Therapy for High Functioning Anxiety: When Success Masks Inner Struggle

High-achieving professionals often mask anxiety behind success - specialized therapy can help address hidden struggles while maintaining performance.

Introduction

Rachel sits in her corner office, looking out at the Chicago skyline. She just closed another big deal, her third this quarter. Her boss praised her work in the team meeting, and her colleagues look up to her as the person who always has it together. But right now, Rachel feels anything but successful.

Her heart is racing, even though there's no real emergency. She's already planning tomorrow's presentation, next week's client calls, and worrying about whether she'll meet next month's targets. Her mind won't stop running through all the things that could go wrong. She checks her phone constantly, responds to emails within minutes, and hasn't taken a real lunch break in months.

From the outside, Rachel appears to be the perfect professional. But inside, she's dealing with what many people don't recognize as anxiety—high functioning anxiety. As a Licensed Clinical Professional Counselor in Westmont, Illinois, I've worked with dozens of clients like Rachel who struggle with this hidden form of anxiety.

In this guide, you'll discover what high functioning anxiety really looks like, why traditional anxiety therapy approaches work for this condition, and how you can find relief while maintaining your success. Whether you're a busy professional in Westmont or surrounding areas, this information can help you understand that you're not alone—and that help is available.

Creative professionals with high functioning anxiety often excel at problem-solving while experiencing internal pressure for perfect outcomes.

What is High Functioning Anxiety?

High functioning anxiety isn't an official medical diagnosis, but it's a term mental health professionals use to describe people who experience anxiety symptoms while still managing to be successful in their daily lives. Think of it like running a race while carrying a heavy backpack—you can still finish the race, but it takes much more energy and effort.

People with high functioning anxiety often:

• Excel at work or school

• Maintain good relationships

• Keep up with daily responsibilities

• Appear calm and collected to others

But underneath this successful exterior, they're dealing with:

• Constant worry and racing thoughts

• Physical tension and restlessness

• Fear of making mistakes or not being "good enough"

• Difficulty relaxing or enjoying their achievements

How High Functioning Anxiety is Different

Regular anxiety might keep someone from going to work or attending social events. High functioning anxiety does the opposite—it often drives people to work harder, achieve more, and appear more put-together than others. But this comes at a significant cost to their mental and physical well-being.

Research published in the Journal of Anxiety Disorders shows that high achievers with anxiety symptoms often experience more stress-related health problems and burnout compared to their peers. This is why anxiety therapy specifically tailored to high functioning individuals is so important.

High functioning anxiety often manifests as feeling overwhelmed despite appearing highly capable and successful to others.

Signs You Might Have High Functioning Anxiety

Many people with high functioning anxiety don't realize they have it because they're "successful." Here are common signs to look for:

At Work:

• You finish projects early but spend hours perfecting them

• You volunteer for extra tasks because saying "no" feels impossible

• You check your work multiple times before submitting it

• You lose sleep before important meetings, even when you're well-prepared

• You feel guilty when you're not being productive

In Relationships:

• You constantly worry about what others think of you

• You avoid conflict, even when you have valid concerns

• You feel like you need to prove your worth to others

• You replay conversations, wondering if you said something wrong

• You have trouble asking for help or support

Physical Symptoms:

• Your mind feels like it never stops racing

• You have trouble relaxing, even during vacations

• You experience tension headaches or muscle tightness

• You feel restless or like you need to keep moving

• You have difficulty falling asleep because your mind won't quiet down

Emotional Patterns:

• You set extremely high standards for yourself

• You feel like anything less than perfect is failure

• You worry about future events that may never happen

• You have difficulty enjoying your successes

• You feel like a fraud, even when you're genuinely skilled

One of my clients, a successful marketing director, described it perfectly: "Everyone sees me as the person who has it all figured out, but inside I feel like I'm constantly trying to keep all the plates spinning without dropping any."

High functioning anxiety often stems from childhood experiences where love and approval seemed tied to achievement and perfect performance.

Why High Functioning Anxiety Develops

Understanding why high functioning anxiety develops can help reduce shame and self-blame. Common contributing factors include:

Childhood Experiences:

• Growing up in environments where love seemed tied to achievement

• Having parents who were highly anxious or perfectionistic

• Experiencing criticism for mistakes or "imperfect" performance

• Learning that being busy or successful gets positive attention

Personality Traits:

• Being naturally detail-oriented and conscientious

• Having high standards and strong work ethic

• Being sensitive to others' emotions and reactions

• Having a strong desire to help others and be liked

Environmental Factors:

• Working in high-pressure careers or competitive industries

• Living in achievement-oriented communities

• Social media pressure to appear "perfect"

• Cultural messages that equate worth with productivity

Brain Chemistry:

• Genetic predisposition to anxiety disorders

• Differences in how the brain processes stress and worry

• Imbalances in neurotransmitters that affect mood and anxiety

As someone trained in neuropsychotherapy, I help clients understand that high functioning anxiety often stems from the brain's attempt to keep us safe and successful. However, this protective mechanism can become overactive and exhausting.

