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High-Functioning Anxiety & Depression Among C-Suite Executives, Professional Leaders, & Entrepreneurs

High-Functioning Anxiety


People with high-functioning anxiety tend to overdo it. They may work extra hours, elect for extra assignments or try to do all tasks perfectly. High-functioning anxiety can negatively affect various areas of a person's life, despite their outward achievements and success. They focus on how society defines success and pressure themselves to achieve or surpass these often unrealistic expectations. This intense pressure can lead to burnout due to their constant drive to overachieve and their fear of failure.

People with high-functioning anxiety may also have strained relationships because they spend so much time focusing on other areas in their lives. Constructive criticism can be difficult to receive for people with high-functioning anxiety. They may find themselves overreacting to any criticism and harshly internalize it. They may neglect self-care like sleep, nutrition, and exercise, and battle physical health problems associated with chronic stress.

While high-functioning anxiety is not recognized in the Diagnostic and Statistical Manual of Mental Disorders, it is understood as a subset of generalized anxiety disorder that often goes unnoticed or undiagnosed. This occurs when a person has anxiety symptoms, but rather than retreat from situations, they work hard to face their fears and are skilled at hiding symptoms.

C-suite executives, leading professionals, and entrepreneurs who experience high-functioning anxiety may exhibit the following symptoms:

  • Elevated levels of perfectionism: Striving for perfection in their personal lives and work by setting unrealistic expectations for themselves.

  • Need for control: A strong need for control in their work, which may result in struggles with delegation, and excessive or increased workloads and stress.

  • Overthinking: Spending a lot of time ruminating and worrying about their work and personal life, often dwelling on worst-case scenarios and potential negative outcomes.

  • Procrastination: Struggling with procrastination and avoiding tasks due to fear of failure or not meeting their own high standards.

  • Physical symptoms: Due to anxiety, they can experience physical symptoms such as headaches, racing heart rate, muscle tension, digestive issues, and difficulty sleeping.

  • Social anxiety: Social situations may become anxiety-provoking such as networking events, public speaking, or meeting new people.

  • Impostor Syndrome: They may begin to feel incompetent or like they are lacking in skills that others perceive them to have. Self-doubt and the underlying feeling of not coping well can lead to a persistent fear of being exposed as a fraud or imposter.

If you're ready to address your anxiety and access strategies for overcoming obstacles, schedule your first appointment with Dr. Danielle Spearman using our online booking calendar.

High-Functioning Depression

High-functioning depression is a lay term that is not a diagnosed condition, however, it is sometimes used to describe experiencing symptoms of a depressive disorder while appearing fine to outsiders. You may be able to be productive daily and others would not know that you are suffering unless you told them.

Signs of high functioning depression:

  • Difficulty getting out of bed in the mornings or hitting that snooze button multiple times 

  • Feeling tired and sluggish throughout the day but difficulty falling asleep at night

  • Relying on coffee to get through the day and/or alcohol to unwind at night 

  • Little interest in your usual activities or hobbies 

  • Not feeling excited about the things you used to 

  • More irritable than usual

  • Thinking the world/life is bleak and mostly negative

  • Tendency to have a negative outlook on situations

  • Low self-esteem or inner self-critic 

  • Feeling not like yourself or empty inside

Depending on the person, high-functioning depression will look different but it’s typically described as: “Faking it till you make it” or “Just getting by”    

People with high-functioning anxiety and depression may use their feelings of anxiety, worry, and sadness to drive productivity and manage success. According to research, Black women are especially prone to being high achievers. They are often operating in roles of leadership, seen as having everything together, the helpful “strong friend” who is revered by others, and often appear happy and fulfilled. The Black Superwoman Schema, aka The Strong Black Woman, is a stereotype that reflects how Black women are socialized to be strong and independent. This role has its benefits and downsides.

Internally, Black women who are experiencing high-functioning anxiety and depression may also be silently dealing with:

  • Low self-esteem and low self-worth, and channel this through overachieving

  • Chronic feelings of sadness, hopelessness, and a lack of relief from self-defeatist thoughts

  • Poor boundaries and an inability to say no out of fear of other people’s reactions or FOMO (that is, the fear of missing out on something good), can often lead to burnout

  • People-pleasing, living in persistent fear of rejection, and being unavailable to others

  • Constant ruminating and self-sabotaging thoughts

  • Poor relationships and no social life from an inability to create genuine connections that are not tied to achievements or what others can benefit from them

  • Imposter syndrome or constant social comparison to others that causes them to feel inferior or insecure

  • Alcohol and drug abuse problems

  • Thoughts of suicide ideation and/or self-harm

It is important to understand that the terms "high-functioning anxiety and depression" can be misconstrued that people should be able to function at a high level even while struggling with serious symptoms of anxiety or depression. Also, describing it as “high-functioning” may make it seem like the symptoms are less serious or less severe. This might increase the likelihood that people will dismiss or minimize their symptoms, feel like others won't take them seriously, or decline to seek treatment. If you are struggling with anxiety or depression, seeking help can improve your functioning, sense of well-being, and quality of life.

Dr. Danielle provides mental health support to high-achieving/performing adults with busy schedules and demanding careers including C-suite executives, organizational leaders, professionals, business owners, attorneys, physicians, public figures, and others. She works with a lot of high-achievers who experience burnout and struggle with work-life balance due to working 12-16 hour days after college to build their careers or CEOs and entrepreneurs who demonstrate creative genius but feel trapped by their own success.

Here is what you can expect to resolve if you are committed to your treatment process and motivated to work with Dr. Danielle:

  • Deconstruct common thought traps.  You will learn how to deconstruct self-sabotaging thought traps that leave you feeling burnt out and inhibit your progress. 

  • Discover how to prioritize progress and not perfectionism.  Perfectionism and procrastination can manifest together and make you feel stuck! Either you spend countless hours stressing to get everything just right or you never even get started to begin with. With mindset and solution-focused behavioral shifts, you can live a balanced, efficient life.

  • Enhance your self-efficacy. You will be given practical tools to manifest your core values and overcome the vicious cycle of imposter syndrome.

  • Reduce anxiety when feeling overwhelmed.  Imagine being able to control your ruminating thoughts and feel more empowered.  You will learn how to calm your mind for improved concentration and a better night’s sleep! 

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