Top 3 signs you have high-functioning anxiety

As a coach and cognitive behavioural therapist (CBT) who works closely with high-achieving women, I often see a common pattern: women who appear to have it all together but silently struggle with anxiety. This isn’t the kind of anxiety that brings life to a halt, it’s what we call high-functioning anxiety.

You’re successful, driven, and capable, but beneath the surface, anxiety drives your behaviour and mindset.

Let’s explore the top three signs that you may be a high-performing woman grappling with high-functioning anxiety.

 1. You achieve, but you never feel like it’s enough

On the outside, your life looks impressive. You’ve climbed the career ladder, earned accolades, and are the go-to person for solving problems. Yet, despite these accomplishments, you’re plagued by a persistent feeling that you’re falling short. High-functioning anxiety often manifests as perfectionism and an intense fear of failure.

Your mind might race with thoughts like, “I could have done better,” or, “If I relax, everything will fall apart.” This relentless drive to achieve comes not from a place of inspiration but from a fear of inadequacy. You may also struggle to celebrate your wins because you’re already thinking about the next goal or the next potential mistake.

CBT often addresses this by helping you challenge these perfectionistic thoughts and cultivate self-compassion. Learning to recognise and acknowledge your accomplishments, rather than constantly moving the goalpost, is key to breaking this cycle.

2. You say ‘Yes’ to everything, even when you’re overwhelmed

High-performing women with high-functioning anxiety often have difficulty setting boundaries. You’re likely the one who always says “Yes, I can do that” at work, at home, and in your social circles. You take on additional tasks and responsibilities, even when you’re already stretched thin. Saying “no” feels impossible because you fear disappointing others or being seen as incapable.

This stems from a deep desire to prove your worth and a fear of being judged. In reality, this constant overcommitment leads to exhaustion, burnout, and resentment. You may feel trapped, wondering why you’re always so busy yet never feel accomplished or fulfilled.

In coaching and CBT, boundary-setting techniques are vital. Learning to identify your limits and assert your needs without guilt can be life-changing. Remember, saying “no” to one thing means saying “yes” to your well-being.

3. You overthink, and your mind rarely rests

Your brain is always on. You overanalyse conversations, decisions, and future scenarios. While your analytical skills serve you well professionally, they can turn into a spiral of worry and self-doubt. High-functioning anxiety often leads to over-preparing, replaying past events, and anticipating worst-case scenarios.

For example, after a successful presentation, instead of feeling relief, you might dwell on one minor mistake or wonder what people really thought of you. This constant mental chatter prevents you from truly relaxing or enjoying the moment. It can affect your sleep, relationships, and overall mental health.

CBT helps you recognise these cognitive distortions and replace them with balanced, realistic thoughts. Techniques like mindfulness, grounding exercises, and thought-stopping can help you redirect your anxious mind and find moments of peace.

What can you do about high-functioning anxiety?

Recognising these signs is the first step. High-functioning anxiety doesn’t mean you’re broken or incapable; it means you’re managing a lot beneath the surface. Seeking support from a therapist or coach can provide you with tools to manage anxiety while maintaining your high performance.

You deserve to succeed without sacrificing your peace of mind. True success isn’t just achieving goals; it’s feeling fulfilled and balanced while doing so.

Remember: You’re more than your accomplishments, and it’s okay to rest, set boundaries, and quiet the noise of anxiety. You’re doing better than you think, and you don’t have to do it all alone. 

 If this resonates with you, consider reaching out to a CBT therapist or coach who can help you navigate the challenges of high-functioning anxiety.