High Functioning Anxiety

Do others describe you as “put together” and “successful” while you feel like you’re a bit of a mess?
Are you constantly worried about making a mistake and double checking yourself?
How much of your time is spent worrying about how others might judge you?

Sure, you are high achieving. But you also feel stressed most of the time. You worry that things could fall apart at any moment, so you are constantly on the lookout for potential problems. No matter how many of your goals you accomplish, you still feel like an imposter. The stress and faint hum of anxiety are still there. You still lay awake at night with a mind full of anxious thought. You have what we call high functioning anxiety.

What is High Functioning Anxiety?

“High functioning anxiety” is the kind of anxiety that is usually well hidden. You or someone you love may appear calm, successful and very well put together on the surface. However, there is all kind of worry going on underneath the surface. This is often the type of anxiety that can be channeled into propelling individuals toward career and financial success. In fact, high functioning anxiety can be associated with several positive characteristics.

However, while it may look like ambition is the driving force, it is actually crippling fear of failure, of disappointing others, worry about making a mistake or “impostor syndrome” that is driving the achievement. Ultimately, no amount of success is rewarding or lowers the anxiety.

When it comes to this type of anxiety, it’s critical to address the root of the problem. If you don’t address the underlying distorted beliefs, no amount of outward achievement will fix the inner feelings of distress, anxiety and seeking of external validation. Individuals with high functioning anxiety are often appear successful to everyone around them. In reality, you may feel empty, overwhelmed and constantly worried and preoccupied. Essentially it is hard to ever feel satisfied or to slow down.

Who Experiences High Functioning Anxiety

It’s common for high achieving and successful professionals in demanding and stressful fields (physicians, other mental health professionals, lawyers etc.) to experience this type fo anxiety. Perhaps this is you. You are successful in your career by standard measures. However, internally you feel chronically anxious, overwhelmed and generally dissatisfied.

You have a tendency to overthink and overanalyze social interactions. To be honest, you have a need to put up a façade and show in social situations. Unfortunately, this makes it hard to feel natural, present and connected in relationships.

​The problem becomes when anxiety starts to have a tremendous impact on your quality of life. In practical terms, the way this tends to play out for professionals and those with high functioning anxiety is in overthinking, rumination and chronic worry about mistakes and excessive focus on judgement and how others are viewing you.

Common behavioral patterns you may experience include people pleasing, difficulty saying no, nervous habits, needing reassurance, being early and over-preparing. These anxious behaviors can lead to a tendency to become excessively emotional or irritable when things don’t go as planned. You may even notice yourself be over-reactive to small changes and disruptions. It often involves excessive self critical reactions to any mistakes.

Generalized Anxiety Disorder

Maybe at some point in your life, you were diagnosed with Generalized Anxiety Disorder (GAD). The formal diagnostic symptoms of GAD include restlessness, being easily fatigued, difficulty concentrating, irritability, muscle tension, sleep disturbances and intrusive thoughts. All of these are common with high functioning anxiety.

Whether or not you’ve ever been labeled as having “Generalized Anxiety Disorder,” the symptoms are there. You may be comforted by this diagnostic label or you may want to fight against it. Whether or not you are labeled with “GAD,” the important thing is that you find a way to manage your anxiety.

You Thought Success Would Bring Peace of Mind

You have assumed the solution to feeling better is doing more and excelling higher. You thought you’d feel less anxious if you had more praise, more financial security or a more secure career. In fact, your identity and sense of self may have become completely tied into these external validations. It then becomes difficult to slow down or enjoy relaxation or personal time because the anxious thoughts continue even during “down” time. You find it hard to ever shift out of work and achievement mode.

Essentially you’ve used achievement as a way to manage the anxiety. Therefore, when you’re not in the mode of achieving or staying excessively busy, your anxiety worsens. You are left with their thoughts and feelings of emptiness that they keep running from. Thus, you find a way to keep busy to avoid that underlying anxiety. Perhaps your friends and family have lovingly encouraged you to “slow down” or “take a break.” They don’t understand that doing exactly that in fact makes you feel more stressed. Over time it can lead the body to be so stressed and over-taxed that it can lead to excessive fatigue and difficulty sleeping and then can shift to feelings of emptiness and depression.

Treatment for High Functioning Anxiety

When you come to counseling for anxiety, our clinical psychologists will do a mental health assessment to get to know you as an individual. They will try to first understand your anxiety, your mental health history and how your anxiety is impacting your life right now. They will then help you come up with an individual treatment plan.

But all of that is pretty broad, so you are still wondering exactly how we will treat your anxiety, right? Our therapists most often use mindfulness techniques and cognitive behavioral therapy techniques in counseling sessions for anxiety. Our clinical psychologists will help you identify triggers for your anxiety, be more present in the moment (mindfulness), learn coping skills for when anxiety comes and help you reframe how you look at your anxiety. ​In therapy, you can spend time working on relaxation skills, mindfulness and meditation skills and various ways of slowing down and learning to cope with and respond to the discomfort that surfaces when slowing down. Additionally, in therapy, you can attempt to challenge and re-program the perfectionistic belief systems that drive this type of anxiety.

It’s important to note that each of our therapists will approach anxiety treatment slightly differently. Each of us is a doctoral level psychologist. However, we’ve attended different trainings, have had different client experiences and bring our unique personality to sessions. You can read an overview of all our psychologists or look at our individual pages for more in depth information.

See Dr. Carswell’s page for more on her specific approach to treatment
See Dr. Daughn’s page for more on her specific approach to treatment ​​
See Dr. Biondoletti’s page for more on her specific approach to treatment


Are you tired of feeling like an impostor? Do you feel like you have to keep achieving or else everyone around you will realize you’re not as put together as you seem? Are you constantly afraid of failing? You may be dealing with anxiety as a high achieving person. The doctoral level psychologists at Wellness Psychological Services are trained to help clients find calm and confidence as they move through life. You don’t have to let anxiety make the decisions for you. Contact us today to find the peace you deserve.


Other Mental Health Services

As a South Tampa counseling clinic, we offer a variety of mental health services. All of our mental health professionals are doctoral level clinical psychologists. Wellness Psychological Services also offers treatment for Trauma/PTSD, EMDR therapy, stress management, counseling for busy professionals, relationship counseling, OCD, health psychology, & anxiety. When requested, our psychologists can integrate life coaching into therapy sessions. For couples & families, our psychologists provide support for couples/marriage counseling, divorce discernment, & collaborative divorce facilitation. If you don’t see the issue you are looking for listed, please reach out and contact Wellness Psychological Services. One of our psychologists may be help with your unique situation. We look forward to helping you live the life everyone see’s on the outside!

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205 S. Hoover Blvd. Ste 202
Tampa, FL 33609

(813) 563-1155

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