High Functioning Anxiety: When Success Doesn't Feel Like Success
A Los Angeles therapist on high functioning anxiety—how it hides behind achievement, why it depletes you, and what real treatment looks like.
From the outside, it looks like competence.
Deadlines met early. Inbox at zero. You're the friend who remembers the birthday, the colleague who absorbs the overflow, the partner who keeps the logistics running.
From the inside, it looks like something else.
You're awake at 2 a.m. rehearsing a conversation from three days ago. You haven't taken a real breath since Tuesday. Your achievements don't feel like yours—they feel like things you barely escaped failing at.
That's high functioning anxiety.
As an anxiety therapist in Los Angeles, I work with a specific kind of client. Young professionals. Creatives. Founders. Graduate students. People whose résumés say everything is fine.
They're not in crisis. They're not falling apart. They're exhausted in a way that doesn't yet have language.
Let's give it one.
What High Functioning Anxiety Actually Is
A note first: high functioning anxiety isn't a formal diagnosis. You won't find it in the DSM. But clinically, it describes something real—and the people living inside it deserve a more honest conversation than wellness content usually offers.
Here's what it tends to look like:
A mental loop of planning, anticipating, and reviewing that rarely shuts off
Difficulty resting without guilt or a low hum of unease
Over-preparing for situations other people move through casually
Saying yes when your body is clearly saying no
Overfunctioning at work, in your family, in your relationships
A racing mind that only quiets when you're producing
Sleep that comes hard or breaks early
A faint, persistent feeling that something is about to go wrong
The signature isn't dysfunction. It's the cost of the function.
People with high functioning anxiety often look like they're thriving by every external measure—and they may be—while privately running on a steady current of low-grade dread.
Why Achievement Becomes the Coping Mechanism
Here's the part most people don't talk about: anxiety and ambition are often two sides of the same coin.
For many high achievers, productivity is how the nervous system regulates itself. The brief relief of crossing something off the list. The promotion. The A. Being called "the responsible one." These don't just feel good—they temporarily quiet an older signal underneath:
If you stop, something bad will happen.
That signal isn't conscious. It usually got installed early—in a family where approval was contingent on performance, a school where being gifted hardened into identity, a culture that conflates worth with output. Los Angeles, for many of my clients, is a particularly fluent dialect of that culture.
The Perfectionism Feedback Loop
Perfectionism is one of the most reliable engines of high functioning anxiety. And it gets misunderstood a lot.
In therapy, we use the term perfectionism to describe something specific—not high standards, but using performance to manage internal threat. The fear that being less than excellent will expose something unacceptable about who you are.
People with genuinely high standards can finish, rest, and feel proud. Perfectionism doesn't allow that. The loop runs predictably: anxiety drives effort → effort produces results → results bring temporary relief → the bar quietly rises.
The threshold for "enough" recedes faster than you can chase it.
When Productivity Becomes Regulation
I describe this in session as productivity-as-regulation. The work isn't only work. It's how you stay okay.
Which is why rest—real rest, not the performative kind—can feel destabilizing. When the doing stops, the feelings the doing was managing tend to surface.
Most people, understandably, get busy again.
The Cost Most People Don't See
Some of what I see most often in my Los Angeles practice:
Chronic emotional exhaustion that doesn't resolve with a weekend away
Difficulty being present in your own relationships, even the ones you love
Resentment that surprises you—at work, at the people who ask things of you, at yourself
Physical signals: tension headaches, jaw clenching, GI issues, disrupted sleep
A sense of being further from yourself than you were a few years ago
The strange grief of having achieved what you wanted and feeling somehow worse
Burnout lives in this territory too. Anxiety drives over-effort. Over-effort depletes you. Depletion sharpens the anxiety. The loop tightens.
Why This Is So Hard to Recognize
A few reasons, all of them stubborn.
It works. Sort of. The strategies that fuel it—planning, controlling, achieving—do produce results. The people around you reward them. Letting them soften can feel less like healing and more like losing your edge.
It's quiet. There may be no panic attacks, no obvious avoidance, no clear "incident." Just a persistent hum that's become so familiar it reads as personality.
You're good at performing wellness. People with high functioning anxiety can describe their patterns lucidly in a first session and still be entirely identified with them. Insight isn't the same as change.
