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High-functioning anxiety in the workplace: causes, symptoms and treatment

Updated: Apr 17

stressed looking woman in an office while colleagues pass lots of documents around in the foreground

Anxiety is a common mental health condition that affects a significant portion of the population, with 22.5% of people reporting high levels of anxiety during 2021 and 2022.

While some individuals may experience more noticeable symptoms, others may exhibit high-functioning anxiety - a form of anxiety characterised by the ability to perform well in various areas of life, despite feeling anxious.

So how exactly does high-functioning anxiety develop in the workplace and what symptoms should we be on the lookout for?

headshot of Dr Tara Tofiq, a Consultant Psychiatrist and specialist in high functioning anxiety

Dr Tara Tofiq shares some insight

Dr Tara Tofiq, Consultant Psychiatrist (below) at Schoen Clinic Chelsea says “People with High-Functioning Anxiety (HFA) are able to accomplish tasks and manage themselves in various settings across the professional and social spheres.

Nevertheless, they will internally experience the same symptoms as those with Generalised Anxiety Disorder (GAD). These symptoms could include physiological manifestations of anxiety, such as increased heart rate, headaches and stomach upset as well as the psychological aspect which includes an impending sense of doom and racing thoughts.”

The difference between HFA and GAD is that in HFA, people can manage the daily demands made on them and therefore do not meet the criteria to be formally diagnosed with an anxiety disorder.

In presentations of GAD, there is an impairment in being able to take care of one’s self, being so anxious at night that it disrupts sleep patterns contributing to fatigue and not being able to complete tasks during the day.

People with HFA often feel trapped in a vicious cycle of self-doubt and uncertainty and the coping strategy is often to do more and keep the mind occupied. This leads to exhaustion and feeling depleted. Going above and beyond is often commended in workplace cultures without looking at the personal cost to the individual.

It is a common misconception held by high achievers that hustling is the only option for success, often this is exacerbated by the workplace culture leading to anxiety in the workplace.

What causes HFA?

The causes of high-functioning anxiety in the workplace are multifactorial and can be a product of internal or external factors. The development of anxiety in the workplace will also vary from person to person. Some potential causes include:

  • Perfectionism:  high achievers often set exceedingly high standards for themselves, leading to constant self-imposed pressure to excel. The fear of failure can trigger anxiety symptoms even when the person appears to be performing well.

  • Workload and deadlines: an excessive workload, tight deadlines, or a fast-paced work environment can create high levels of stress and trigger anxiety symptoms. This pressure to consistently meet expectations can contribute to anxiety in the workplace.

  • Work-life balance: difficulty maintaining a healthy work-life balance can significantly impact an individual's mental health. The inability to disconnect from work-related stressors can perpetuate anxiety symptoms, even outside of working hours.

  • Fear of judgment: a constant fear of being judged by colleagues, superiors, or subordinates can contribute to high-functioning anxiety. This fear may stem from a desire to maintain a positive image and may result in overthinking and self-doubt.

How does HFA present?

Now we’ve looked into some of the causes, let’s take a look at how high-functioning anxiety presents in individuals.

It’s important to note that due to its very nature, high-functioning anxiety may often go unnoticed by others, manifesting in subtle ways. Common symptoms may include:

  • Excessive worrying:  individuals with high-functioning anxiety may constantly worry about work-related matters, including minor details or future projects, leading to persistent feelings of unease.

  • Perfectionism and overachievement: striving for perfection and constantly seeking approval can be common characteristics of high-functioning anxiety. While this drive for excellence can lead to success, it can also cause significant stress and anxiety.

  • Difficulty with delegation: people with high-functioning anxiety may struggle with delegating tasks, fearing that others may not meet their standards. This can result in an excessive workload and increased anxiety levels.

  • Physical symptoms: anxiety can manifest in various physical symptoms, such as headaches, muscle tension, gastrointestinal issues, fatigue, or difficulty sleeping.

Treating high-functioning anxiety (HFA)

Addressing high-functioning anxiety in the workplace requires a comprehensive approach that combines self-care strategies and professional support.

Cognitive-Behavioural Therapy (CBT) can be highly effective in managing anxiety by helping individuals identify and challenge negative thought patterns, develop coping mechanisms and learn relaxation techniques.

In addition to therapy, there are many stress management techniques such as mindfulness, deep breathing exercises, and regular physical activity that can help reduce anxiety symptoms and improve overall well-being.

High-functioning anxiety in the workplace is a significant concern which can impact an individual's well-being and performance and it is important to recognise the signs early.

Schoen Clinic Chelsea is a leading London private mental health clinic specialising in offering group and one-to-one therapies for adult mental health conditions.

If you’re struggling, please speak to your GP or contact our clinic by calling 020 3146 2300 or email

This page was reviewed by Dr Tara Tofiq, Consultant Psychiatrist at Schoen Clinic Chelsea on 18th May 2023.

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