How Do I Know If My Anxiety Is Serious Enough for Therapy?
High-functioning anxiety often goes untreated for a long time because the person experiencing it looks just fine from the outside. But if your anxiety is affecting your functioning, your relationships, or your self-esteem, then it’s serious enough for therapy. You don't need to wait for a crisis to deserve support.
What High-Functioning Anxiety Actually Looks Like in High-Achieving Women
Many people picture anxiety as panic attacks, substantial avoidance, or an inability to get through the day. However, in my work with high-achieving women, it often looks more subtle, like overpreparing for every conversation so nothing catches you off guard, or rehearsing potential situations in your head for hours when you’re trying to sleep. It often looks like keeping emotions wrapped up tightly while constantly thinking and scanning.
High-achieving women are often the last to be identified as struggling - which makes sense, given that their anxiety is often part of what's been driving their success. The overthinking, the over-functioning, and the relentless preparation look like strengths from the outside. And they are - until they continue in overdrive for too long.
Anxiety in high-achieving women doesn't look like falling apart - it looks like never allowing yourself to.
The Difference Between Stress and Anxiety That Needs Attention
Many women I work with dismiss their anxiety as stress. So what’s the difference? Stress is situational and specific to context. It shows up when things are hard and lifts when things change. Anxiety persists even when things are going well, constantly finding new things to attach to.
What I often see is women who have built genuinely impressive lives but never feel like they get a break from the constant chatter of their minds. They might hit a milestone they've been working toward for years and feel nothing; or worse, turn to the next “to-do” on their endless list. They might have a relationship end, and suddenly everything they've been managing starts to surface at once.
Achievement can mask anxiety for years. It often takes a transition - a breakup, a move, or even a promotion - to make it visible.
Signs Your Anxiety Is Connected to Something Deeper Than Your Current Circumstances
Sometimes anxiety responds well to skills and strategies. But when it's connected to something older, your long relied no coping skills tend to hit a ceiling.
Some signs it may go deeper:
The same patterns keep repeating across different relationships and situations despite full awareness of them.
Physical symptoms like tension, disrupted sleep, and difficulty being present don't resolve no matter how much self-care you practice.
You understand exactly why you feel the way you do - and you still feel that way.
Understanding your anxiety and actually healing it are two different things — and for many high-achieving women, only the first one has ever been addressed.
Why High-Achieving Women Wait Longer to Seek Therapy — and What That Costs
The belief that keeps most of my clients from reaching out sooner is some version of: “It’s not bad enough. Someone else always has it worse. I should be able to handle this.”
Unfortunately, the same competence that’s made them successful reinforces that belief. The anxiety stays functional because of their ability to push through, manage symptoms, and keep ‘performing.’ At the same time, it costs them the pain of relationships following the same painful patterns, a growing disconnection from their own needs, and exhaustion of maintaining the ‘functional’ version of themselves.
You don't have to be in crisis to deserve the same care you give everyone else.
What Therapy for Anxiety Actually Looks Like - Especially If You've Tried It Before
If you've been to therapy before and felt like it didn't go deep enough, you're not alone. Many high-achieving women have had experiences in therapy that stayed at the level of insight - understanding their patterns, without shifting them - and walked away thinking therapy just isn't for them.
The approaches I use - including EMDR, somatic therapy, and IFS - work in combination with traditional talk therapy. They work with the body and nervous system, not just the thinking mind, to help you reach what insight alone doesn't. For women whose anxiety is connected to past experiences, these approaches often help them access emotions and experiences and change patterns that years of talking about the problem haven’t.
"High-functioning anxiety is often the last to be treated because the woman experiencing it is too busy succeeding to appear unwell."
Frequently Asked Questions
Can I go to therapy if I'm not sure I have anxiety?
Yes - you don't need a diagnosis to start therapy. Many women come in knowing something feels off without having a name for it yet. Part of early work together is figuring out what's actually underneath the anxiety - not just managing it better.
What if I've tried therapy before and it didn't help?
A previous therapy experience that didn't go deep enough or change your patterns isn't a sign that therapy won't work for you. It may mean the approach or fit wasn't right. Modalities like EMDR and IFS work differently than traditional talk therapy and often reach what talk therapy alone doesn't.
How is a psychologist different from a therapist for anxiety treatment?
A psychologist holds a doctoral-level degree and is trained in psychological assessment as well as treatment. For complex anxiety - especially when it's connected to past experiences or trauma - that depth of training can matter.
Do you take insurance for anxiety therapy?
My practice is private pay only. I'm happy to provide a superbill you can submit to your insurance for potential out-of-network reimbursement, or I can help you submit superbills through a third-party.
Ready to Find Out If Therapy Is the Right Next Step?
If you've been managing your anxiety for years and are starting to wonder whether there's a version of your life that doesn't require this much effort - you’re in the right place.
I work with high-achieving women virtually across Colorado, Washington, and all PSYPACT states. If you'd like to talk about whether we're a good fit, I'd love to hear from you.