High-Functioning Anxiety: When You’re Doing Great… and Still Not Okay
You’ve checked all the boxes—thriving at work, managing your responsibilities, maybe even keeping up with social commitments. From the outside, it looks like you’ve got it all together.
But inside? It’s a different story.
Your mind won’t stop racing. You're constantly anticipating the next problem, the next task, the next way you might let someone down. You overthink every interaction. You replay conversations. You push yourself to be “on” all the time, even when you're exhausted. And despite everything you achieve, it never quite feels like enough.
Welcome to high-functioning anxiety.
It’s the kind of anxiety that doesn’t always show. You might look calm, competent, and capable, but inside, you’re juggling stress, self-doubt, and a chronic inability to rest. You feel guilty for slowing down, and maybe even ashamed for struggling when others see you as successful.
And that’s what makes it so isolating.
You might wonder, Why am I like this? or What’s wrong with me? But the truth is: nothing is wrong with you. You’ve likely developed these patterns—perfectionism, people-pleasing, overthinking—as a way to cope. They may have helped you succeed, but they’re also taking a toll.
Therapy can help.
At my practice, we use evidence-based approaches to help you understand and gently shift the patterns that are keeping you stuck in survival mode. Some of the tools we may use include:
🧠 Cognitive Behavioral Therapy (CBT)
We work to uncover and shift the unhelpful thoughts that drive anxiety—like catastrophizing, self-criticism, or assuming the worst. CBT helps you build more balanced thinking and recognize that productivity doesn’t determine your worth.
Thought Record (aka Catch-It, Check-It, Change-It):
This tool helps identify and reframe anxious thoughts. It’s especially helpful for perfectionists and overthinkers.
Catch it – What’s the anxious or self-critical thought? (“I’m going to mess this up.”)
Check it – Is it true? What’s the evidence for and against it?
Change it – What’s a more balanced or realistic thought? (“I’ve handled challenges before. I don’t have to be perfect.”)
🧘♀️ Acceptance and Commitment Therapy (ACT)
ACT helps you notice anxious thoughts without getting swept away by them. Instead of fighting your inner experience, you learn to make room for it—while also reconnecting with what really matters to you. Rest. Joy. Creativity. Authenticity.
Values Clarification
People with high-functioning anxiety often chase productivity over purpose. This exercise helps reconnect with what actually matters—like creativity, connection, or rest—and gently guide your actions back toward those values.
🌀 Dialectical Behavior Therapy (DBT)
DBT provides practical skills for managing emotional overwhelm, building resilience, and improving boundaries—especially the ones we need to set with our inner critic. Mindfulness and self-compassion are central here.
TIPP Skills for Fast Emotional Regulation
When anxiety feels overwhelming, this set of DBT tools helps you calm your nervous system quickly:
T – Temperature (splash cold water on your face or hold an ice cube)
I – Intense Exercise (a quick burst like jumping jacks)
P – Paced Breathing (inhale 4, exhale 6)
P – Paired Muscle Relaxation (tense and release muscles)
Therapy isn’t about “fixing” you—it’s about supporting the real you. It’s about creating a space where you don’t have to perform, prove, or pretend. A space where it’s safe to exhale.
You don’t have to carry it alone.
Ready to breathe again? Let’s talk.