Evidence-based therapy approaches like CBT and neuropsychotherapy provide effective treatment for high functioning anxiety while honoring professional goals.

How Anxiety Therapy Helps High Functioning Anxiety

The good news is that therapy for anxiety, specifically tailored for high functioning individuals, can be incredibly effective. Because you already have many coping skills and life management abilities, you often have strengths that make anxiety counseling very successful.

Evidence-Based Approaches That Work

Cognitive Behavioral Therapy (CBT): CBT is one of the most researched treatments for anxiety disorders. For high functioning anxiety, CBT helps you:

• Identify thought patterns that fuel anxiety

• Challenge perfectionist beliefs

• Develop more balanced thinking

• Learn practical worry management techniques

For example, if you constantly think "I have to be perfect or I'll fail," we'll work on developing thoughts like "I can do quality work without being perfect" or "Mistakes are learning opportunities, not disasters."

Acceptance and Commitment Therapy (ACT): ACT helps you change your relationship with anxiety rather than trying to eliminate it completely. This approach teaches you to:

• Accept anxiety as a normal human experience

• Focus on what truly matters to you (your values)

• Take meaningful action even when feeling anxious

• Develop psychological flexibility

Neuropsychotherapy Approaches: As a certified neuropsychotherapist, I help clients understand how their brain responds to stress and anxiety. This includes:

• Learning about your nervous system's stress response

• Developing brain-based strategies for calming anxiety

• Understanding how perfectionism affects brain function

• Using neuroplasticity to create new, healthier thought patterns

Mindfulness-Based Therapy: Mindfulness techniques are particularly helpful for high functioning anxiety because they help you:

• Stay present instead of worrying about the future

• Notice anxiety without being overwhelmed by it

• Develop self-compassion

• Create space between thoughts and reactions

What to Expect in High Functioning Anxiety Therapy

Initial Assessment: We'll explore how anxiety shows up specifically in your life, including:

• Your anxiety triggers and patterns

• How perfectionism affects your daily choices

• Your current coping strategies

• Your goals for therapy

Skill Building: You'll learn practical techniques such as:

• Breathing exercises that calm your nervous system

• Ways to challenge anxious thoughts

• Strategies for setting realistic expectations

• Techniques for saying "no" without guilt

• Methods for managing worry and rumination

Integration: We'll work on applying these skills to your specific situations:

• Preparing for work presentations without excessive worry

• Managing perfectionist tendencies in relationships

• Creating healthy boundaries between work and personal life

• Developing self-compassion when mistakes happen

Through specialized anxiety therapy, professionals learn to maintain success while finding inner peace and reducing perfectionist pressures.

Practical Strategies for High Functioning Anxiety

While professional anxiety therapy provides the most comprehensive support, here are some strategies you can start using today:

1. Practice the "Good Enough" Standard

Choose one area of your life where you'll aim for "good enough" instead of perfect. Maybe it's how you organize your workspace or how you format emails. Notice how it feels to let something be less than perfect.

2. Set Specific Worry Time

Designate 15 minutes daily as your "worry time." When anxious thoughts come up throughout the day, write them down and tell yourself you'll address them during worry time. This helps contain anxiety rather than letting it spread throughout your day.

3. Challenge Your Inner Critic

When you notice harsh self-talk, ask yourself:

• "Would I speak to a friend this way?"

• "What evidence supports this thought?"

• "What would I tell someone else in this situation?"

4. Practice Saying No

Start with small requests and practice phrases like:

• "I can't take that on right now"

• "Let me check my schedule and get back to you"

• "I'm not available for that"

Remember, "no" is a complete sentence—you don't need to justify every boundary you set.

5. Use the 5-4-3-2-1 Grounding Technique

When anxiety peaks, notice:

• 5 things you can see

• 4 things you can touch

• 3 things you can hear

• 2 things you can smell

• 1 thing you can taste

This helps bring your focus back to the present moment instead of getting caught in anxious thoughts.

