10 Signs of High-Functioning Anxiety in Women – and What to Do About It
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As a busy woman, you likely know the challenges of self-doubt, worry, and perfectionism. You might seem composed and successful on the outside, but inside, it can feel heavy. If you often want more and feel anxious underneath, you may have high-functioning anxiety. This phenomenon isn’t an official diagnosis, but it’s real. It can greatly impact your work, relationships, health, and sense of self.
Understanding high-functioning anxiety is important, especially for women. Cultural expectations often push us to be productive, nurturing, and strong emotionally. This urge to push through and hide discomfort can make anxiety look like excellence. But it can also damage your well-being over time.
Let’s look at high-functioning anxiety in women. We’ll cover signs you might see in your life and, most importantly, ways to start healing.
What Is High-Functioning Anxiety?
While most people experience some form of anxiety – such as before a big test or presentation – high-functioning anxiety persists. It drives you to achieve more, plan meticulously, and often say yes when you should say no.
If you are a woman with high-functioning anxiety, you probably experience the following common anxiety symptoms:
worry
racing thoughts
irritability
Despite these symptoms, you still manage daily life well – excelling in work, school, or social situations. These symptoms often go unnoticed. You may hide them by overpreparing, staying intensely focused, or piling up achievements.
Behind closed doors, the struggle can feel isolating. You may believe you’re the only one who feels this way or worry that asking for help will make you appear weak.
Why Women Are Especially Prone to High-Functioning
Women are twice as likely to develop anxiety disorders compared to men. Societal pressures, hormonal influences, and the expectation to “perform” through difficult moments (think monthly cycles, postpartum, and menopause) can make women more vulnerable to high-functioning anxiety. Women often feel pressure to meet high standards. They fear disappointing others, so they hide their anxiety. This leads them to conceal both physical and emotional discomfort.
What are 10 Signs of High-Functioning Anxiety?
Recognizing high-functioning anxiety in yourself is the first empowering step toward change. Here are ten common signs, illustrated by real-life experiences and supported by research.
Perfectionism That Feels Exhausting
If you constantly push yourself to meet impossibly high standards, replay mistakes, and fear judgment, you may be experiencing perfectionism rooted in anxiety. Small mistakes can lead to harsh self-criticism. This makes it tough to relax or enjoy your successes.
Overthinking Everything
Women with high-functioning anxiety spend excessive time ruminating about decisions, conversations, or future events. This mental “replay” can be exhausting and often leads to difficulty moving on from perceived missteps.
The Need for Control Over Chaos
You may feel a strong need to plan, organize, or predict every possible outcome. Routines offer comfort, but unexpected changes can make you feel lost and upset.
Chronic, Low-Level Worry
It’s not just the big things – worry invades everyday tasks and responsibilities. You might often stress about relationships, money, or your kids’ safety. This happens even when logic suggests everything is okay.
Procrastination Followed by Overcompensation
Fear of not doing something perfectly can lead to putting tasks off. When deadlines approach, you work hard — often to the point of exhaustion – to make up for it. The cycle repeats, building stress over time.
Trouble Saying “No”
You may worry about disappointing others. So, you take on too much. You fear saying no to requests or invitations. The result is often overcommitment, resentment, and burnout.
Sleep Problems and Physical Symptoms
High-functioning anxiety affects more than just thoughts. It can cause insomnia, headaches, stomach problems, muscle tension, fatigue, and even tingling or numbness in your hands and feet.
People-Pleasing and the Fear of Disapproval
A desire to avoid conflict or rejection means you prioritize others’ needs, often at the expense of your own. You may struggle to set boundaries or speak up about your true feelings.
Internal Self-Criticism and Imposter Syndrome
The inner voice of someone with high-functioning anxiety is relentless. You question if you’re doing “enough” and worry that others will discover you aren’t as competent as you seem.
Outward Calm, Inner Turmoil
People may see you as “the calm one,” but inside, your mind races with worry, doubt, and chaotic thoughts. You do well at masking your anxiety, but the internal pressure builds.
These signs can be subtle. Women with high-functioning anxiety often get praised for being productive, reliable, and successful. It can feel validating in the short term, but over time, anxiety may manifest physically and emotionally, leading to significant distress.
What Can You Do About High-Functioning Anxiety?
If you recognize yourself in these signs, know that you are not alone. High-functioning anxiety is more common than you think. Recent statistics indicate that many Americans have generalized anxiety disorder. However, many more experience anxiety without receiving a diagnosis. High-functioning anxiety is often overlooked.
