High-Functioning Anxiety: When You Look Fine But Feel Everything
- Esther Dietrichsen-Farley
- May 27
- 3 min read
Updated: Jun 23
You’re doing all the right things.
You show up for work, meet deadlines, reply to messages, keep up with family - and maybe even smile through it. From the outside, things look fine. But inside, there’s a quiet storm. You feel everything too much, and yet strangely numb at the same time.
This experience is often described as high-functioning anxiety, and it's more common than you might think.
What is High-Functioning Anxiety?
While not an official diagnosis, high-functioning anxiety refers to people who appear calm, capable and composed on the outside, but who feel overwhelmed, restless or self-critical underneath. Because they’re still coping and often excelling, it tends to go unnoticed - even by themselves.
They might say:
“I’m just tired all the time.”
“I can’t switch off, even when I try.”
“I don’t feel like myself anymore.”
According to Psychology Today, symptoms of high-functioning anxiety may include:
Overthinking and mental rehearsal
Trouble sleeping or waking up exhausted
A sense of dread without a clear cause
Difficulty relaxing or resting
People-pleasing and fear of letting others down
Emotional numbness or flatness, even while staying busy
You might be high-achieving and reliable, and yet carry a constant undercurrent of tension that no one else can see.
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Why It’s So Often Missed
High-functioning anxiety is difficult to recognise because it hides behind competence. People around you may say you're doing great. You might tell yourself you're fine because you're keeping it together.
But just because someone is functioning doesn’t mean they’re thriving.
This way of coping can become a mask. You stay in motion because slowing down feels risky. Many people I work with say things like, “I don’t want to fall apart. I don’t think I’m allowed to.”
That belief alone can delay getting support, even when your inner world is asking for it.
The Link Between High-Functioning Anxiety and Burnout
Over time, high-functioning anxiety can tip into burnout: a state of emotional, mental and physical exhaustion. The World Health Organization recognises burnout as a legitimate occupational phenomenon, typically marked by:
Exhaustion
Mental distance from your work
Reduced professional effectiveness
But you don’t need a corporate job to burn out. Long-term people-pleasing, internal pressure, emotional suppression, and never feeling “enough” can take just as much from you.
As Dr Gabor Maté suggests, burnout is often a loss of connection to self, where performance or caregiving replaces authenticity. Left unchecked, this can show up as emotional flatness, irritability, chronic tension or physical symptoms without a clear cause.
Why Therapy* (at Its Best) Doesn’t Ask You to Perform
If this resonates, therapy offers something different. A place where you don’t have to explain yourself perfectly or keep it all together.
At The Farley, I offer private therapy in Southampton and online across the UK for adults who are functioning on the surface but struggling underneath. You don’t need to be in crisis to reach out. Sometimes the quietest struggles are the ones we’ve carried the longest.
Therapy with me doesn’t ask you to perform. It offers space to be as you are, and time to reconnect with what matters to you - without pressure, judgement or fixing.
Final Thoughts
High-functioning anxiety doesn’t always look like anxiety. It might look like being dependable, productive or strong. But if it’s driven by fear, perfectionism or a chronic sense of never-enough, it can wear away at your emotional health until you're no longer in your own life.
If any of this feels familiar, you’re not alone. And you’re not too late.
I offer person-centred therapy for burnout, emotional numbness and high-functioning anxiety, both online and in person in Southampton.
You’re welcome here.
If you’re coping outwardly but carrying too much inside, high-functioning anxiety might be the missing piece. Therapy can help make sense of it. Feel free to get in touch.