6. Create Buffer Time

Build extra time into your schedule for transitions, travel, and tasks. This reduces the pressure to rush and the anxiety that comes with cutting things close.

Anxiety Therapy Westmont: Finding Local Support

If you're in Westmont, Illinois, or surrounding areas like Downers Grove, Hinsdale, or Oak Brook, finding a local therapist who understands high functioning anxiety is important. Look for mental health professionals who:

Understand Professional Pressures: Your therapist should recognize the unique challenges of high-achieving environments and competitive workplace cultures.

Have Experience with Anxiety Disorders: While high functioning anxiety isn't a formal diagnosis, it shares many features with generalized anxiety disorder and other anxiety conditions. Look for therapists with specific anxiety training.

Offer Flexible Scheduling: Many professionals with high functioning anxiety have demanding schedules. Find a therapist Westmont IL who offers evening or weekend appointments.

Use Evidence-Based Approaches: Look for anxiety counseling that includes proven methods like CBT, ACT, or mindfulness-based therapies.

What to Look for in a Therapist

Specialized Training: Consider therapists with additional certifications in:

• Anxiety disorders

• Neuropsychotherapy

• Mindfulness-based approaches

• Workplace mental health

Cultural Understanding: If you work in specific industries (finance, healthcare, law, etc.), it can be helpful to find someone who understands those professional environments.

Personal Fit: The therapeutic relationship is crucial for success. Look for someone who:

• Makes you feel heard and understood

• Doesn't judge your achievements or ambitions

• Balances challenge with support

• Respects your time and professional commitments

When to Seek Professional Help

Consider reaching out for anxiety therapy if:

• Your anxiety is affecting your sleep, relationships, or physical health

• You feel constantly exhausted despite your successes

• You're using unhealthy coping mechanisms (overworking, avoiding social situations, substance use)

• You feel like you're living your life for others instead of yourself

• You want to enjoy your achievements instead of constantly worrying about the next challenge

• Your perfectionism is preventing you from taking healthy risks or trying new things

Remember, seeking therapy for anxiety is a sign of strength and self-awareness, not weakness. Many of my most successful clients have found that anxiety counseling doesn't just reduce their anxiety—it actually helps them perform better because they're not wasting energy on excessive worry.

Recovery from high functioning anxiety allows professionals to maintain their drive for excellence while enjoying greater peace and work-life balance.

Real Stories of Recovery

Here are some success stories from my practice (details changed to protect privacy):

James, a financial advisor: "I used to work 70-hour weeks and still felt like I wasn't doing enough. Through anxiety therapy, I learned that my need to control everything was actually making me less effective. Now I delegate more, take time off without guilt, and actually enjoy my work again."

Lisa, a teacher: "I was spending hours perfecting lesson plans that should have taken 30 minutes. My therapist helped me understand that my students needed a present, engaged teacher more than they needed perfect handouts. I now focus on 'good enough' planning and have energy left for my family."

David, a small business owner: "I realized my anxiety was trying to protect me, but it was working overtime. Now I can use my natural attention to detail without letting it control my life. I'm more creative and decisive because I'm not paralyzed by the fear of making mistakes."

Maria, a healthcare professional: "Learning about high functioning anxiety was life-changing. I finally understood why I felt exhausted even when things were going well. Therapy helped me set boundaries and practice self-compassion. I'm a better healthcare provider because I'm taking care of myself too."

The Perfectionism Connection

Perfectionism and high functioning anxiety often go hand in hand. If you struggle with this combination, you might:

• Set impossibly high standards for yourself

• Feel like anything less than perfect is failure

• Spend excessive time on tasks that should be straightforward

• Avoid trying new things because you might not excel immediately

• Feel like your worth depends entirely on your achievements

Healthy vs. Unhealthy Perfectionism

Healthy Standards:

• Setting high but achievable goals

• Striving for excellence while accepting "good enough" when appropriate

• Learning from mistakes without self-criticism

• Maintaining perspective about what really matters

Unhealthy Perfectionism:

• Setting impossible standards that lead to constant stress

• Feeling like a failure when anything is less than perfect

• Procrastinating because you're afraid of not doing something perfectly

• Avoiding challenges where you might not succeed immediately

Perfectionism therapy helps you maintain your high standards while reducing the anxiety and stress that come with unrealistic expectations.

Building a Sustainable Life

Recovery from high functioning anxiety isn't about lowering your standards or becoming less ambitious. It's about finding a sustainable way to pursue your goals while also taking care of your mental health.

