Anxiety is often imagined as something visible and disruptive; panic attacks, avoidance, or an inability to cope with daily life. However, this stereotype overlooks a quieter, less recognised experience: anxiety that exists alongside outward success. Many individuals who experience anxiety continue to perform well academically, professionally, and socially, appearing organised, driven, and reliable. Beneath this, however, there can be a constant undercurrent of worry, tension, and self-doubt.
This is often described as “high-functioning anxiety.” While not a formal diagnosis, it reflects patterns commonly associated with conditions such as Generalised Anxiety Disorder. People experiencing this may look like they are coping well, yet internally feel overwhelmed. This post explores what high-functioning anxiety can look like, the subtle signs that are often missed, and evidence-based ways to manage it.
Signs You Might Be Missing
Inability to Switch Off
A common but overlooked sign of high-functioning anxiety is the inability to mentally “switch off.” While it may look like dedication to others, it may indicate persistent worry. This might involve feeling compelled to check emails after hours or struggling to be present at home as thoughts about work loop around in your mind. You might notice yourself feeling restless, “wired but tired,” or irritable. Feeling constantly keyed up and persistent worry is a common sign of anxiety (Craske & Stein, 2016).
Perfectionism
Perfectionism in high-functioning anxiety can be a double-edged sword. On the one hand it can lead to high performance, on the other hand it may involve rigid standards and harsh self-criticism. Thoughts like “If it’s not perfect, it’s not good enough” can drive over-preparing and difficulty finishing tasks. Despite strong performance, satisfaction is often limited, as achievements rarely feel “good enough.” Emotionally, this is linked to fear of failure and chronic self-doubt. This pattern is not just about striving for high standards; it is also closely tied to ongoing worry. Research shows that individuals with higher levels of perfectionism, particularly those who fear making mistakes or hold very high personal standards, tend to experience more frequent and persistent worry (Handley et al., 2014).
Procrastination
Procrastination here is less about laziness and more about avoiding discomfort. Thoughts such as “What if I do it wrong?” can delay action. These types of thoughts may lead to task delay until the sense of urgency about a looming deadline forces completion, creating a cycle of avoidance and pressure. You might notice yourself experiencing a cycle of dread about the task, temporary relief from procrastinating, then guilt about the delay. This reflects a short-term coping pattern, where avoiding the task helps reduce anxiety in the moment, but ultimately leads to more stress and pressure later on (Sirois & Pychyl, 2013). In the context of anxiety, this cycle of avoidance can also maintain and strengthen ongoing worry.
Excessive Checking or Rechecking of Work
Having an element of check and review built into your processes is important for delivering quality work. However, persistent doubt can lead to excessive and repeated checking behaviours, such as rereading emails or reviewing work multiple times. Thoughts like “Did I miss something?” drive these behaviours. While checking provides brief relief, uncertainty quickly returns. These safety behaviours often work to maintain anxiety (Gústavsson et al., 2021).
Difficulty Accepting Feedback
Difficulty accepting feedback may also be a subtle feature of high-functioning anxiety. Feedback may be interpreted less as neutral or constructive information and more as evidence of personal inadequacy. Thoughts like “this means I’m not good enough” can lead to overthinking, self-doubt, or withdrawal. Even when performance is strong, feedback can feel disproportionately threatening, reinforcing anxiety and perfectionistic concerns. This mirrors findings that anxious individuals are more sensitive to negative evaluation and may process feedback in a way that heightens worry and self-criticism (Gu et al., 2010).
Reassurance Seeking
Reassurance seeking involves frequently asking others for validation or seeking confirmation from other sources (for example, online), that something is “okay.” You might notice yourself constantly seeking input from colleagues about decisions you need to make, rather than relying on your own judgment. While it provides short-term relief, anxiety often returns quickly. Over time, this can reduce confidence in one’s own decision-making. It is considered a maintaining factor in anxiety, as it limits tolerance for uncertainty (Gústavsson et al., 2021).
A Mindfulness-Based Approach to managing high functioning anxiety
High-functioning anxiety is often maintained by trying to control, suppress, or “fix” anxious thoughts while still pushing through daily demands. Acceptance and Commitment Therapy (ACT) offers a different approach by focusing on how we relate to thoughts and feelings, rather than trying to eliminate them (Hayes et al., 2012).
Acceptance
Acceptance involves making space for uncomfortable thoughts and feelings rather than fighting them. For example, noticing “I’m not doing enough” without immediately responding by overworking or self-criticising can reduce the cycle of pressure that often maintains anxiety (Hayes et al., 2012).
Cognitive Defusion
It’s common for people to experience thoughts as facts or things they have to act on. Cognitive defusion helps create distance from thoughts so they feel less impactful. One example of cognitive defusion is where we add “I’m having the thought…” to the start of our thoughts. For example, the thought “I’m going to fail” becomes “I’m having the thought that I might fail”. This process may help to reduce the impact the thought has over us (Hayes et al., 2012).
Being Present
People with high-functioning anxiety often spend a lot of time worrying about the future or overanalysing the past. Mindfulness helps bring attention back to the present moment, reducing mental overload and supporting clearer focus (Hayes et al., 2012).
Values and Committed Action
ACT also encourages clarifying personal values. These values then guide committed action, which involves taking small, meaningful steps even when anxiety is present, such as setting boundaries or reducing overchecking behaviours.
Overall, ACT supports a shift from trying to control anxious thoughts to changing how we respond to them, helping individuals build a more balanced and values-driven life despite feelings of anxiety (Hayes et al., 2012).
Still performing but struggling on the inside?
High-functioning anxiety can be difficult to recognise. When anxiety is hidden behind achievement, productivity, and reliability, it can easily be dismissed or even reinforced. However, functioning well on the outside does not mean feeling well on the inside. Recognising these patterns is an important first step toward change. If you’re ready to explore a different way of working, ACT offers a powerful set of evidence-based tools and techniques. By learning to accept your thoughts and feelings, connect with your values, and take committed action, you can find more sustainable ways to work.
If you’re interested in learning more about anxiety and how to manage it, don’t hesitate to schedule a free 15 minute consultation.
Disclaimer – this newsletter is for education and information purposes only. It does not constitute individual advice. The information contained in this newsletter may not be applicable or appropriate for everyone. If you need support, consider seeking individualised support from a qualified health professional.
References
Craske, M. G., & Stein, M. B. (2016). Anxiety. The Lancet, 388(10063), 3048–3059.
Gu, R., Huang, Y. X., & Luo, Y. J. (2010). Anxiety and feedback negativity. Psychophysiology, 47(5), 961-967.
Gústavsson, S. M., Salkovskis, P. M., & Sigurðsson, J. F. (2021). Cognitive analysis of specific threat beliefs and safety-seeking behaviours in generalised anxiety disorder: revisiting the cognitive theory of anxiety disorders. Behavioural and Cognitive Psychotherapy, 49(5), 526-539.
Handley, A. K., Egan, S. J., Kane, R. T., & Rees, C. S. (2014). The relationships between perfectionism, pathological worry and generalised anxiety disorder. BMC psychiatry, 14(1), 98.
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2011). Acceptance and commitment therapy: The process and practice of mindful change. Guilford press.
Sirois, F. M., & Pychyl, T. A. (2013). Procrastination and the priority of short-term mood regulation: Consequences for future self. Social and Personality Psychology Compass, 7(2), 115–127.
