You get things done, your calendar is colour-coded, people rely on you. You seem calm, capable and confident, but what they don’t see is the 3am spirals, the clenched jaw, the inner critic that never shuts up and the constant feeling that you’re on misstep away from everything falling apart. If this hits too close to home, you may be one of the many women silently struggling with high-functioning anxiety.

What is High-Functioning Anxiety?

It’s not an official diagnosis in the DSM, but high-functioning anxiety is very real. It’s a pattern of anxiety-fuelled performance, productivity and perfectionism which creates emotional exhaustion behind the scenes. Common signs include:

1. Overthinking everything

“I’m not really anxious, I’m just tired… or stressed… or overthinking.”

2. Difficulty relaxing, even on weekends or public holidays

“Rest is lazy. I’ll rest when everything’s done.”

3. A constant sense of urgency or dread

“If I stop, everything will unravel.”

4. People-pleasing and fear of disappointing others

“If I don’t do it perfectly, I’ll disappoint someone.”

5. Trouble Sleeping (but still showing up on time)

“I’m exhausted, but at least no-one can accuse me of being late.”

6. Success driven by fear or failure, not joy

“Everyone thinks I’ve got it together, I can’t let them see me fall apart.”

How is high-functioning anxiety different from regular anxiety?

The difference is in how it looks. Traditional anxiety may show up as panic attacks, avoidance or visible distress. High-functioning anxiety hides behind achievements and control.

Regular Anxiety                                            High-functioning Anxiety

Difficulty showing up                                     Always showing up, and showing up early

Fear leads to avoidance                                   Fear leads to over-performance

Withdraws socially                                          Over-commits and over-pleases

Appears visibly anxious                                  Appears calm, productive and “fine”

Because it looks like you’re coping, no one thinks you need help. Not even you sometimes.

Why women are especially affected

Society tends to reward women for being nice, neat, nurturing and performing nonstop. High-functioning anxiety thrives in this environment. There’s the pressure to “have it all”; a career, a happy family, overall wellness, and a social life. The added influence of social conditioning which encourages women to suppress difficult emotions. Not to mention traumatic histories or childhoods where love was earned through achievement. And then there’s the hormonal fluctuations, which amplify anxiety symptoms during PMS, postpartum and in perimenopause. All of these factors create the perfect storm.

FAQs about high functioning anxiety

Is high-functioning anxiety a real diagnosis?

No, but it’s a real experience. Mental health professionals often treat it as a combination of generalised anxiety disorder (GAD), perfectionism and burnout.

Can it lead to burnout or depression?

Absolutely. The pressure to constantly perform and manage everything alone can eventually lead to exhaustion, panic attacks, emotional numbness or even depressive episodes.

Do I need mental health support if I’m still getting things done?

If your inner world is suffering, even if your outer world looks polished, therapy or counselling can help. You don’t have to wait until you can’t cope to get support.

How to calm the chaos without quitting everything

If you suspect you’re dealing with high-functioning anxiety, the goal isn’t to stop being competent or caring, it’s to stop suffering silently. Here are some first steps to take:

Identify your patterns

High-functioning anxiety often hides in plain sight. You might look together on the outside, but inside your mind is a tangle of worry, self-doubt and overthinking. Start by getting curious about your patterns. Journal your thoughts or use a notes app to jot down moments when your stress spikes. Do you tense up before meetings? Ruminate after social interactions Obsess over getting everything just right? Noticing where perfectionism, fear or guilt sneak in helps you name the problem and know what needs to be addressed. Journalling apps like Day One are useful tools to help get you on the right track.

Set boundaries around over-functioning

High-functioning anxiety often makes us say “yes” when we’re already at capacity. It convinces us we’ll disappoint others if we don’t do it all. But one of the kindest things you can do for yourself is to starts saying “no”, even when it feels wildly uncomfortable. Cancel that extra commitment. Delegate. Let someone help you without apologising or over-explaining. Boundaries aren’t about being selfish; they’re about reclaiming your time and energy so you can thrive instead of just survive.

Work with a mental health professional

Therapy or counselling can be a game-changer, especially with someone who understands how anxiety can show up in women who are high-achieving, people-pleasing and chronically hard on themselves. A good counsellor won’t ask you to lower your standards, they’ll help you separate your self-worth from your productivity and guide you in developing healthier ways to cope. You don’t have to carry this alone, seeking support isn’t a weakness, it’s wisdom. Reach out to counselling services like Mustard Seed Tree to speak to a counsellor.

Create Intentional rest

Many women with high-functioning anxiety struggle to slow down, even when they’re exhausted. Rest gets squeezed in between to-do lists or replaced by doom-scrolling. But true rest is intentional and nourishing. It’s not about doing nothing; it’s about doing less of what drains you and more of what restores you. Things like lying under a tree, taking a slow walk, painting, journaling, or sitting in silence allow you to give yourself rest without earning it. A mindfulness app like Headspace can be a great tool to help find some calm in the storm.

Practice self-compassion

If your inner monologue is full of criticism, judgement or “shoulds”, it’s time to rewrite the script. Self-compassion isn’t indulgent, it’s an emotional survival skill. When things go wrong, speak to yourself like you would to your best friend; with kindness, understanding and grace. You don’t have to be perfect to be worthy of rest, love or peace. The voice inside your head matters, so make sure it’s one that heals, not harms.

You don’t have to be fine all the time

High-functioning anxiety is sneaky because it rewards you for suffering. But the truth is you deserve peace, not just performance. Let’s stop applauding burnout and start honouring emotional wellness.