Creating Balance

Work-Life Integration: Instead of perfect work-life balance (which can become another source of pressure), focus on integration:

• Setting boundaries that protect your personal time

• Learning to be present wherever you are

• Recognizing that some seasons may require more work focus, others more personal focus

Redefining Success:

• Include well-being and relationships in your definition of success

• Celebrate progress, not just perfect outcomes

• Value effort and growth, not just results

• Remember that success includes being happy and healthy

Building Support Systems:

• Cultivate relationships outside of work

• Find activities that bring you joy independent of achievement

• Connect with others who understand your experiences

• Consider joining support groups for professionals or high achievers

The Role of Neuropsychotherapy in Treatment

As someone certified in neuropsychotherapy, I often incorporate brain-based approaches into anxiety treatment. Understanding how your brain responds to stress can be incredibly empowering.

How Anxiety Affects the Brain

When you have high functioning anxiety:

• Your amygdala (alarm system) becomes hyperactive

• Your prefrontal cortex (rational thinking center) can become overwhelmed

• Stress hormones like cortisol remain elevated

• Your nervous system stays in a state of high alert

Brain-Based Healing

Neuropsychotherapy approaches include:

• Understanding your unique stress response patterns

• Learning techniques to activate your parasympathetic nervous system (rest and digest mode)

• Developing body awareness to catch anxiety early

• Using neuroplasticity to create new, healthier thought patterns

This scientific understanding often helps high-achieving clients feel more confident about the therapy process because they can see how the techniques actually work in the brain.

Neuropsychotherapy approaches help high-achieving individuals understand their brain's response to stress and develop sustainable success strategies.

Moving Forward: Your Next Steps

If you're reading this and thinking, "This sounds like me," you're already taking an important step. Recognizing high functioning anxiety is often the hardest part of the journey.

Immediate Steps You Can Take:

1. Start small: Choose one strategy from this article and practice it for a week

2. Track your patterns: Notice when anxiety is highest and what triggers it

3. Practice self-compassion: Speak to yourself with the same kindness you'd show a good friend

4. Reach out for support: Consider scheduling a consultation with a therapist who specializes in anxiety

Finding the Right Support

When looking for anxiety therapy Westmont or in surrounding areas, consider:

• Therapists who understand high functioning anxiety

• Professionals with specialized training in anxiety disorders

• Someone who offers flexible scheduling for busy professionals

• A therapeutic approach that resonates with you (CBT, ACT, neuropsychotherapy, etc.)

Remember Your Strengths

As someone with high functioning anxiety, you already have many qualities that will help you in therapy:

• Strong motivation to improve

• Ability to set and work toward goals

• Intelligence and insight

• Commitment to personal growth

• Resilience and determination

Conclusion

High functioning anxiety can feel like a constant balancing act—maintaining success while managing internal struggle. But you don't have to carry this weight alone. With the right combination of therapy for anxiety, practical strategies, and support, you can learn to achieve your goals without sacrificing your peace of mind.

Anxiety therapy for high functioning individuals isn't about making you less ambitious or successful. It's about finding sustainable ways to pursue your goals while also taking care of your mental health. You deserve to feel proud of your accomplishments and enjoy your successes, not just survive them.

Many successful people have found that addressing their anxiety doesn't just improve their mental health—it actually enhances their performance because they're no longer wasting energy on excessive worry and perfectionism.

If you're ready to take the next step toward managing your high functioning anxiety, I'm here to help. Together, we can help you maintain your drive for excellence while finding greater peace and satisfaction in your daily life.

You don't have to choose between success and well-being. With the right support, you can have both.

About the Author: Monika Breidenbach is a Licensed Clinical Professional Counselor (LCPC) with specialized training in Neuropsychotherapy (NPT-C) and certification as an Integrative Mental Health Professional (CIMHP). With over eight years of experience, she specializes in treating high functioning anxiety, perfectionism, and stress management for professionals and young adults. Monika practices in Westmont, IL, offering both in-person and virtual therapy services. She understands the unique challenges faced by high achievers and provides evidence-based treatment that honors both ambition and well-being.

Contact Information: To schedule a consultation or learn more about high functioning anxiety therapy in Westmont, IL, call (708) 406-9792 or visit www.monikabreidenbach.care. Take the first step toward thriving, not just surviving.

Disclaimer: This article is for informational purposes only and does not constitute medical or psychological advice. The strategies described may not be suitable for everyone. If you are experiencing significant anxiety or other mental health concerns, please consult with a qualified healthcare professional. Individual results may vary, and therapy outcomes depend on many factors including your active participation in treatment.