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ARTICLESMay 26, 2025

The Subtle Signs of Anxiety That High Performers Often Miss

Anxiety and High-Performers– A Hidden Struggle

At a glance, high-performers with anxiety may seem confident, poised, and in control. They juggle demanding workloads, lead teams, and accomplish ambitious goals. Yet beneath this polished exterior, many are silently battling anxiety — often without even realizing it. While anxiety in high performing individuals can culminate into visible panic attacks, rumination or crippling fear, high achievers may also experience anxiety that is subtle, not obvious to others and masked by perfectionism, overworking and a relentless inner critic.

Some research shows other elements of high achievement orientation – such as when avoidance also occurs or there is a focus on outperforming others, this may coincide with higher levels of anxiety. Competition and focus on outcomes is part and parcel of many professional careers and can be common among executives, entrepreneurs, physicians, lawyers and other high-stakes professionals. This includes professional athletes who are under tremendous pressure to perform and who public praise and criticism is directly related to outcomes in their play.

Recognizing the subtle signs is crucial. Left unchecked, anxiety can quietly erode mental and physical health, relationships, and professional performance over time. Anxiety can also culminate into negative behavioural outcomes.

Why High-Achievers Often Miss the Signs

High-achievers are often conditioned to normalize stress. From an early age, they are praised for resilience, discipline, and pushing through discomfort. Over time, constant pressure and inner tension become so familiar that they seem like a normal part of success.

Moreover, societal narratives reward busyness and hustle culture. In this environment, warning signs of anxiety — like chronic tension, perfectionism, or emotional numbing — are easily mistaken for dedication or work ethic.

Many high-performers also fear that acknowledging anxiety might be perceived as weakness, threatening their reputation or self-image. As a result, they may suppress or rationalize symptoms, pushing themselves harder rather than slowing down to address underlying issues.

Subtle Signs of Anxiety That High-Performers Overlook

Here are some of the most common — and most easily missed — signs of anxiety in high-functioning individuals:

1. Chronic Overthinking and Overanalyzing

High-performers often frame their constant mental activity as “strategic planning” or “being thorough.” However, when decision-making becomes paralyzed by second-guessing, excessive contingency planning, or ruminating over past conversations, it may signal underlying anxiety. Overthinking can become exhausting, eroding confidence over time.

2. Perfectionism That Feels Urgent and Critical

Perfectionism is often viewed as a badge of honor in professional circles. But when the drive to be flawless feels compulsive — not just motivating — it’s often anxiety-driven. Research by Dr. Gordon Flett and Dr. Paul Hewitt, pioneers in perfectionism studies, shows that maladaptive perfectionism strongly correlates with anxiety sensitivity, which can culminate as social anxiety and other anxiety disorders.

Signs include:

Fear of making even minor mistakes

Harsh self-criticism

Never feeling that work is “good enough,” even after success

3. Restlessness That Disguises Itself as “Ambition”

Always feeling the need to do more, achieve more, or stay busy can sometimes reflect ambition — but it can also be a coping mechanism to outrun anxious thoughts. Restlessness may show up as constantly starting new projects, difficulty relaxing during downtime, or feeling uncomfortable when not being productive.

4. Physical Symptoms Written Off as “Stress” or “Lifestyle”

Anxiety doesn’t just live in the mind. It manifests physically — but high-performers often dismiss or normalize these symptoms:

Muscle tension (especially jaw clenching or neck stiffness)

Gastrointestinal issues (like IBS or acid reflux)

Chronic headaches or migraines

Insomnia or restless sleep

Elevated heart rate even at rest

There is an abundance of research that shows a correlation between anxiety and increased risk for physical health conditions, including heart disease and gastrointestinal disorders.

Why These Signs Matter

Because these symptoms are subtle — and often rewarded or normalized — high-achievers might delay seeking support until anxiety intensifies into full burnout, panic attacks, or serious health issues. Early recognition allows for early intervention, potentially preventing a downward spiral that affects every area of life: work performance, relationships, and personal well-being.

Recognizing anxiety doesn’t mean losing your edge. In fact, addressing anxiety can enhance decision-making, creativity, emotional intelligence, and sustainable leadership over the long term.

