnout, resentment, and low self-worth.

When life feels like a never-ending performance, where you’re required to overachieve and avoid mistakes, it’s only a matter of time until something gives. And too often, it’s our mental wellbeing. 

Masking or suppressing your feelings may help you keep pushing, but it can also prevent you from getting the support you need and deserve.

>> READ MORE: Mentall wellness is for Black women, too

How to deal with high-functioning anxiety

Managing anxiety begins with self-awareness, recognizing when it shows up and developing healthy ways to respond.

Practice self-compassion

A harsh inner critic only fuels anxiety. Instead of criticizing yourself when you make a mistake or when things don’t go as planned, show yourself kindness. Try positive self-talk or an affirmation for anxiety.

Set boundaries

Your work doesn’t make you any more valuable than you already are. You’re enough right now, even if you don’t record another accomplishment. Overextending yourself often adds to work stress and burnout. Allow yourself to say “no” or “not now” as you create a healthy work-life balance.

Have an outlet 

Find activities that bring you joy and help you de-stress, like going for a walk, hanging out with friends, journaling, or truly letting things go through prayer. Movement and mindfulness are proven to help release built-up tension and calm the mind ^5,6.

Make time for rest

It’s okay, and often necessary, to step away from the busyness and unplug. In a state of rest, the mind can declutter and restore itself. This is especially true when we get quality sleep, so rest is everything.

>> READ MORE: Do this if you’re feeling stuck in life

When to get help

While daily habits to manage anxiety can make a difference, it’s okay to seek additional help, especially if the symptoms disrupt your life. 

“It’s best to address symptoms early,” advised Jackman. “If you’ve tried stress reduction techniques but need more resources, it could be time to seek professional help. It’s never too early to start with a therapist.”

Therapy for anxiety can be a safe space to explore your thoughts, identify triggers, and build tools that help you thrive. You can also explore support groups for Black women to build a sense of community.

If the symptoms feel unbearable, talk with your doctor. Anxiety medication may provide relief and can be an effective option alongside therapy. 

And if you’re experiencing thoughts of death, dying, or suicide, you can get immediate help by calling or texting the Suicide and Crisis Lifeline at 988.

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FAQs

Is high-functioning anxiety a mental health diagnosis?

No, you won’t find high-functioning anxiety in the DSM-5, so it’s not a clinical diagnosis ⁷. But mental health professionals may use the term to describe people with anxiety who tend to be productive in their daily lives. What’s most important is that you recognize the symptoms and can talk with your doctor or therapist for support.

What causes high-functioning anxiety?

High-functioning anxiety can stem from childhood experiences, trauma, or social and cultural pressures ². Black women, for example, are often taught as children to work twice as hard just to be seen as equal to their white counterparts. Genetics can also play a role ².

How do you treat high-functioning anxiety?

Your doctor or a licensed therapist can determine the best way to treat your symptoms. Therapy, like CBT, SFBT, or ACT, can help address the thoughts and beliefs that feed the anxiety. Your doctor may also recommend medication if your symptoms feel intense ⁸.

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References

1 Office. (2025). Anxiety. U.S. Food and Drug Administration. https://www.fda.gov/consumers/womens-health-topics/women-and-anxiety

2 Hubbard, L. (2023, July 11). Behind the mask: Managing high-functioning anxiety. Mayo Clinic Health System. https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/managing-high-functioning-anxiety

3 High-Functioning Anxiety: Symptoms, Treatment, and Ways to Cope. (2023, April 11). Lyra Health. https://www.lyrahealth.com/blog/high-functioning-anxiety/

4 High-functioning anxiety is complex, but help is available – WellMed Medical Group. (2024, December 17). WellMed Medical Group. https://www.wellmedhealthcare.com/high-functioning-anxiety-is-complex-but-help-is-available/

5 Working Out to Relieve Stress. (2021, October 19). Www.heart.org. https://www.heart.org/en/healthy-living/healthy-lifestyle/stress-management/working-out-to-relieve-stress

6 Kriakous, S. A., Elliott, K. A., Lamers, C., & Owen, R. (2020). The Effectiveness of Mindfulness-Based Stress Reduction on the Psychological Functioning of Healthcare Professionals: a Systematic Review. Mindfulness, 12(1), 1–28. https://doi.org/10.1007/s12671-020-01500-9

7 American Psychiatric Association. (2013). Section I: DSM-5 Basics Introduction Use of the Manual Cautionary Statement for Forensic Use of DSM-5. https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/DSM/APA_DSM-5-Contents.pdf

8 What is High Functioning Anxiety, and Do I Have It? | Banner. (2022, May 10). Bannerhealth.com. https://www.bannerhealth.com/healthcareblog/teach-me/signs-you-have-high-functioning-anxiety-and-what-to-do-about-it

8 What is High Functioning Anxiety, and Do I Have It? | Banner. (2022, May 10). Bannerhealth.com. https://www.bannerhealth.com/healthcareblog/teach-me/signs-you-have-high-functioning-anxiety-and-what-to-do-about-it