8 Ways to Cope With High-Functioning Anxiety and ADHD

If you have ADHD and anxiety, you might find yourself living with high-functioning anxiety without even realizing it. On the outside, you stay busy, always deliver, and seem like you have your shit together. People probably admire how much you accomplish – your productivity, your attention to detail, and your drive. But on the inside, it’s a different story. You may feel like you’re constantly running on empty, managing an endless mental checklist, and barely keeping up with the demands of daily life.

Let’s explore what high-functioning anxiety is, how it shows up in sneaky ways (especially if you have ADHD), and eight ways you can find relief today.

What Is High-Functioning Anxiety?

High-functioning anxiety is a specific type of anxiety common in 30-and-40-somethings where you appear calm and capable on the outside but experience significant stress and turmoil internally. For people with ADHD, high-functioning anxiety can mesh with common ADHD traits like impulsivity, hyperfocus, and a tendency to overcommit. These conditions create a perfect storm where you constantly push yourself to excel, often at the expense of your emotional and physical well-being.

While high-functioning anxiety can lead to success, it often leaves you feeling:

• Overwhelmed by perfectionism and needing to get everything just right.
• Exhausted by over-preparation: spending too much time double-checking or redoing tasks, or worrying that you haven’t done enough.
• Disconnected and struggling to share vulnerabilities or ask for help.

Sneaky Ways High-Functioning Anxiety Shows Up

It can be tough to even recognize the impacts of high-functioning anxiety in your life. That’s because it’s a coping mechanism whose results are celebrated and whose negative impacts are culturally ignored and pushed under the rug. Its effects can feel “normal” – but over time, they add up in negative ways. Here are some common but subtle signs of high-functioning anxiety in adults:

‍You’re Always Overcommitted
Your eyes are bigger than your stomach when it comes to your own capacity. You might have trouble saying no, whether it’s at work, with friends, or in your personal life. You also might overplan when you feel energized, without taking into account how those plans will drain you. You tend to feel like you should handle everything, even if it means sacrificing your own needs.

You’re the Go-To Person
Everyone knows they can rely on you, and you’re proud of that. But there’s a constant undercurrent of pressure to never let anyone down, and that creates chronic anxiety.

‍You Procrastinate – Then Overwork
ADHD can make starting and finishing tasks challenging. You have to force yourself to focus unless there’s a deadline looming dangerously close. Combine that with anxiety about doing them perfectly, and you end up in a cycle of overwhelm and last-minute bursts of hyperfocus. Naturally, this leaves you drained and wondering why you can’t just be normal about deadlines. ‍

Your Body Feels the Stress
Anxiety and ADHD are both accompanied by physical symptoms. Maybe you’ve noticed frequent headaches, stomach issues, fatigue, chronic pain, or trouble sleeping but haven’t found any real cause. Chronic anxiety and hypervigilance are heavily linked to all of these physical symptoms. 

‍You’re Constantly Ruminating on “What-If” Scenarios
You’re great at anticipating potential problems, but the mental load of preparing for every possibility leaves you feeling constantly hypervigilant. There’s often very little room for relaxation or a feeling of peace.

How ADHD Intensifies High-Functioning Anxiety

ADHD and high-functioning anxiety often amplify one another, creating a unique set of challenges. If you’re neurodivergent, you may have grown up hearing messages that you’re “too much” or “not enough” or simply just not the right kind of person. These experiences can lead to a deep-seated drive to prove your worth, pushing you to overachieve while masking the anxiety underneath.

Certain aspects of ADHD also directly exacerbate high-functioning anxiety, including:

• Procrastination: Delaying tasks until the last minute increases pressure and intensifies anxious thoughts.
• Time Blindness: Struggling to estimate how long tasks will take and what your energy will be like later often leads to overcommitting, falling behind, and guilt.
• Emotional Intensity: Heightened emotions and a tendency toward dysregulation can make anxiety feel overwhelming and harder to manage in the moment.
• Perfectionism: Coupled with impulsivity, perfectionist tendencies can create a cycle of second-guessing, overworking, being unable to celebrate your wins, and harsh self-criticism.

8 Steps to Overcome High-Functioning Anxiety

If any of this resonates with you, it’s important to remember that you’re not alone. It takes patience and effort, but overcoming anxiety is possible. Here are some manageable strategies to start addressing high-functioning anxiety.

