High-Functioning Anxiety & the High-Achieving Woman

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Tell us if you can relate to this. You’re a successful woman. You earned the prestigious degree and landed the career of your dreams or you’re at least on the right path. From the outside, it looks like you’re excelling in all areas of life. People think of you as a strong confident woman, always pushing forward and achieving more, but internally, it feels like a constant scramble to maintain that image.

Your coworkers, friends, and family know they can depend on you. You’re the first to show up and the last to leave. You are helpful, proactive, detail-oriented, and organized. You’re great at giving off the appearance that everything is going well, but that’s on the exterior.

Inside, anxiety runs rampant. You’d love to take a mental health day to relax and recharge but you don’t dare call into work. Your schedule is bursting at the seams, but you’re afraid to say “No” when someone asks you to take on another commitment.

You’re not sure how much longer you can keep up with everything without falling apart. You don’t want to let yourself or anyone else down though, so you keep going. Day after day.

Can you relate?

If so, take a deep breath. Let down your guard for a few minutes, and let us help.

What are symptoms of high-functioning anxiety in women?

Let’s start with what high-functioning anxiety is not. It does not meet the full clinical criteria for an anxiety disorder diagnosis. Don’t let that trick you into thinking that it doesn’t create problems that negatively impact your overall quality of life though.

High-functioning anxiety can prevent you from functioning at your fullest potential.

It can stop you from feeling your best and enjoying the life you’re working so hard to create for yourself.

Women with high-functioning anxiety experience many typical symptoms of anxiety. This can include things like:

  • Excessive worry
  • Fear
  • Overthinking
  • Difficulty relaxing
  • Insomnia or trouble sleeping

Where some people’s struggle with anxiety holds them back in life, your anxiety propels you forward. It has helped drive you to work towards and achieve your goals.

It might sound like a good thing at first glance, but when you’re driven by a fear of failure and being afraid to disappoint others, it eventually catches up with you.

What causes high-functioning anxiety in women?

Many different factors can lead to anxiety, including high-functioning anxiety. Here are some of the common ones.

High-functioning anxiety risk factors:

  • Genetics
  • Brain chemistry
  • Personality
  • Early childhood experiences (such as critical/demanding parents)
  • Traumatic life events
  • High-stress jobs

Anxiety, whether high-functioning or not, can be caused by relationship issues, financial concerns, and job-related stress. It can also be the result of internal insecurities or low self-esteem.

What does high-functioning anxiety look like in real life for women?

It’s easy to read through a list of high-functioning anxiety symptoms or “medical” definitions and think it doesn’t apply to you, so let’s dive into how this can play out in your everyday life as a woman.

Here are some common struggles and feelings that women with high-functioning anxiety experience:


It’s the struggle to feel like you need to be perfect in order to be “good enough.” Anything less than perfect is unacceptable. You may have high expectations from those around you but it doesn’t compare to the expectations you have for yourself.

It causes you to spend copious amounts of time on projects trying to get it “just right.” You read through the emails over and over again looking for errors or ways to reword sentences. You skip lunch to put in extra time. You may struggle with getting started on tasks you’re unfamiliar with.

Procrastination can be connected to perfectionism.

Fear of failure

This goes right along with perfectionism for many women. You’re afraid to fail which makes it even more difficult to step out and try something new. It’s not just the failing that you’re worried about; you don’t want to let others down.

You’re worried you won’t meet the expectations of those around you and you may struggle with feeling like you’re not meeting your own expectations either, so you work harder and increase your effort because you have to succeed.

Experiencing failure, even small failures, can feel catastrophic when you are living with high-functioning anxiety.


Overanalyzing things is a daily struggle. You’re constantly second-guessing and doubting the decisions you’ve made. You’re afraid of making the wrong choice, saying the wrong thing, or doing something you shouldn’t. So you overthink it all, to the point where it’s hard to take action.

You may feel paralyzed when a decision rests on your shoulders, or you may be able to make a decision but then keep rethinking it wondering if you made a mistake.


You feel the need to be constantly productive at all times. That may look like working long hours or being unable to disconnect from work at the end of the day. You may find that your thoughts keep going back to work long after the workday is done.