How to Manage Anxiety Effectively as a High-Performer

Managing anxiety doesn’t mean losing your ambition or drive. In fact, for many high-performers with anxiety, learning to regulate their stress and anxiety strengthens focus, resilience, and long-term success. The answer is not to shut off anxiety as it can also give us important information that we lose when we try to suppress it. Here are evidence-based strategies tailored for individuals accustomed to high demands:

1. Mindfulness and Present-Moment Awareness

Practicing mindfulness helps break the cycle of overthinking and future-oriented worry. Mindfulness-Based Stress Reduction (MBSR) programs, developed by Dr. Jon Kabat-Zinn, have been shown to significantly reduce anxiety symptoms in both clinical and non-clinical populations. This type of approach can be helpful for high performers in addressing their anxiety

Simple practices such as mindful breathing, body scans, or mindful walking can help high-performers reconnect with the present moment, easing the constant drive toward the next task or achievement.

2. Reframing Perfectionism

Cognitive Behavioral Therapy (CBT) techniques can help reframe perfectionistic thinking. Instead of aiming for flawless outcomes, high-achievers can practice setting “good enough” standards and acknowledging that excellence allows for imperfection. A 2015 systematic review in Behavior Research and Therapy found that targeting maladaptive perfectionism in therapy coincided with reductions in anxiety symptoms.

Key reframes include:

“Done is better than perfect.”

“Mistakes are part of growth, not evidence of failure.”

3. Building Micro-Rest into the Day

Many high-achievers resist rest until reaching exhaustion. Instead, inserting small recovery periods — even 5–10 minutes between tasks — can recalibrate the nervous system. Techniques like deep breathing, progressive muscle relaxation, or stepping outside for natural light exposure have shown benefits in regulating stress hormones such as cortisol.

Research from the Journal of Applied Psychology shows that micro-breaks during work hours can improve mood and enhance productivity.

4. Naming and Validating Emotions

Suppressing feelings to stay “professional” may seem necessary, but emotional suppression has been linked to higher anxiety and even physical health problems. Simply naming what you’re feeling (“I notice I’m feeling anxious right now”) activates areas of the brain responsible for emotion regulation, according to research.

Validating your experience — without judgment — interrupts the cycle of shame that can fuel hidden anxiety.

When to Seek Professional Help

While self-help strategies can be powerful, it’s essential to recognize when anxiety requires professional intervention from therapists and psychologists who work with high functioning anxiety and professionals in high pressure careers. Seeking therapy isn’t a sign of weakness — it’s an investment in your performance, health, and quality of life. High performers with anxiety may benefit from structured and comprehensive approaches to help them manage.

Signs that professional support may be beneficial:

Anxiety is interfering with sleep, relationships, or daily tasks

Physical symptoms are persistent or worsening

Emotional numbness, burnout, or detachment from achievements

A growing reliance on unhealthy coping mechanisms (e.g., overwork, alcohol, excessive screen time)

Persistent feelings of dread, even when external stressors are minimal

Therapies such as Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), and Mindfulness-Based Cognitive Therapy (MBCT) are all evidence-backed treatments for anxiety. In some cases, medication prescribed by a healthcare provider, lifestyle or spiritual changes can also be a helpful part of a broader treatment plan.

Choosing a therapist who understands the pressures faced by high-achievers — such as performance demands, leadership responsibilities, and identity investment in success — can make a significant difference.

Final Thoughts: Redefining Strength

For high-performers, recognizing and addressing anxiety is not about giving up ambition — it’s about building a foundation for sustainable success.

Unchecked anxiety can erode health, creativity, and leadership over time. By contrast, managing anxiety effectively enhances decision-making clarity, emotional resilience, and true presence — all hallmarks of exceptional, enduring success.

In a culture that often glamorizes relentless striving, true strength lies not just in pushing forward, but in knowing when to pause, reflect, and heal.

If you recognize yourself in these signs, know that you are not alone — and support is available. Addressing anxiety early can transform it from a hidden liability into a catalyst for personal and professional growth.

At the Momenta Clinic, we understand that high achievers—whether executives, leaders, or elite performers—often carry an invisible weight. The same drive that fuels excellence can also come with relentless self-pressure, racing thoughts, and a quiet sense of unease that rarely pauses. We offer a space where these experiences are not pathologized, but explored with clarity and respect. Our approach is grounded in evidence-based strategies that align with the way high performers think and function—structured, collaborative, and focused on insight that leads to meaningful change. You don’t have to burn out to take a deeper look. Contact us to get started on your journey to calm!