High-functioning Anxiety: The Untold Story of Many Successful Women

As of 2023, about 301 million people, an estimated 4% of the global population, have an anxiety disorder. In women of the economically productive age groups, the expression of anxiety doesn’t always look like the typical stress outbursts and/or withdrawal from social life – as wary as women in general are about earning the respect and stature in society that they have been deprived of, discriminatively, for ages, they often mask their anxiety and stress with what seems to be a vigor and passion for work. A popular name for this masked form of anxious behavior is “High functioning Anxiety”. 


High-functioning anxiety is a subset of generalized anxiety disorder that often goes unnoticed or   undiagnosed due to its unique expression. It occurs when a person has anxiety symptoms, but rather than retreating from situations or interactions, they work harder than usual to face their fears and are skilled at covering up symptoms – sometimes subconsciously. “High-functioning Anxiety” is not a medical term (yet), however, is commonly used to describe anxiety with increased functionality triggered by stress and obsessive thinking rather than by healthy motivation and intrinsic drive. 


Anxiety, whether high-functioning or not, can be caused by relationship issues, financial concerns, and academic/occupational stress. It can also be the result of internal insecurities or low self-esteem. Many people develop high-functioning anxiety as a result of a difficult childhood, overly demanding parents, traumatic life experiences as a young child or due to an unhealthy competitive environment at school or at home. Sibling rivalry, punishing underachievement and overly praising victory can cause people to turn into anxious individuals who obsessively seek to overachieve. Women who are raised by strictly gender-biased families have a higher likelihood to develop mental health issues like high-functioning anxiety. In a household where boys are cut slack for chores or bad behavior but their female siblings are strictly dealt with for the same, girls may develop the tendency to fight hard for recognition and appreciation, often resulting in them becoming exhaustively critical professionals or overly hard working homemakers. At home or in an office environment, high-functioning anxiety is often perceived as people-pleasing, perfectionism, being a workaholic or even, in unfortunate cases, attention seeking. The most common features of High-functioning anxiety are: 


  1. Obsessively thinking about later outcomes of regular activities; being critical about small details that usually do not affect the final result, often out of fear of criticism,
  2. Not taking enough breaks or rest from work even when there isn’t any urgent deadline or crisis, 
  3. Being overprotective and controlling about family members’ needs, habits and behavior; relentlessly working to make sure everyone is happy and taken care of even at the expense of one’s own health and personal needs,
  4. High-functioning anxiety might cause individuals to become too competitive instead of being cooperative; they find it difficult to trust peers/family members and to delegate duties, which eventually overburdens them,
  5. A never-ending to-do list and a hard to maintain routine are the support system of people with high-functioning anxiety. 


The core difference between typical anxious disorders and high-functioning anxiety is how they are perceived from outside. People expect anxious individuals to be rather underconfident, scared of taking risks, nervous about speaking up in social situations or at a time of conflict; high-functioning anxiety makes people proactive, hardworking, critical thinkers and often very eloquent speakers who are able to lead, direct and represent. 


Just because they carry it well, doesn’t mean it’s not heavy. 


High-functioning anxiety often results in complications such as:

  1. Clinical anxiety and depression, 
  2. Hypertension, 
  3. Stress-induced fatigue, muscle pain, sweating and sleep disorders, 
  4. Cluster headaches or chronic migraine,
  5. Accelerated cardiac diseases. 


Numerous successful and renowned women around the world have spoken  about their experience with high-functioning anxiety and how it made their life miserable at times despite achieving very high standards set by themselves. Celebrities like Oprah Winfrey, Adele or Emma Stone pointed out that they often pushed their limits too hard because of their anxiety, rather than because of their drive for success and excellence. Homemakers in every culture have a tendency to drown into an anxious state while trying to make their family and home perfect – it is often because the efforts they make everyday to keep the home together go underappreciated, unrecognized and are taken for granted. 


As important as identifying the root-causes of high-functioning anxiety are, it’s crucial to identify symptoms in ourselves, in family members, friends or colleagues, and help them reach out for help and positive change. Just like any other anxiety disorder, high-functioning anxiety shows through habits like fidgeting, nail-biting, hyperventilating, occasional panic attacks, knuckle cracking, lip-chewing, or an unhealthy sleep pattern. Just because a woman is achieving success, doesn’t mean she is mentally healthy and sound. Through therapy (such as CBT) and lifestyle modification, a woman with high-functioning anxiety can unlock her untapped potential and live a more fulfilling life, away from the fear of being the neglected and underestimated half of the society.  

Although high-functioning anxiety is not a pleasant experience for anyone, it has helped women to break-free shackles that held them down for too long – that’s why this condition is more often found in women in positions of leadership and authority. However, if women need to anxiously and obsessively work for progress and the world remains a “man’s world” even in 2024, it indicates a moral failure of the global community besides being a big barrier in achieving the Sustainable Development Goals. We need to bring about necessary changes collectively, so that the future doesn’t rob women of their mental peace in exchange for the respect and appreciation they have always deserved. 



Maisha Ahsan Momo

Executive Director,

House of Volunteers Bangladesh


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