Signs of High-Functioning Anxiety You May Be Overlooking

By Arielle Hartz, Holistic Therapist & Coach – Serving Maryland via Telehealth

How do you want to live your one precious life?

Many of the adults I work with are outwardly capable, responsible, and successful. They show up for their careers, their families, and their commitments. They are often described as driven, thoughtful, and reliable. And yet internally, they may be carrying a quiet but persistent sense of unease, a constant hum of pressure that rarely lets them fully rest. This experience is often referred to as high-functioning anxiety. Because high-functioning anxiety does not always look like panic attacks or visible distress, it can go unnoticed for years. Many people assume that because they are “managing,” they must be fine. However, the nervous system tells a different story. Beneath productivity and achievement, there can be exhaustion, overthinking, and a deep longing to feel more grounded and at ease.

What Is High-Functioning Anxiety?

High-functioning anxiety is not a formal clinical diagnosis, but it is a very real lived experience. It often describes individuals who maintain work performance and daily responsibilities while internally experiencing chronic worry, tension, or self-doubt.

Common Signs Include:

• Constant overthinking and mental loops

• Perfectionism and fear of making mistakes

• Difficulty relaxing or being present

• High productivity driven by internal pressure

• Emotional disconnection or feeling numb

In fast-paced professional environments such as many areas across Maryland, high-functioning anxiety can become normalized. Over time, however, prolonged internal activation can lead to burnout, emotional disconnection, and physical symptoms related to nervous system dysregulation.

The Existential Layer

For many adults, anxiety is not only about stress or workload. It is also about deeper existential questions, such as:

  • Am I living in alignment with my values?

  • Is this the life I truly want?

  • Who am I beneath my roles and expectations?

Existential therapy invites us to slow down and listen to these inner stirrings. Anxiety can sometimes be understood as a signal, a call toward greater authenticity and conscious choice.

How Holistic and Somatic Therapy Can Help

In my work as a holistic, somatic, trauma-informed therapist serving clients across Maryland through telehealth, I integrate multiple therapeutic approaches to support both insight and embodied change. These include Existential Therapy, Person-Centered Therapy, Cognitive Behavioral Therapy, Internal Family Systems, Psychodynamic Therapy, and somatic nervous system regulation practices.

Is Telehealth Therapy Effective?

Online therapy is highly effective for anxiety support. Telehealth allows clients to access therapy from the comfort of their home, integrate nervous system practices in their real environment, and maintain consistency despite busy schedules.

A Gentle Invitation

You do not need to reach a crisis point to begin therapy. If something within you feels ready for change, support, or deeper self-understanding, therapy can offer a compassionate space to reconnect with your inner wisdom and move toward a more grounded and meaningful life.

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