What Therapy for High Functioning Anxiety Actually Involves
If you're considering anxiety therapy in Los Angeles, the work for high functioning anxiety looks different from generic anxiety management.
The goal isn't to make you less ambitious. It's to separate your competence from your compulsion.
Beyond Symptom Management
Most short-form anxiety advice targets symptoms—breathing, grounding, reframing thoughts. These tools have their place, but for high functioning anxiety, they tend to become another item on the to-do list. You can optimize your way through them and feel no different at the core.
Deeper work tends to include:
Examining the early relational templates that taught you achievement equals safety
Distinguishing your nervous system's actual signals from your habitual responses
Building tolerance for the discomfort of not performing—rest, receiving, being seen without producing
Developing a sense of self-worth that doesn't require continuous output
Naming the costs you've been quietly absorbing as the price of being who you are
Nervous System Work
Much of high functioning anxiety lives in the body. The mind is the last to know.
Working with the nervous system—learning what activation actually feels like, what regulation feels like, what real rest is and isn't—is often a meaningful part of recovery. Not a wellness trend. A clinical one.
A Final Note
One of the harder truths about high functioning anxiety is that it can persist for years before someone decides it's worth addressing. There's no obvious bottom. The career keeps progressing. The relationships keep functioning. The internal experience quietly gets worse.
If you're recognizing yourself here, you haven't failed at anything. You've built a life on strategies that worked—right up until they started costing more than they returned.
Working with an anxiety therapist in Los Angeles who understands high functioning anxiety isn't about dismantling what you've built. It's about giving you a different relationship with the engine underneath it. The version of you that doesn't have to earn rest. The one that gets to actually inhabit the life you've worked this hard to create.
If you're considering modern therapy in Los Angeles—or virtual therapy across California, Nevada, or Oregon—I'd love to talk.
Frequently Asked Questions
Is high functioning anxiety a real diagnosis? Not formally. You won't find high functioning anxiety in the DSM, but it describes a recognizable clinical pattern: significant internal anxiety paired with strong external functioning. It overlaps with generalized anxiety, perfectionism, and chronic stress—and it captures something specific about how anxiety shows up in high achievers.
Can therapy help if I'm still functioning well? Yes—and this is often the most useful time to start. People who wait until they're in crisis face a steeper climb. Early work tends to be more nuanced and more identity-focused. Functioning well doesn't mean nothing is wrong. It usually means you've built effective compensations.
How is therapy for high functioning anxiety different from generic anxiety treatment? It focuses less on basic symptom management and more on the underlying relationship between achievement, identity, and self-worth. The work typically includes nervous system awareness, attention to early relational patterns, and steady examination of the beliefs that make rest feel unsafe.
Do you offer virtual therapy outside of Los Angeles? Yes. I offer virtual therapy across California, Nevada, and Oregon, which makes consistent work possible for busy professionals, frequent travelers, and people in areas with fewer specialized therapists.
How long does it usually take to feel different? It varies, but many clients notice meaningful shifts within the first couple of months—not the disappearance of anxiety, but a different relationship to it. Deeper change in patterns like perfectionism and overfunctioning generally unfolds over a longer arc, often six months to a year or more.
Does online therapy work?
One of the biggest concerns about online therapy is that therapists don't have an opportunity to observe the patient—something that is usually integral to an assessment and diagnosis. The tone of voice, body language, and overall demeanor provide insight into an individual's well-being.
A major component of effective therapy involves the relationship between the therapist and the patient. As online therapy is impersonal (often, it's completely anonymous), many people have raised concerns about whether digital communication can provide skills, tools, and healing power to individuals staring at a screen.
Despite the concerns, research consistently shows that online treatment can be very effective for many mental health issues. Here are the results of a few studies:
A 2014 study published in the Journal of Affective Disorders found that online treatment was just as effective as face-to-face treatment for depression.
A 2018 study published in the Journal of Psychological Disorders found that online cognitive behavioral therapy is, "effective, acceptable, and practical health care." The study found the online cognitive behavioral therapy was equally as effective as face-to-face treatment for major depression, panic disorder, social anxiety disorder, and generalized anxiety disorder.
