Why High-Performing Women Struggle With Anxiety

Mental health issues in high-performing women often get missed or dismissed. This often shows up as what's called high-functioning anxiety, anxiety that hides behind competence and success instead of slowing you down in a way anyone else can see. When we see a successful woman, it is hard to imagine that you could be struggling from a mental health concern. Have you ever been so burnt out at work, but everyone around you keeps praising you for how well you're doing? Maybe you haven't eaten all day, or you're running on 4 hours of sleep, but you're getting the work done. If this sounds like you, you're not alone.

Why the Standards Are So High

You had to push past many barriers to get to the position you are in now, and you are often expected to be agreeable and accommodating. In addition to needing to work harder to be successful in your career, once you achieve your goal, there is now more pressure to perform a certain way. These expectations, and fear that what you have could be taken from you, can cause high levels of anxiety.

A lot of this pressure isn't just in your head, it's structural. If you're one of the only women in the room at your level, you may feel like you're representing every woman, not just yourself, so there's less room to make a mistake. You've likely had to overperform just to be seen as equally competent to your male peers, and to be taken as seriously showing emotion or asking for help can read as weakness in a way it often doesn't for men in the same room. On top of that, many high-performing women are still carrying most of the mental load at home, the appointments, the planning, the emotional labor, on top of a demanding career. So the anxiety isn't only about the job. It's about holding all of it together at once, and knowing that if you slip, it may be read differently coming from you than it would from someone else.

Anxiety as a Defense

We all have defensive symptoms in place to protect us from being hurt or feeling painful emotions. These defenses often allow us to get through the day and avoid something deeper and often more unpleasant. We like routine, patterns, and predictability. So we don't want anything to threaten the status quo.

Do you notice you have a hard time sitting still? Your body never wants to slow down? This may be a sign that there is something you are avoiding. Usually, when we take the time to slow down and be in the present moment, that is the time our brains and bodies will communicate the more painful truths that we would like to not have to face. Maybe you slow down and you have to face that there are issues that need to be addressed in your relationship, or there are financial stressors to tackle. Our anxiety keeps us moving so we don't have to sit with the discomfort of these stressors. It also makes us feel like we are taking action and doing something productive.

Anxiety is energy, and it wants you on the move.

Sometimes the answer is to actually do nothing. Maybe we slow down and sit with our grief, our anger toward a friend, or our dissatisfaction with work. Sometimes our emotions simply need us to witness them and give them space to be expressed. These emotions are often distressing, and our bodies do a wonderful job of protecting us from any pain. But sometimes sitting in the pain is what heals is. By not being afraid of our deeper parts, we can finally break these patterns driven by anxiety, slow down, and start being more present in our lives.

Signs of High-Functioning Anxiety

When you don't slow down enough to actually feel what's underneath the anxiety, it doesn't just go away. It moves into your body. This is a lot of what makes high-functioning anxiety so easy to miss, it doesn't always look like a panic attack you can point to. More often it looks like tension, you've stopped noticing because it's just become part of how you feel every day.

Some symptoms of high-functioning anxiety are:

● Back, neck or shoulder pain

● Headache

● Increased heart rate

● Insomnia

● Shortness of breath

● Upset stomach

● Tension

● Avoidance/procrastination

● Catastrophizing

● Chronic worrying

● Difficulty relaxing

● Fear of failure

● Irritability

● Racing thoughts

● Reassurance seeking

● Self-doubt

If you are experiencing any of these symptoms, you may be struggling with high-functioning anxiety. Sometimes we move so fast we don't even notice we have a headache or that our shoulders are tense.

What You Can Do

So what do we do? The first thing you can do for yourself is to slow... down... and notice..

Notice where the tension is in your body. Notice your senses. Are you cold? Hot? What do you smell? Taste? Notice the environment your body is in and how you feel in that space. What do you need right now? Water? A walk outside? To talk to a friend? Trying to slow down and notice your internal experience is the first step to identifying your needs. We need to recognize we are stressed before we can do anything else about it. Once you have relaxed your body, then you can start to see what is underneath the anxiety.

What is the anxiety actually telling you? It could be telling you that the project you are working on in work is really important to you and you want it to go well. It could be telling you you are not confident in what you're working on. Or maybe there is a relational issue in your life that your anxiety is trying to make you pay attention to. Try to notice what in your life you could be avoiding.

After you've identified what is underneath the anxiety, then we try to put any fear of addressing that issue to the side. You are brave and can handle any discomfort this practice brings. So much of our anxiety is fear of the pain of sitting with the unpleasant thing. But do it anyway. Do it scared! When you identify what emotion is underneath the anxiety, then you can figure out what the need is. Do you need to cry? Do you need to have a difficult conversation with someone? Do you need to take a day off from work? Do you need self-care? Do you need physical activity?

Voila! That's it! You just successfully slowed down, moved past the anxiety, felt the core emotion, and then identified what you need! This is emotional processing. And the more you do it, the less scary it will be.

Moving Forward as a High-Performing Woman

While your anxiety may be part of your superpower and has helped you to be high-performing, there are other ways to manage your busy and stressful life. I want you to know that there is nothing wrong with you. This anxiety is truly trying to help you be successful, and it is coming from such a good place. You can have gratitude for the anxiety while trying to make changes so you are not fueled by it anymore.

If you want to make meaningful change to your anxiety and to explore the societal pressures you've experienced as a high-performing woman, a therapist can be a great resource. In therapy you will learn more about what your anxiety is telling you and what the specific underlying concerns are. It is also more comforting to practice emotional processing with professional support than trying to do it on your own.

About Alyssa

Alyssa Sidwell, LMHC is a New York City-based therapist offering virtual therapy and EMDR to clients across New York State. She specializes in trauma, anxiety, substance use, and relationship patterns, helping clients understand how their past shows up in their present. Her style is relational and grounded in AEDP, IFS, and psychodynamic therapy. Her work centers on the healing power of a safe, genuine therapeutic relationship, with warmth, curiosity, and a little humor. Her practice welcomes people of all gender identities and sexual orientations.

If you’d like to work on high-functioning anxiety in therapy, book a free consultation call with

Alyssa here https://calendar.app.google/qC8n8VdHjKo6RK6XA.

You can also check out her website at sidwelltherapy.com.