Fortunately, there are effective ways to manage it and heal. Here’s what you can do:
Reflect and Increase Awareness: Take some time to step off the performance treadmill and reflect on how anxiety shows up in your life. Awareness is a powerful catalyst for change.
Seek Professional Support: Therapy is a great way to manage anxiety. Cognitive-behavioral therapy (CBT) is especially helpful. It teaches you to reframe maladaptive thoughts and behaviors. Some women find help from different therapies. This includes dialectical behavioral therapy (DBT), acceptance and commitment therapy (ACT), group therapy, or family-based work. The choice depends on your personal needs.
Practice Self-Compassion: Be gentle with yourself when anxious thoughts bubble to the surface. Treat yourself as kindly as you would a friend. Remind yourself that you are enough—even when anxiety says otherwise.
Challenge Perfectionism and Negative Self-Talk: Notice when you’re being excessively hard on yourself. Try to reframe mistakes as opportunities to learn, not sources of shame. Use positive self-talk and affirming statements to boost confidence and resilience.
Set Boundaries: Learning to say “no” is not a sign of weakness—it’s an act of self-care. Remind yourself that your worth is not dependent on always saying yes or pleasing everyone.
Prioritize Health and Self-Care: Regular exercise, nutritious food, adequate sleep, and meaningful social connection can all help regulate anxiety and strengthen your mental health.
Connect With Others: High-functioning anxiety can feel isolating, so reach out to supportive friends or family members. Share your experience honestly. You might be surprised by how many people understand and relate to your feelings.
Consider Medication: Sometimes therapy and lifestyle changes aren’t enough on their own. A doctor or psychiatrist may recommend medication, such as SSRIs (Selective Serotonin Reuptake Inhibitors) or SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors). These medicines help balance brain chemicals that affect your mood and can ease ongoing anxiety.
Practice Mindfulness and Relaxation: Mindfulness meditation, guided breathing, gentle yoga, or visualization exercises can calm the body’s stress response and help anchor you in the present moment.
Honor Your Individual Journey: There is no one-size-fits-all pathway out of anxiety. What matters most is not ignoring your body’s signals or your emotional discomfort. The sooner you reach out for help, the sooner you can start healing.
Hope and Support for Anxiety
If you are a high-functioning woman, you probably have a strong desire to succeed and care for others in your life (i.e., partner, children, friends). You deserve support, relief, and joy as much as anyone else. Accepting help and focusing on your mental health can change how you view anxiety. You can replace fear and struggle with calm, rooted in self-compassion, connection, and inner peace.
If you’re ready to take the next step, Coral Rose Counseling specializes in supporting women with anxiety, offering meaningful, personalized support through virtual sessions. Serving clients in Georgia and Virginia, Coral Rose Counseling understands what you’re going through and is here to help you find relief, confidence, and balance. Reach out today to connect and start your journey toward change and healing.
Coral Rose Counseling is here to help women in Georgia and Virginia, offering empathetic, expert virtual therapy for anxiety. Don’t wait. Reach out today to start a new chapter in your journey.
Resources
Harvard Health Publishing. (2024, June 9). Anxiety. Harvard Medical School. https://www.health.harvard.edu/topics/anxiety
Harvard Health Publishing. (2025, July 6). Generalized Anxiety Disorder - A to Z. Harvard Medical School. https://www.health.harvard.edu/mind-and-mood/generalized-anxiety-disorder-a-to-z
Cleveland Clinic. (2025, June 16). Signs you have high-functioning anxiety. https://health.clevelandclinic.org/what-is-high-functioning-anxiety
Mayo Clinic. (2023, October 23). Mayo Clinic Q and A: Understanding high-functioning anxiety. https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-understanding-high-functioning-anxiety/
Women’s Health Magazine. (2024, May 11). High-functioning anxiety: Definition, symptoms, how to cope. https://www.womenshealthmag.com/health/a60722310/what-is-high-functioning-anxiety/
Newport Institute. (2025, May 15). High-functioning anxiety in young adults. https://www.newportinstitute.com/resources/mental-health/high-functioning-anxiety
Arrowwood Addiction Treatment Center. (2024, November 29). High-functioning anxiety symptoms and treatment options. https://arrowwoodaddictiontreatmentcenter.com/insights-into-high-functioning-anxiety-identifying-symptoms-and-treatment-options
PMC National Institutes of Health. (2017, April 5). Anxiety disorders among women: A female lifespan approach. https://pmc.ncbi.nlm.nih.gov/articles/PMC5613977/
Mayo Clinic Health System. (2023, July 11). Managing high-functioning anxiety. Mayo Clinic. https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/managing-high-functioning-anxiety