A 2014 study published in Behaviour Research and Therapy found that online cognitive behavioral therapy was effective in treating anxiety disorders. Treatment was cost-effective and the positive improvements were sustained at the one-year follow-up.
The Potential Benefits of Online Treatment
Online therapy offers some benefits over traditional face-to-face treatment:
People in rural areas or those with transportation difficulties may have easier access.
Many online therapy sites allow users to sign up with "nicknames" which can entice people who are embarrassed about getting services under their real names.
Most online therapy services cost less than face-to-face treatment.
Scheduling is more convenient for many people.
Studies show online therapy requires 7.8 times less of a therapist's time than face-to-face treatment—meaning therapists can often treat more people online than they can in-person.
Clients don't have to worry about seeing people they know in the waiting room.
It can be easier for some people to reveal private information when they're sharing it online.
Individuals with anxiety, especially social anxiety, are more likely to reach out to an online therapist.
The Potential Drawbacks
Online therapy isn't for everyone. Here are some potential risks and drawbacks:
Online therapy isn't meant for people with certain problems or conditions (such as suicidal intent or psychosis).
Without being able to interact face-to-face, therapists miss out on body language and other cues that can help them arrive at an appropriate diagnosis.
Technological issues can become a barrier. Dropped calls, frozen videos, and trouble accessing chats aren't conducive to treatment.
Some people who advertise themselves as online therapists might not be licensed mental health treatment providers.
Sites that aren't reputable may not keep client information safe.
It can be difficult to form a therapeutic alliance with someone when meetings aren't face-to-face.
It can be difficult for therapists to intervene in the event of a crisis.
How to Find an Online Therapist
If you are interested in online therapy, there are many options to choose from. Think about what type of services you want most—phone therapy, video chats, live chats, audio messaging, or text messaging.
You may find a local therapist who offers online services, or you might find you prefer a large organization that offers a substantial directory of therapists to choose from.
But do your homework and shop around for the service and price plan that best suits your needs.
Find the full article here.
If you're looking for a therapist who provides online sessions, I invite you to contact me to schedule your free phone consultation today! Contact Me Here
Using Essential Oils for Energy
Life is exhausting. Family, pets, work, anxiety…It can all lead to relying on cup after cup of coffee to get through the day.
There isn’t one magic fix that instantly leads to increased energy: good sleep, eating healthy food, thyroid function, and stress management all play a part. But there is one supporting player on the better energy all-star team that’s often overlooked: essential oils.
While using essential oils for energy isn’t a replacement for prioritizing all the other factors that could be contributing to fatigue, it can help.
Essential oils that encourage deep breathing: peppermint, eucalyptus, and cardamom
We often don’t think about it, but deep breathing is directly connected to better energy. One reason why many people have an energy deficit is because they’re taking such shallow breaths all the time and there isn’t enough oxygen flowing through the body and to the brain.
When it comes to which specific essential oils are linked to deeper breathing, peppermint increases VO2; eucalyptus and cardamom are both popular oils that can provide respiratory support. (Eucalyptus is a decongestant, promoting deeper breathing. Cardamom is considered “warming” and can help improve circulation.)
Mood-boosting essential oils: orange, lemon, lime, grapefruit
Fatigue can also often stem from a mood imbalance. Mood is a big piece of energy. We know that chronic stress and depression can lead to chronic fatigue, and we also know that citrus essential oils such as orange, lemon, lime, and grapefruit, are linked to boosting mood.
Because memory and smell are so intricately linked, other essential oils can help boost mood too, based on what makes you specifically feel warm and fuzzy inside. For some people, lavender is a mood-boosting scent because they have such happy memories tied to it; it’s very individual.
Essential oils that support good sleep: lavender, chamomile, valerian root
Getting good sleep is a big part of feeling energized throughout the day, which is why working essential oils into your nighttime routine can be beneficial too. If you are really wanting to use essential oils for energy, you likely aren’t going to be using the same blends all the time; your morning blend will be different than your night blend because you don’t want to perk up at 10 p.m., which is likely what peppermint will do.
Lavender, chamomile, and valerian root are all essential oils that are linked to promoting good sleep. Lavender can calm the nervous system, helping you relax, while chamomile can help with anxiety and valerian root is literally used as a natural sleep aid.
