How to Support Someone with High Functioning Anxiety
They Seem Fine—But They’re Not
They show up early, follow through, keep the group chat alive, and make it look effortless. But underneath the calm surface is a constant current of overthinking, tension, and the pressure to keep it all together.
This is what high functioning anxiety often looks like: competent on the outside, consumed on the inside.
If you’ve ever had a hunch that someone you love is quietly struggling—even though they’re the one everyone leans on—this post is for you. Because offering support to someone with high functioning anxiety isn’t about giving advice. It’s about helping them feel safe enough to be human.
What Is High Functioning Anxiety?
Let’s be clear—“high functioning anxiety” isn’t a formal diagnosis. It’s a descriptive term that captures a specific experience: someone who appears successful, productive, and put-together on the outside, but internally feels anxious, restless, and never good enough.
According to the Anxiety & Depression Association of America, women are twice as likely to be affected by anxiety disorders. When they’re high achievers, they’ve learned to mask their symptoms behind perfectionism, people-pleasing, and relentless productivity.
In many cases, high achiever stress is the very thing that keeps the anxiety going: "If I stop, I’ll fall apart. If I rest, I’ll let everyone down."
How It Feels: Real Examples of High Functioning Anxiety
Here’s what your loved one might say to themselves, even if they never say it out loud:
“I can’t let anyone see me struggle.”
“If I don’t do it perfectly, it’s going to fall apart.”
“Why do I feel like I’m failing, even when everyone says I’m doing great?”
“I can’t relax—there’s always something I’m forgetting.”
They might show up with:
Chronic tension in their shoulders and jaw
A smile that doesn’t quite reach their eyes
Avoidance of slowing down or asking for help
Emotional exhaustion masked as “just being tired”
This isn’t just regular stress. This is the kind that burns quietly and gets mistaken for ambition, until it becomes burnout.
Just because they’re still lit doesn’t mean they’re not burning out.
Unsplash image by @thomasbormans
Why “You’re Doing Great!” Doesn’t Help
If you’ve ever tried to reassure them with “You’re amazing, don’t worry so much,” and it didn’t land? You’re not alone. People with high functioning anxiety often can’t absorb reassurance—because their internal critic is louder.
When you say, “You’re doing fine,” their brain may respond, “You don’t get it. I’m barely holding it together.”
Here’s what helps instead:
“You look like you’re juggling a lot—how’s your mind holding up lately?”
“You always show up for everyone. Who’s showing up for you right now?”
“You don’t have to have it all figured out. I’m here even when it’s messy.”
How to Offer Meaningful Mental Health Support
Supporting someone with high functioning anxiety doesn’t mean fixing them. It means creating space where they feel safe enough to exhale.
Here’s how to start:
1. Get Curious, Not Critical
Instead of asking why they’re anxious (which can feel invalidating), try:
“What’s been feeling heavy for you lately?”
“What does your anxiety usually sound like in your head?”
Curiosity opens the door. Judgment shuts it.
2. Normalize Mental Health Support
People with high functioning anxiety often assume they should be able to push through on their own. They may not recognize that what they’re feeling is anxiety—or that help is even available for someone who “looks fine.”
You can gently normalize mental health care by talking about it in a low-pressure, shame-free way:
“A lot of high achievers deal with anxiety—it’s actually super common.”
“Have you ever thought about talking to someone who really gets this stuff?”
If they’re not ready for therapy, that’s okay. Even reading about what anxiety actually feels like can help them feel less alone. Your goal isn’t to push—it’s to offer a gentle nudge toward understanding and support.
3. Offer Regulating Practices—Together
They may not take time for themselves, but they might join you in something grounding:
A short walk after dinner
Breathing together before a stressful event
Sending them a 2-minute nervous system reset video
Support nervous system regulation, not just productivity.
4. Be Consistent, Not Just Present in a Crisis
Show up regularly, not just when they’re visibly melting down. The quiet check-ins matter.
“Just thinking about you—how’s this week treating you?”
“Want to grab coffee and not talk about to-do lists for once?”
Consistency builds trust.
5. Respect Their Autonomy
Even well-intentioned advice can feel like one more thing they’re doing wrong.
Instead of “You need help,” try:
“I know you probably have a dozen reasons not to slow down. But you matter too. If you ever want someone to talk to—or just sit with you—I’m here.”
You're not there to fix them. You’re there to remind them they’re worth caring for—without conditions.
Final Thought: You Don’t Have to Rescue Them. Just Be With Them.
People with high functioning anxiety are often the last to admit they’re struggling—and the first to show up for others.
Your support doesn’t have to be perfect. It just has to be real.
If all you do is create space for them to be honest without fear of being judged or “too much,” that’s enough.
So the next time you see someone who looks like they have it all together… don’t assume they do.
Ask gently, stay curious, and remind them they’re not alone in it.
Get the free printable: 5 Scripts to Support Someone with High Functioning Anxiety — so you never have to guess what to say when someone you love is struggling silently.
You might also like:
If reading this brought someone specific to mind—or if it sounds a little too familiar—you’re not alone. Sometimes the people who give the most support are the ones who need it, too.
💬 You’re Not Broken—You’re Burnt Out: A love letter to high-functioning women who are exhausted from holding it all together.
🧠 Why Emotional Boundaries Matter in Healthy Relationships: Learn how to protect your energy while still showing up for others.
✨ What No One Tells You About Perimenopause: If your mood swings and brain fog don’t match your life stressors, there might be more going on.
🌍 What You Need to Know About Starting Therapy While Living Abroad: For expats navigating mental health support from unfamiliar places.
