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Could you have high-functioning anxiety?

Updated: Jun 28, 2023

High-functioning anxiety is a form of anxiety where individuals may outwardly appear successful, driven, and high achieving, while internally experiencing significant anxiety and stress. It is not a diagnostic label in itself, but it is a real and valid experience that some of us have. I often see high-functioning anxiety like a swan on water: on the surface, the swan is gracious, smooth and elegant in its movements but under the surface, it is frantically moving its legs. Most people only get to see the surface level.

swan on a lake in the city

If you were wondering whether this might apply to you, here are some signs and symptoms of high-functioning anxiety:

  1. Perfectionism: A desire for everything to be perfect, which can lead to overworking, over-preparing, and overthinking even the most minor details.

  2. Overthinking: Constantly worrying about the future and over-analyzing every decision, making it difficult to make choices or take action.

  3. Difficulty Relaxing: Difficulty finding time to relax and often feeling restless or agitated when trying to unwind.

  4. Fear of Failure: A fear of failure or making mistakes that can result in being overly critical of oneself and others.

  5. Procrastination: Putting things off because of the fear of not doing them perfectly or the fear of failure.

  6. Physical symptoms: Symptoms such as headaches, muscle tension, stomach issues, difficulty sleeping, and fatigue may occur due to stress and anxiety.

  7. People-pleasing: Constantly seeking approval or validation from others, which can result in over-committing and difficulty saying no.

  8. Difficulty in social situations: Difficulty in social situations such as public speaking, meeting new people, or networking events.

It's important to note that everyone experiences anxiety differently, and not all symptoms will apply to everyone with high-functioning anxiety. The way we cope with it and approach it varies too, from more helpful way to largely unhelpful long term solutions.

Ioana Rotaru is a London-based Psychotherapist specialising in working with people with histories of childhood emotional neglect and trauma who now want to improve their relationship with themselves and others. If you would like to explore addressing any of the issues in this article, please get in touch with Ioana at for a free 15-minute consultation about how therapy might help.

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