But beneath the productivity, accolades, and polished LinkedIn profiles, many high achievers are quietly struggling with something that rarely gets discussed openly:

High-functioning anxiety.

Unlike debilitating anxiety that stops someone from working or socializing, high-functioning anxiety often fuels success — at least on the surface. The result? Professionals who look composed and accomplished while internally operating in a constant state of stress.

At Phoenix Pointe Psychiatry, we regularly work with driven professionals across Arizona who say the same thing:

“I’m doing well. I just don’t feel calm. Ever.”

Let’s unpack what that means.

---

What Is High-Functioning Anxiety?

High-Functioning Anxiety (HFA)

A non-clinical term used to describe individuals who meet criteria for an anxiety disorder but continue to perform well professionally and socially.

It is not an official DSM-5 diagnosis. Instead, it typically overlaps with:

• Generalized Anxiety Disorder (GAD)

• Social Anxiety Disorder

• Panic Disorder

• Obsessive tendencies

• Perfectionistic personality traits

---

Key Terms Defined

Generalized Anxiety Disorder (GAD)

A clinical anxiety disorder characterized by excessive worry occurring more days than not for at least six months, often accompanied by restlessness, muscle tension, irritability, and sleep disturbance.

Perfectionism

A personality trait involving excessively high performance standards paired with overly critical self-evaluations.

Cognitive Distortions

Habitual, inaccurate thinking patterns (e.g., catastrophizing, black-and-white thinking).

Hypervigilance

A heightened state of sensory awareness driven by fear of potential threats or mistakes.

Burnout

Emotional exhaustion and depersonalization caused by prolonged stress, often work-related.

---

What High-Functioning Anxiety Looks Like in Arizona Professionals

• Constant mental to-do lists

• Difficulty relaxing even on vacation

• Checking email late at night

• Over-preparing for meetings

• Fear of being “found out” as incompetent

• Physical tension (jaw clenching, GI symptoms, headaches)

• High caffeine dependence

• Trouble sleeping despite exhaustion

From the outside: success.
On the inside: relentless pressure.

---

Why It’s So Common in High Achievers

Anxiety can be reinforcing.

It drives:

• Preparation

• Risk calculation

• Productivity

• Achievement

• Hyper-responsibility

The problem? The nervous system never turns off.

Over time, chronic activation of the stress response can lead to:

• Sleep disorders

• Irritability

• Depression

• Relationship strain

• Physical symptoms (hypertension, IBS, migraines)

---

10 Practical Tips for Managing High-Functioning Anxiety

1. Schedule Worry Time

Set aside 15–20 minutes daily to intentionally write down worries. Containment reduces rumination.

2. Practice “Done Is Better Than Perfect”

Ship projects at 90% instead of 100%. Observe that catastrophe rarely follows.

3. Reduce Caffeine Strategically

Gradual tapering can significantly lower baseline anxiety.

4. Track Sleep Like a KPI

High performers track revenue — track sleep with equal seriousness.

5. Use Body-Based Regulation

Cold exposure, breathwork (4-6 breathing), and resistance training calm the nervous system.

6. Set Email Boundaries

Create defined digital shutdown times.

7. Reframe Productivity Identity

You are not your output. Separate identity from achievement.

8. Challenge Catastrophic Thinking

Ask: “What’s the most likely outcome?”

9. Consider Therapy

CBT is especially effective for anxiety disorders.

10. Evaluate Medication When Appropriate

SSRIs, SNRIs, or non-stimulant agents can reduce physiologic hyperarousal when symptoms impair quality of life.

---

6 Common Questions About High-Functioning Anxiety

1. Is high-functioning anxiety a real diagnosis?

No, it’s not a formal DSM diagnosis. It describes individuals who meet criteria for anxiety disorders but continue performing at a high level.

2. Can anxiety actually improve performance?

In moderate amounts, yes. Mild anxiety increases alertness and focus. Chronic anxiety, however, erodes long-term performance.

3. How is high-functioning anxiety different from burnout?

Burnout is typically situational and work-related. Anxiety is pervasive and affects multiple domains of life.

4. How do I know if I need professional help?

If anxiety:

• Disrupts sleep

• Causes physical symptoms

• Impacts relationships

• Feels uncontrollable
  It’s worth a professional evaluation.

5. Will medication change my personality?

When appropriately prescribed and monitored, medication reduces excessive anxiety — it does not remove drive or ambition.

6. Is this common in entrepreneurs?

Extremely. Founders often rely on anxiety-driven vigilance. Without boundaries, it becomes unsustainable.

---

When to Seek Help

You don’t need to wait for a breakdown.

Many Arizona professionals seek care not because they’re failing — but because they want to feel calm while succeeding.

At Phoenix Pointe Psychiatry, we provide:

• Comprehensive psychiatric evaluations

• Medication management

• Therapy referrals

• Lifestyle-integrated treatment plans

• In-person visits in Tempe

• Telehealth throughout Arizona

• Appointments typically within two weeks

If you’re thriving professionally but struggling internally, support is available.

Success does not have to come at the expense of peace.