High-Functioning Anxiety: When “I’m Fine” Is Just Code for “I’m Spiraling”

By Erin Meyer, LCPC, M.Ed., MA

We all know someone who looks like they’re doing amazing on the outside, but inside, they’re one bad email away from unraveling. And sometimes? That someone is you.

This is high-functioning anxiety. And it’s not talked about nearly enough.

It hides behind busy schedules, perfectly written emails, and never-miss-a-deadline personas. From the outside, you look “put together.” But the truth? You’re gripping the steering wheel for dear life, and you’ve been in survival mode for years.

What is high-functioning anxiety, clinically speaking?

It’s not a formal diagnosis in the DSM, but it’s a very real experience recognized in clinical practice. It’s a form of chronic anxiety where individuals manage to meet their responsibilities and appear outwardly successful, while experiencing persistent inner turmoil. It often stems from early life conditioning that taught you your value is tied to performance, perfection, or people-pleasing.

You might relate if:

• You struggle to relax, even when things are going well

• Your mind is always racing with worst-case scenarios

• You overcommit and overdeliver, but feel resentful and burned out

• You rely on control, planning, and productivity to soothe your nervous system

• You minimize your own anxiety because you’re “high-functioning”

The danger of high-functioning anxiety is that it flies under the radar, until your body forces you to stop. Panic attacks, chronic fatigue, burnout, digestive issues… eventually, the bill comes due.

So what can you do?

Start by interrupting the performance loop.

Notice when you’re acting from fear of being “not enough.” Ask yourself: “Is this coming from pressure or presence?”

Use somatic tools to down-regulate your nervous system.

Breathwork (like 4-7-8 breathing), grounding exercises (5-4-3-2-1), and even walking barefoot outside can help signal safety to your body.

Talk about it.

You don’t need to earn support by falling apart. You’re allowed to ask for help before you hit a wall. Therapy, community, or even honest conversations with safe people can start to break the cycle of silent suffering.

Here’s the truth: You don’t need to “achieve your way” out of anxiety. You need safety. Self-compassion. And room to exhale.