Is It Productivity or High-Functioning Anxiety?
If you’re someone who thrives on productivity and ambition, it might feel counterintuitive to question whether those qualities could actually be a form of high-functioning anxiety. After all, you’re managing your responsibilities, achieving goals, and even excelling in some areas. But beneath the surface, does it feel sustainable—or is it starting to take a toll?
As a therapist specializing in trauma recovery, I work with many clients who identify with these patterns, and one thing I admire about them is their innate drive to figure themselves out. There’s often a deep curiosity that draws them into therapy—a desire to make sense of the cycles they’re stuck in and learn how to live in a way that feels more fulfilling. And what I’ve found over time is that when these clients soften and begin to show themselves compassion, incredible growth and healing unfold.
What Is High-Functioning Anxiety?
High-functioning anxiety isn’t an official diagnosis, but it’s a pattern that resonates deeply for many people. It’s a kind of anxiety that keeps you constantly on the go—checking off to-do lists, over-preparing for every scenario, and meeting deadlines with precision. On the outside, it might look like you have it all together. But on the inside, there’s often a sense of restlessness, self-doubt, or fear driving the bus.
Common signs of high-functioning anxiety:
Perfectionism, where nothing ever feels “good enough.”
Difficulty delegating tasks or saying no, leading to burnout.
Overthinking or second-guessing decisions, even minor ones.
A constant need to stay busy, even during downtime.
Trouble sleeping or relaxing, due to racing thoughts.
An inner critic that’s always pointing out what you “should” be doing.
Differentiating Productivity from High-Functioning Anxiety
So how do you know if what you’re experiencing is just part of your ambitious nature or if it’s high-functioning anxiety? Here are some questions to ask yourself:
Are your productive habits motivated by fear or curiosity?
Productivity driven by curiosity feels expansive—like you’re building toward something meaningful. Anxiety-driven productivity often feels more like a hamster wheel, powered by the fear of falling behind or not being “enough.”Do you feel like you’re on autopilot?
High-functioning anxiety can create a sense of compulsion, where you’re ticking boxes out of obligation or fear rather than because you’re truly engaged.What happens when you try to rest?
Do you allow yourself to rest without guilt, or does your inner critic pipe up, making you feel like you’re wasting time?
The key difference lies in how these patterns impact your well-being. If your drive to succeed leaves you feeling chronically depleted or disconnected, it’s worth taking a closer look.
What Makes High-Functioning Anxiety So Persistent?
One reason high-functioning anxiety can be so challenging to address is the fear of what might happen if you “let it go.” I’ve heard many clients express a worry that if they work through their anxiety in therapy, they’ll lose their edge or their drive.
But here’s the truth: Anxiety-driven productivity isn’t the only way to accomplish things—it’s just a well-worn path your brain has taken for years. Therapy isn’t about taking away your drive; it’s about helping you channel it in a way that feels healthier and more balanced.
In fact, one of the most beautiful transformations I see in therapy is when clients shift their inner critic into a compassionate voice. They discover they can still achieve incredible things, but from a place of ease and alignment rather than fear.
How Therapy Can Help
When treating high-functioning anxiety, brain- and body-based modalities like EMDR (Eye Movement Desensitization and Reprocessing), Internal Family Systems (IFS), and Sensorimotor Psychotherapy can be incredibly effective. These approaches go beyond talk therapy to address the root causes of your anxiety—often rooted in past experiences or relational patterns.
EMDR: Rewiring the Brain
EMDR works by using bilateral stimulation (like eye movements) to help your brain process unresolved experiences that may be fueling your anxiety. Imagine your mind as a filing cabinet; EMDR helps take the disorganized files that trigger anxiety and sort them into a system that makes sense, allowing your brain to “close the drawer” on old fears.
Click here to learn more about EMDR.
Internal Family Systems: Befriending Your Inner World
IFS helps you understand the different “parts” of yourself that contribute to high-functioning anxiety. For example, you might have a perfectionist part that pushes you to achieve and a fearful part that avoids taking risks. In therapy, we help these parts work together, creating a more harmonious internal system.
Click here to learn more about IFS
Sensorimotor Psychotherapy: Listening to Your Body
Anxiety often lives in the body, showing up as tension, restlessness, or a racing heart. Sensorimotor Psychotherapy teaches you how to tune into these sensations, recognize what your body needs, and find ways to regulate in the moment.
Click here to learn more about Sensorimotor Psychotherapy
Why Therapy Intensives Are Especially Effective
In my practice, I’ve found that therapy intensives—longer, focused sessions—are incredibly helpful for clients with high-functioning anxiety. Here’s why:
Deep Focus: Instead of spreading out your work over weeks or months, intensives allow us to dive deeply into specific patterns or triggers.
Immediate Relief: For many clients, intensives offer a sense of progress and relief much faster than traditional therapy schedules.
Less time in therapy (not to mention less money spent!): Because we can get so much more done in intensive sessions, you’d be in therapy for less time and less hours than traditional talk therapy.
Ethical and Regulating: Extended sessions are particularly important for modalities like EMDR, where it can take 45 minutes or more to reach a natural stopping point. Starting and stopping prematurely can disrupt the process and leave you feeling unregulated.
Click here to learn more about therapy intensives.
Takeaways
Here are some key insights to remember with high-functioning anxiety:
High-functioning anxiety can be both a strength and a challenge. It’s worth exploring how it’s serving you—and where it might be holding you back.
Productivity doesn’t have to come from a place of fear. Therapy can help you find a more balanced way to achieve your goals.
Brain- and body-based modalities are game changers. Approaches like EMDR, IFS, and Sensorimotor Psychotherapy address anxiety at its roots, creating long-lasting change.
You don’t have to lose your edge to heal. In fact, therapy often enhances creativity, energy, and clarity by helping you work from a place of self-compassion rather than self-criticism.
Investing in yourself is a gift. Whether through weekly therapy or intensives, this work has the potential to change not just how you manage anxiety, but how you experience your life.
Looking to connect with a psychotherapist in Washington, DC and Virginia who specializes in high-functioning anxiety and provides therapy intensives for faster healing and relief?
Take your first step towards healing from your past and experiencing deep, lasting change.
(Washington, D.C. and Virginia residents only)
About the author
Margot Lamson, LICSW, is a licensed psychotherapist offering in-person and virtual therapy in Washington, D.C. and Virginia. She is trained in multiple trauma-focused approaches, including EMDR, to support clients seeking meaningful and lasting healing. Margot also provides intensives, combining evidence-based and holistic techniques, to help clients achieve significant progress and feel better faster in a focused, supportive setting.
