High-functioning anxiety is not a medical diagnosis, but it is an increasingly common issue that’s being talked about by Forbes, US News & World Report, the Cleveland Clinic, and even the meditation app Headspace.
So, what is high-functioning anxiety?
On the outside, a person might appear to have it all together all the time:
- High-Achieving
- Perfectionistic
- Busy & In Control
- Meeting Deadlines
- Detail Oriented
- Organized & Productive
- People Pleasing
- Seemingly Confident
BUT….with high-functioning anxiety, the outward success comes at a cost of inner turmoil:
- Constant Worry
- Overthinking
- Harshly Self-Critical
- Restless & Irritable
- Fear the Worst will Happen
- Feeling Stressed
- Overextended
- Can’t say No
- Mental & Physical Fatigue
Is it worth it?
Even though a little bit of anxiety can drive action and success, too much can take a toll on the body and mind.
That’s why people with high-functioning anxiety struggle not only with constant worry but also things like insomnia, muscle tension, racing heartbeat, exhaustion, and mood swings.
The thing about high-functioning anxiety is that it is very much an INNER struggle. Nobody would ever know on the outside, and the symptoms don’t meet the criteria for an anxiety diagnosis.
Root Causes of High-Functioning Anxiety
Confident and successful on the outside, with constant fear and worry on the inside. That’s what high-functioning anxiety looks like.
For anyone experiencing high-functioning anxiety, it can feel like a normal way to be—as if it’s necessary to be in a constant state of stress just to keep up with life’s demands.
But what if it’s not actually normal? What if it could be possible to stay organized, productive, and goal-oriented without compromising your inner peace?
The first step to breaking the cycle of high-functioning anxiety is to look at where it’s coming from.
Here are 5 potential root causes of high-functioning anxiety:
Personality
High-functioning anxiety might just feel like who you are, based on your personality. It is more common in people who tend to be shy or nervous in new situations or those who have a tendency to worry.
Stressful Life Events
Any experience that your body perceives as traumatic can create a stress response in the body that cascades into anxiousness. Even if we compensate by overachieving, the stress builds up on the inside.
Alcohol Use or Abuse
It’s common for those with high-functioning anxiety to have a cocktail or glass or wine to calm the nerves or relieve the anxiety. The problem is that it’s a short-term fix. Drinking alcohol can lead to sleep problems, fatigue, and worse anxiety the next day.
Thyroid Imbalance
Thyroid hormones regulate your metabolism but also influence mood. Both an overactive (hyper) and underactive (hypo) thyroid can lead to nervousness and anxiousness. Routine labs don’t usually evaluate a complete thyroid panel, so it’s possible to have thyroid imbalance even if you’ve been told your labs are normal.
Sympathetic Overdrive
Your sympathetic nervous system activates in response to stress, releasing a cascade of chemical messengers (like adrenaline) and hormones (like cortisol). With ongoing stress, your sympathetic response can overpower the more calming parasympathetic response. That creates agitation, anxiousness, muscle tension, sleep problems, and more.
High-functioning anxiety is very much an INNER struggle. Nobody would ever know on the outside, and the symptoms don’t meet the criteria for an anxiety diagnosis.
Nutritional Support for High-Functioning Anxiety
For anyone out there getting ALL THE THINGS done—yet barely holding on by a thread on the inside—there’s a chance it might be high-functioning anxiety.
If you have constant worry or feel exhausted by trying to meet life’s demands, you might feel like you just need to keep on pushing through.
I’m here to tell you that it’s possible to lessen the stress and anxiousness by nourishing your body and brain with targeted nutrients.
Here are 5 supplements to lessen the anxious feelings and make you more resilient to stress:
Probiotics
Probiotic blends of Lactobacillus and Bifidobacterium strains show promise for supporting stress and anxiety. They work by supporting the gut-brain axis and modulating inflammation in the body and brain.
Magnesium
Magnesium is needed to produce several neurotransmitters in the brain that affect anxiety and mood. It has a relaxing effect, calming the nervous system as well as tense muscles.
Vitamin B6
Vitamin B6 works together with magnesium in supporting neurotransmitter production in the brain. Other B vitamins (like B12 and folic acid) may also be beneficial, so one option is to take a B Complex or multivitamins providing the entire family of B vitamins.
Ashwagandha
Ashwagandha is considered an adaptogenic herb because it supports the body’s stress response (the hypothalamic-pituitary-adrenal axis). It can be helpful for relieving anxiety, calming the nerves, and supporting better sleep.
St. John’s Wort
Lots of people think of St. John’s Wort when they think of depression, but it works by supporting healthy levels of neurotransmitters (like serotonin) in the brain and can therefore also be very useful to alleviate anxiousness and stress.
Nutritional and herbal supplements will not put an end to high-functioning anxiety on their own, but they can nourish the body from the inside out to be more resilient to stress.
RELATED: BREAK UP WITH STRESS AND ANXIETY FOR GOOD
Vagal Toning for High-Functioning Anxiety
Overthinking. Overachieving. Perfectionistic. People-Pleasing.
The vagus nerve is at the center of your parasympathetic nervous system—the arm of your nervous system that puts you into rest and relaxation.
Better vagal tone means your body can relax faster after experiencing stress.
You can practice vagal toning exercises as part of your everyday routine AND use them in the moment for immediate stress relief.
Here are 3 quick ways to activate and tone your vagus nerve:
Deep Breathing
Slow and deep belly breathing is a powerful way to tone the vagus nerve. You can do this anytime and anywhere. One way to make a practice of deep breathing is to try an app that will alert you with reminders and guide you through quick breathing exercises.
Humming
The vagus nerve connects to the vocal cords, so the act of humming stimulates the nerve. Other ways to use the vocal cords to stimulate the vagal nerve include singing, laughter, or chanting.
Cold Water Splash
Exposure to cold is known to activate the vagus nerve. You can make a routine of this by ending your showers on cold. If you need a quick cold exposure in the moment, try splashing your face with cold water.
Over time, other ways to tone your vagus nerve include yoga, meditation, exercise, and eating a healthy diet filled with foods like fruits, veggies, and fermented (probiotic-rich) foods.
So, next time you catch yourself in a state of overthinking and overwhelm, give yourself a quick break (even as little as one minute!) to reset your nervous system with a vagal toning exercise.
People with high-functioning anxiety struggle not only with constant worry but also things like insomnia, muscle tension, racing heartbeat, exhaustion, and mood swings.
Ready to Stop Chasing Symptoms and Start Uncovering Solutions?
If you’re tired of being told everything is “normal” when you know something feels off… I see you.
Your body has deep inner wisdom. Those symptoms? They’re not random. They’re guideposts asking for attention. And when we take the time to uncover the root cause, small shifts can lead to big changes.
As a naturopathic doctor and functional medicine practitioner, I help high-performing women in their 30s–40s move from health prescriptions to true health transformation. Through precision testing, personalized protocols, and faith-aligned, whole-person care, we work together to restore hormonal balance, optimize fertility, and rebuild vibrant energy from the inside out.
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