Dr. Kathleen Isaac, a clinical professor at NYU Langone Health, started a support group for doctors amid the pandemic, but attendance was limited. She explains this in a recent NY Times article, "I think there's a sense of 'I'm fine, I know what I'm doing,'" she said. "There's such a culture of perfectionism, and it's so competitive that people want to present their best self. It's harder to admit they're struggling."

High achievers maintain their professionalism at all costs, even when feeling overwhelmed, stressed, and anxious on the inside. High-functioning anxiety is not unique to doctors; this form of pressure occurs in many professionals working in intense environments where results are valued over self-care.

People with high functioning anxiety pride themselves on being hardworking, detail-oriented, and helpful, but these traits can be a recipe for burnout. They maintain a wall; there simply isn't time to process emotions. These professionals may blame themselves for the irritability, poor sleep, and decision fatigue that accompany burnout.

How to recognize high-functioning anxiety

Hardworking professionals sometimes have a hard time slowing down, even outside of work. There is no off switch. High achievers may fear failure and often have difficulties setting boundaries between work and home time.

A detail-oriented coworker planning a project can be a dream for a team member, but detail-oriented can also lead to overthinking or procrastination. Another example would be an online entrepreneur who spends time creating content that is never perfect enough to post.

High achievers with anxiety are especially helpful and often work in healthcare or other caregiving roles. It is not unusual for them to get overwhelmed with projects, taking on more and more to keep peace and make other people happy. They can't say no.

People pleasers put others' needs first

Professionals receive little training on self-care. The culture of medicine still values working through lunch or not drinking water during a shift to limit bathroom breaks and be more available for patients. Self-care isn't just a bubble bath at the end of the day; self-care is an attitude of self-awareness and self-reflection that allows someone to set appropriate boundaries to prevent burnout.

Living with high-functioning anxiety

Practice gratitude. Consistent journaling is a challenge; here, gratitude refers not to a list but to the ability to accept one's perceived faults as human. Imperfections are unique opportunities to learn rather than defects that fuel impostor syndrome. Books like Brené Brown's The Gifts of Imperfection: Let Go of Who You Think You're Supposed to Be and Embrace Who You Are can be life changing.
Get rid of the "shoulds" in favor of more realistic expectations. Think of the "shoulds" like ants, one or two of them are no big deal, but a whole bunch together can carry you away like a scene from an Indiana Jones movie.
Thoughts are just thoughts. Your real identity and value are inherent to you as a person and not contingent on success. Your negative thoughts about yourself and your worth are not the truth.

Leading with high-functioning anxiety

Your vulnerability is also your strength. The self-awareness and willingness to share difficult times and what you learned is often more helpful than recounting wins.
People with high-functioning anxiety are often self-critical and believe this internal dialogue is necessary to perform. The danger is this negative self-talk can detract from the joy of wins. Think of a professional athlete who can't celebrate their victory because they focus on a missed shot. Ahimsa is a yoga concept of non-violence or "do no harm." It is why many yogis choose a vegetarian diet, but ahimsa can also refer to self-compassion. Treat yourself with kindness.
Non-attachment is a difficult concept for people in results-focused industries and environments like healthcare. Non-attachment doesn't mean that you no longer care about the outcome; with non-attachment, your emotional state is not tied to the result.

Final Thoughts

Professionals with high-functioning anxiety can continue to strive for perfection without being perfectionists. By practicing these mindfulness concepts, high achievers can find greater contentment in their work and life while mitigating burnout.