1. Challenge Perfectionism
   
   • Set "good enough" goals: Instead of aiming for perfection, define what "good enough" looks like for each task. Be intentional about ensuring it’s not perfect. Write it down and remind yourself as many times as necessary that meeting this standard is absolutely still a success.
   • Try a "failure log." Keep a journal where you document small mistakes or setbacks and what you learned from them. Over time, this helps you reframe failure as a natural and valuable part of growth.
2. Set Boundaries
   
   • Practice saying no. Use simple scripts like, "I’d love to help, but I’m at capacity right now," to decline requests. Bonus: Practice not overexplaining yourself whenever it feels safe and possible. 
   • Schedule time for yourself. Block off specific time slots in your calendar for relaxation or activities you enjoy. Treat this time as non-negotiable.
3. Build Self-Compassion Through Action
   
   • Self-compassion breaks. When you feel overwhelmed, pause and ask yourself: "What would I say to a friend in this situation?" Write it down or say it aloud. It might feel silly at first, but it can build trust and compassion within yourself. 
   • Create a comfort toolkit: Fill a box or drawer with items that soothe you, like a favorite book, a soft piece of fabric, calming oils, or a playlist of songs that make you feel grounded. Turn to this kit when anxiety spikes.
4. Use ADHD-Friendly Tools
   
   • Body-doubling: Work alongside a supportive friend or coworker to help you stay focused and reduce procrastination.
   • Visual schedules: Use colorful charts, sticky notes, or whiteboards to map out your day. This reduces mental clutter and helps you focus on one task at a time.
5. Practice Grounding Techniques
   
   • 5-4-3-2-1 exercise: Name five things you see, four you can touch, three you hear, two you smell, and one you taste. This pulls you out of anxious thoughts and into the present moment.
   • Progressive muscle relaxation: To ease physical tension caused by anxiety, spend a few minutes tensing and releasing each muscle group, starting from the top of your head and moving downward. Try and take deep, slow breaths throughout the exercise. Notice how it feels and what changes (if anything) in your body. 
6. Engage in Regular Physical Activity
   
   • Movement breaks: Set a timer to stand up and stretch, take a five-minute walk, or do 10 jumping jacks and push-ups to reset your focus and energy. If possible, do this every hour. If not, do it as often as you can. 
   • Try mindful movement: Activities like yoga, qi gong, and tai chi combine gentle exercise with mindfulness, helping relieve stress and reconnecting you to your body. 
7. Reframe "What-If" Thinking
   
   • Schedule worry time: Allocate 20 minutes daily to write down your worries. Write them all down, big or small. When anxious thoughts arise outside this window (because they will), talk to them: tell them they can wait until your next scheduled worry time.
   • Flip the script: For every "what if" thought, challenge yourself to imagine a positive outcome instead. This trains your brain to consider possibilities beyond fear.
8. Seek Therapy If you’ve tried overcoming anxiety before but it’s continued to haunt you, you might benefit from anxiety therapy tailored to you. Therapy can provide a safe space to explore the roots of your anxiety and ADHD, give you insight into your unique habits and coping skills, and help you learn new approaches toward a life with more balance and ease. An anxiety therapist might guide you through techniques like:
   
   • Cognitive Behavioral Therapy (CBT): Learn to understand and reframe unhelpful thought patterns and beliefs.
   • Mindfulness Practices: Develop skills to stay present, tolerate distress, and improve self-compassion, even when you’re struggling. 
   • Skill-Building for ADHD: Strategies designed specifically for you to manage time, prioritize tasks, and create sustainable routines.

A More Balanced Life Is Possible. Anxiety Therapy Can Help.

Living with high-functioning anxiety and ADHD can feel like an endless highwire tightrope act, but you don’t have to walk it alone. Therapy offers tools to help you balance your drive for success with self-compassion and regulation, so you can feel more grounded and less overwhelmed.

If this sounds like the kind of support you need, I’m here to help. Learn about my therapy services (including EMDR and talk therapy) if you’re located in Idaho, Iowa, or South Carolina. For all other locations, check out my coaching services. My coaching program offers all the same expertise, tools, and guidance as therapy in a more direct and goal-oriented approach that you can benefit from anywhere. Together, we can work toward a life where you’re thriving – not just surviving.