How to use essential oils for energy
Now that you know which oils contribute to better energy, how do you use them? Topical use, applying a few drops of your chosen oil or blend to your wrists or neck. The reason why topical use is best is because you basically become a walking diffuser.
For the quickest effects, inhalation is best. Nothing is faster than inhalation, and adding a diffuser can be used in this way. Take a whiff of peppermint. You’ll instantly perk up!
Whether you choose to apply an essential oil topically or use a diffuser, the effects won’t last more than a couple hours, so because of this, you may want to incorporate them into your routine throughout the day. Perhaps you have one blend you smell in the morning, one in the afternoon, and one before bed.
While essential oils are only one piece of the energy-boosting puzzle, they can work in conjunction with other holistic solutions such as eating more nutrient dense foods and taking measures to minimize stress. When used together, a clearer picture of better energy starts to come together, and in turn, it could transform your entire day.
Read the full article at Well + Good.
If you live in the Los Angeles or Westlake Village area and are interested in therapy, I invite you to contact me via email at: tanyasamuelianmft@yahoo.com . I provide a complimentary consultation. Check out my services to see which one might fit your needs. Contact me now to see if we might be a good fit to work together! Or book your appointment here!
Breaking the Cycle of Fear
In every moment, you have the power to create your future. The “failures” you’ve had in the past don’t define your future or mean that you are going to “fail” again. You have the power to define who you are, what you want, and how to get there. Every day, remind yourself: I am not going to let my past define me. I am going to define me. I am going to create my future.
Get Comfortable with being Uncomfortable
Change is uncomfortable, but it’s also the only constant in life. The world around us—our relationships, jobs, living situations, friends, everything—is constantly changing and influencing us. Amid all of this change, why would we expect that we would stay the same? We’re constantly changing. Honor that. A lot of people feel that a change of heart is a negative thing. That it reflects a fickle nature. It doesn’t. You don’t have to prove yourself to anybody. You have to find what fits for you—right now, at this time in your life.
When we don’t honor the ways in which we’ve changed, we end up sticking with something just because we don’t want to quit. We end up stressed, overworked, and miserable, holding on for dear life to a dream we don’t even want anymore. This is dangerous—but as long as you’re still breathing, as long as you’re still alive, you have the opportunity to change your situation and find a dream that’s worth the gamble. Each breath is an opportunity to change. Each breath is an opportunity to be better than we were before. With each breath, we choose our future.
Lesson: You always have the opportunity to grow if you’re willing to change.
Stretch Yourself
The body is often naturally tight, and that’s okay. Breathe into your muscles and they will loosen. The same thing happens in life. Breathe into your fears and they will loosen their grip on you, opening you up to new opportunities. The more you breathe into your fears, the easier it gets to do so, and the more flexible you will become in trying new things.
Change is happening all around us and inside of us. If you’re flexible, you’re able to move easily with those changes and find your flow. If you’re not, you’ll get stuck, be unable to shift and adapt, and live in a way that isn’t working for you anymore.
The more flexible you are and the more you keep moving, the less likely you are to get stuck in your fears, doubts, and worries.
Lesson: Stay flexible and available for new opportunities.
Never Call It Failure
Things don’t always work out the way we want or plan. When a deal falls through, a client goes to a competitor, a job opportunity vanishes, a relationship ends, a proposal is rejected, or an experience falls short of your expectations, don’t call it a failure. Shift your mind-set. Stop asking, How did I fail? How can I stop failing? Instead, ask, How did that situation make me stronger? What can I learn from that experience?
It’s important to do a reality check. Do you want to keep pursuing this goal, or do you want to stop? Ask yourself: Is this something I want to push forward, or do I want to let it go and put my energy in another direction? Am I happy on this journey?
Lesson: You can’t fail if you don’t stop trying.
If you’re comfortable being uncomfortable, stretching yourself, and not calling fears failure, you’ll see opportunities for growth daily. Embrace growth, embrace change, and find your flow.
Read the full article on Goop.
If you live in the Los Angeles or Westlake Village area and are interested in therapy, I invite you to contact me via email at: tanyasamuelianmft@yahoo.com . I provide a complimentary consultation. Check out my services to see which one might fit your needs. Contact me now to see if we might be a good fit to work together! Or book your appointment here!