We do want to note that working long hours isn’t always a sign of being a workaholic. It may be that you truly love your job and are passionate about it. The key is to look at where your motivation for working long hours stems from. If it comes from your enjoyment of the work, that’s one thing. But if it comes from anxiety or fear, it can indicate a problem.

This can also spread outside of your job. If you’re limited to how much time you spend at work, you may find yourself filling your free time by serving on a board or doing something else that feels like work.

Assuming the worst

Fear leads you to assume the worst in every situation.

You get an unexpected email from your boss scheduling a meeting and you assume your job is on the line. Your best friend doesn’t respond to your text so you assume she must be angry with you. Your partner is late getting home so you assume they might be cheating, or they may have gotten into a terrible accident.

You frequently cause yourself unnecessary stress and anxiety by assuming the worst.

Even when it seems that things are going well in your life, you can’t beat the uneasy feeling that something bad is about to happen. It makes it impossible for you to rest and relax.

Nervous habits

You have an unconscious nervous habit that shows up. This could include things such as:

  • Fidgeting
  • Nail-biting
  • Hair pulling or twisting
  • Repetitive scratching
  • Knuckle cracking
  • Lip chewing

The obstacles to women overcoming high-functioning anxiety

There are many strategies to help you overcome the obstacles caused by high-functioning anxiety, but there are some common thoughts and beliefs that may be making it difficult for you, including:

  • Appearances can be deceiving. Having the outward appearance of “having it all together” can make it difficult to recognize and identify high-functioning anxiety.
  • How you process emotions. You may tend to bottle up your emotions or sweep them under the rug. Doing this might allow you to trick yourself into thinking there isn’t a problem for a while.
  • Not believing your struggles are valid. The fact that your struggle with anxiety isn’t obvious to others doesn’t mean it’s not real, but you may fear others will think you’re being ungrateful or “making a big deal out of nothing.”
  • Reluctance to seek help. When you’re the dependable person whom others come to for help, it can be hard to admit when you need help. You may struggle with feeling like you aren’t “good enough” if you can’t power through it on your own.

If you saw yourself in any of the descriptions above, we encourage you to take steps towards addressing your anxiety.

As a high-achieving woman, you’re doing great things, and you deserve to enjoy them and feel your best. We want to help you feel on the inside the way others see you on the outside.

5 Tips for women to overcome high-functioning anxiety

There are several actionable steps you can take to address your high-functioning anxiety. Here are a few you can try:

  1. Acknowledge the anxiety. Now that you are informed on how this anxiety can look in your life, it’s time to recognize the symptoms for what they are. It’s OK to acknowledge the areas where you’re struggling by being honest with yourself.
  2. Practice self-care. This can include things like taking baths, drinking tea, exercising regularly, or journaling. Find the activities that help you rest and recharge and do them regularly.
  3. Utilize relaxation techniques. Practicing deep breathing, yoga, and meditation can help you find relief from some of the symptoms of anxiety.
  4. Be kind to yourself. If you struggle with negative thinking, you may benefit from practicing a strategy called positive reframing. You can learn more about it in our blog post: The Simple Attitude Change that Will Dramatically Increase Your Quality of Life
  5. Talk to a professional. At Forward in Heels in New York, we have therapists who specialize in working with anxiety disorders and women with high-functioning anxiety.

How can therapy benefit women with high-functioning anxiety?

There is a misconception that therapy is only for people with “serious mental health disorders.”

However, therapy can be effective for helping with a wide range of life challenges including fear of failure, building healthy self-confidence, overcoming perfectionism, and high-functioning anxiety.

Therapy can help you:

  • Build an understanding of the role and function of anxiety in your life
  • Learn to identify the symptoms and how they manifest in your life and career
  • Learn how to identify and reframe unhelpful thoughts
  • Gain a deeper understanding of the root causes behind your anxiety
  • Learn new coping strategies to overcome anxiety
  • Learn how to set healthy boundaries

Shira Tanen, a therapist at Forward in Heels in New York, contributed her insights and expertise to this blog post. She is taking new clients and ready to work alongside you to create a warm and non-judgmental atmosphere where you can unpack and explore your thoughts and feelings, as you work to overcome the symptoms of high-functioning anxiety.

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