High-Functioning Anxiety Signs and What You Can Do About It

What is high-functioning anxiety?

High-functioning anxiety is a term used to describe someone who is able to operate normally in their daily life despite having ongoing anxiety. Outwardly, you may appear to be coping with work, school, or other responsibilities, even being very successful. But beneath the surface, you may be suffering from feelings of fear or dread, uncontrollable worries, spiralling negative thoughts, and exhaustion.

High-functioning anxiety is also known as “high-performing anxiety” or simply “functioning anxiety.” It is not a clinical diagnosis and it doesn’t feature in the DSM-5, the latest version of the diagnostic handbook on mental health. Instead, it usually falls under generalized anxiety disorder (GAD), a common mental health disorder that involves persistent feelings of worry and nervousness. The concept of high-functioning anxiety can also be a useful reminder that some of us can be struggling with anxiety even when it’s not apparent to others.

If you have high-performing anxiety, you might feel that you’re often on the verge of losing control or being overwhelmed by the nagging self-criticism, impending sense of doom, or persistent stress and tension. But somehow you manage to keep it all together, maintain the outward appearance of being okay, and make it successfully through the day. But you don’t have to wait until you can no longer hide your inner struggles. Even when it’s masked from others, anxiety can take a serious toll on your long-term health and well-being. By acting now, you can use proven techniques to ease your worries, calm your nerves, and relieve your symptoms.

Key signs you have high-functioning anxiety

A little anxiety isn’t always a bad thing. When you’re facing a challenging situation, such as a work deadline, a presentation, or an exam, anxiety can increase your focus, help you stay alert and prepared, and enhance your productivity and problem-solving. That’s why many people with high-functioning anxiety can seem so proactive, organized, and achievement-oriented. Others may even see you as a high-flier or a model employee.

But when anxiety becomes constant, even if it’s not apparent to others, it can damage your body and mind.

Outward traits of high-functioning anxiety

Think of a duck on water: everything above the surface seems calm and relaxed, but beneath the surface, it’s a whir of frantic paddling to keep going. Similarly, when you have high-functioning anxiety, above the surface, you may appear to be:

• Organized, dependable, proactive.
• Able to handle the demands of work or school, meet deadlines, and solve problems.
• A high achiever who strives for perfection.
• Unable to maintain a healthy work-life balance.

Inner experiences

While you may seem outwardly fine, you could still be suffering greatly on the inside with high-functioning anxiety symptoms such as:

• Negative thoughts, constant overthinking, self-criticism, or “what if” thinking.
• Uncontrollable worries such as a fear of failure, despite your success.
• Perfectionism and people-pleasing, never being able to say “no.”
• Irritability, trouble relaxing, and a racing mind.
• Physical symptoms like headaches, sweating, pounding heart, upset stomach, dizziness, muscle tension, fatigue, or sleep problems.

Emotional toll

Anxiety can affect people in very different ways. How visible the symptoms are to others isn’t a measure of how much of an emotional toll they can take on you. High-functioning anxiety can:

• Trigger self-doubt, guilt, and sadness.
• Make it difficult to enjoy your achievements.
• Cause irritability, moodiness, and affect your closest relationships.
• Lead to insomnia, burnout, digestive issues, elevated blood pressure, and an increased risk of depression.

Why high-functioning anxiety often goes unnoticed

Other people can often miss your signs of anxiety because you’re able to keep your outward functioning in life intact. Even if you return home from work or school utterly spent, then find it impossible to unwind, relax, or sleep well at night, others don’t see that side of you.

If any symptoms of anxiety are noticeable, such as your need for reassurance or worries about the quality of your work, they can often be mistaken for diligence, reliability, or ambition. Your achievements can mask your internal suffering.

It’s easy to overlook your own symptoms as well. You might just dismiss the negative thoughts, feelings of unease and worry, and difficulty relaxing as the “price of success.” For many, being stressed and anxious all the time is so common, it just feels normal. And if you’re someone who views having a mental health issue as a sign of weakness, you may simply refuse to acknowledge how much you’re struggling each day.

Whatever the reasons for your high-functioning anxiety going unnoticed, it’s important to take steps to address the problem. You don’t need to wait until you feel so overwhelmed that you’re no longer able to cover up your anxiety.

What to do if you recognize the signs

It’s not an indication of weakness to take time for yourself to relax and unwind, manage stress, and seek a better work-life balance. Acknowledging the impact of functioning anxiety on your life is the first step to addressing your symptoms and regaining control of your life. These strategies can help:

Get moving. Exercise is a great way to burn off tension, ease stress, and relieve anxiety. It can also help to boost your self-esteem, and interrupt the daily worries that can cycle through your head.

Put an end to negative thinking. Whether you assume responsibility for things that are outside your control, always expect the worst-case scenario to happen, or tend to look at everything in black-or-white (“If everything is not perfect, I’m a total failure”), you can learn to counter negative thoughts and look at life in a more balanced way.

Manage stress. You can manage stress at work by resisting perfectionism, improving your organizational skills, delegating more, and learning to say no. Adding relaxation techniques such as yoga, deep breathing, and mindful breathing to your daily routine can also lower your stress and anxiety levels.

Connect with others. Don’t be afraid to let others know how you’re really feeling. Social support from people you trust can help you better understand what you’re going through and get a more realistic perspective on your sources of anxiety.

Invest in self-care. Self-care measures such as eating a healthy diet, reducing caffeine and alcohol, and prioritizing sleep can ease anxiety and improve well-being.

Treatment for high-functioning anxiety

If self-help strategies aren’t enough, it may be time to seek professional help.

Therapy. Therapy for anxiety disorders can give you the tools to overcome high-functioning anxiety for good. Cognitive behavioral therapy (CBT), for example, can help you change the negative patterns of thinking and behaving that contribute to your anxiety. When you’re anxious, seeking therapy online may be more comfortable as well as convenient. Many leading online therapy companies offer therapists who specialize in anxiety.

Medication. Anxiety medication includes benzodiazepines, antidepressants such as SSRIs, and beta-blockers. While they’re not a cure for anxiety, they can offer you relief. To find the right medication for you, consult with a psychiatric care provider, in-person or at one of the many online psychiatry platforms.

Last updated or reviewed on November 25, 2025