Dear Diary...
Writing down your feelings is a powerful tool for relationships because by doing it, you get to know the number-one most important person in your life: yourself. The quality of any romantic relationship is going to be directly correlated to your own self-worth. You are the person you really need to get to know, and journaling is a great ally in that process.
Writing can help you tune in to your inner voice and appreciate who you are—in other words, your journal shouldn’t just be a dumping ground for frustrations about your partner. (Although that can definitely be helpful in some situations, like if you need to have a talk with them and want to organize your thoughts.) Rather, you can also look at it as a place to dig deep into who you are and what you want.
Here are a few journal prompts that can help take a person’s relationships to the next level, whether single or attached.
Journal Prompts for Single People
The perfect day visualization: A big roadblock people come up against when dating is that they don’t really know what they want. And if you’re not clear on your endgame, you risk wasting time and energy on people who ultimately aren’t going to be the best fit for you.
To find that clarity, try this two-part journaling exercise. First, take a little time to dream about what [your ideal] partnership looks like and feels like. These prompts can help get you started, but feel free to be creative here:
Journal out a whole day spent with this person. What does it feel like when you wake up together? Where do you go? What do you do? Really dig in and get specific.
Keep coming back to how it feels physically and emotionally. Are you energized? Does it give you a sense of safety? Are you having fun?
Next, use the intel gleaned from your perfect-day visualization to make a list of qualities you want to prioritize in a partner. What are the nonnegotiables for you?
The post-date debrief: One of the ickier aspects of dating-app culture is that it can make a person feel like they’re on a job interview, and it’s easy to put too much focus on the performance aspect. We’ve all fallen down the rabbit hole of self-doubt. But this is the absolute wrong approach. We’re often so preoccupied with being chosen that it’s easy to forget that you are picking your partner, as well.
You can use your journal to flip the script. Don’t just get caught up in the ‘shiny object’ aspects of their persona or appearance, ask yourself about the qualities they exhibited and if those are in alignment with what’s most important to you. Here are some things she suggests you journal about after a date:
How did your evening make you feel?
What did you enjoy about spending time with this person (or not)?
Did they make you feel good or kick up insecurities?
It’s not about judging your date. It’s about being connected with yourself through the dating process and assessing whether you two humans are a good fit for one another. You might be surprised to realize that person you were hoping to impress isn’t actually that impressive themselves!
Journal Prompts if You’re in a Relationship
The stress-buster: Stress is a major relationship buzzkill—if you’re obsessing over your to-do list or a conflict with someone at work, it’s hard to be present with your partner. Compounding this is the fact that self-care can often take a backseat when you’re coupled up. It erodes the foundation of the relationship long-term, because you both need to be taking care of yourselves in order to have the energy and clarity to take care of each other.
Here’s how you can use your journal to calm your mind and clear mental space for your S.O.
At night in bed, jot down a list of everything you want to get out of your head. This might help you sleep better—and wake up knowing exactly what priorities you need to tackle the next day. (That way, you’re not thinking about them during quality time with your bedmate.)
In the morning, do a free-write for at least four minutes and see what comes up on the page. Think of it like a juice cleanse for your brain.
The self-love party: Let’s be honest: One of the perks of being in a relationship is having someone constantly tell you how great they think you are. But if you’re solely looking to your partner to validate you, you’re likely heading down a sketchy path. We aren’t going to get all our needs met by a significant other. That’s unreasonable and unrealistic.
If you find that your moods peak and dip based on the amount of attention you’re getting from your plus-one, try giving yourself the gratuitous praise you’re seeking. Make a list of the things that you appreciate about yourself, and not a short list! Go for at least 50: traits, body parts, habits, you name it. Like how you set the dining room table? Include it. Think you have lovely feet, claim it. Love how you are a good friend to x person? Celebrate it. It’ll take the pressure off your partner to be the president of your fan club—but, more importantly, it can help you fall a little deeper in love with you.
Read the full article on Well+Good.
If you live in the Los Angeles or Westlake Village area and are interested in therapy, I invite you to contact me via email at: tanyasamuelianmft@yahoo.com . I provide a complimentary consultation. Check out my services to see which one might fit your needs. Contact me now to see if we might be a good fit to work together! Or book your appointment here!