By Milissa Aronson | Boundaries
Posted: October 15, 2025
You wake up before your alarm. Your mind rehearses the day ahead. Even when everything looks "in control" on the outside — your career, your relationships, your “functioning” life — inside you might feel hollow, tight, and constantly on alert.
If you are someone who outwardly appears composed but inwardly lives in tension, restlessness, or relentless “shoulds,” welcome. You may be carrying high-functioning anxiety. And though coping strategies may sometimes serve you, you may be ready for something more profound to shift.
What High-Functioning Anxiety Is (and Why It’s Hard to See)
While “High-functioning anxiety” isn’t an official diagnosis, many mental health professionals would map its experience onto generalized anxiety disorder, perfectionism, or overcontrol strategies. Yet High-functioning anxiety is unique and, in everyday life, it takes a particular shape:
- You overthink decisions, replay conversations, and anticipate negative outcomes.
- You manage to look composed, maintain relationships, and perform well in your job (you may even excel in your job).
- You wrestle with self-doubt and fear of failure.
- You struggle with making decisions, becoming fixated on finding the “right” answer.
- You push yourself beyond your limits to avoid fear of being “found out.”
- Inside, you carry tension, guilt, second-guessing, shame, and inner critic narratives.
- You may sleep poorly, feel fatigue, and have somatic tension, but it’s dismissed as “normal stress” by you and other people in your life.
Because you “look okay,” others may not sense how much you're carrying. It becomes easy to discount your own internal experience, or to see it as a “quirk” rather than something that needs healing. This tension is especially common in women, partly because many social and cultural expectations press women to be highly competent, caring, and “put together.”
This duality — functional and seeming “fine” on the outside while feeling overstimulated inside — is at the core of high-functioning anxiety. This is the reason that high-functioning anxiety often hides in plain sight. As the Mayo Clinic puts it: “Behind the mask” is where the fear, self-criticism, and burnout often live.
Want a deeper dive? See these posts:
The Hidden Cost: Why “Functioning” Isn’t the Same as Thriving
It is tempting to see these traits as a character flaw or something to “get over.” However, the cost of living in this tension accumulates over time. It might show up as:
- Emotional numbing or flattening, with joy, ease, spontaneity feeling further and further away.
- Chronic physical symptoms, such as headaches, digestive issues, muscle tension, and fatigue.
- Burnout or collapse when the tank finally runs dry
- Relationship strain from overthinking, withdrawal, or emotional unavailability
- Disconnection from self – you lose clarity on your own needs, desires, values
You may rationalize that you don’t deserve more ease until you’ve “earned” it. But the body and nervous system don’t operate under logic. Your body responds and reacts to patterns, and the pattern of overdrive and restraint eventually fractures.
Why Coping Strategies Often Stop Working
Yes, tools matter. Grounding, breathwork, journaling, boundary practices are all helpful. But here’s what often happens:
- Tools can only regulate surface symptoms, not shift underlying tension.
- You may become reliant on tools to “get by” without addressing the root.
- Deep patterns, such as beliefs like “If I rest, I’ll fail” or “I must always be productive to be safe” remain untouched
- The anxiety may “work” for you. It might keep you driven and productive. This can make it harder to see and more difficult to address due to its perceived benefits.
When tools stop “working as well,” or when the weight of constant doing becomes too great, something deeper must shift. You have space to own that deeper, emotionally intelligent voice, and EMDR with insight-oriented therapy often work quite well as the next step for someone who’s already tried “talk therapy” or surface strategies.
Short on coping skills for anxiety? If you want practical anxiety supports while you consider deeper work, visit Anxiety Treatment or check out this post.
Why Depth Work + EMDR Can Help Where Coping Alone Doesn’t
Here’s how deeper therapy modalities make a difference:
- EMDR (Eye Movement Desensitization & Reprocessing) – EMDR is an evidenced-based intervention that helps you process implicit trauma or body-stored tension that you may not fully remember or articulate. The nervous system’s reaction patterns can be reprocessed so that you are freed from their grip. (Want more background information on EMDR?)
- Depth / Insight-Oriented Psychotherapy - This process facilitates reflective exploration of your beliefs, relational patterns, early sensitivities, and emotional dynamics. You begin to see why you default to overdrive, what your “no” looks like, and how your internal world was shaped.
- Nervous System / Somatic Integration - Rather than fighting the body, you gradually learn to move with it - shifting from control to attunement, from fight/flight (or freeze) to regulation.
In short: EMDR and more in-depth work do more than just help symptoms. They help you shift your relationship with yourself. By doing this, you don’t just address your current problems and stress, you transform so that future stress and problems don’t affect you in the same way.
Learn more about EMDR Therapy
A Gentle Next Step
If this post is resonating — that tension you’ve carried, the “stuck” feeling, the exhaustion — know this: change is possible. You deserve a baseline of safety and aliveness.
If you're in the New Providence, NJ area or surrounding towns, and you're curious about integrating EMDR and in-depth work for high-functioning anxiety, I’d invite you to explore a consultation with me. We’ll talk about your story, your goals, and whether this deeper path fits.
Even if now isn’t the time, consider this your permission: you don’t have to carry this tension forever. Rest, integration, clarity are all possible!