At The Midtown Practice, we frequently see successful professionals who appear to have it “together” on the outside yet internally struggle with persistent anxiety. Our clients – executives, lawyers, doctors, and other high-achievers – often express a striking disconnect between their outward success and inner turmoil. While they excel in their careers, they privately battle perfectionism, self-doubt, and relentless pressure.

Understanding High-Functioning Anxiety in New York City

Through our work with hundreds of professionals in Manhattan, we observed that high- functioning anxiety presents uniquely in our NYC patient population. The city’s demanding pace and competitive culture can mask these symptoms, making them harder to identify and address. Many of our clients initially resist seeking help, viewing their anxiety as simply “the cost of success” in New York.

What We’re Seeing in Our Practice

In our Midtown offices, we commonly observe high-functioning anxiety manifesting as:

1. Perfectionism that leads to exceptional work but internal torment
2. Difficulty delegating despite managing large teams
3. Constant mental rehearsal of meetings and conversations
4. Physical symptoms like tension headaches and sleep disruption
5. Success-driven anxiety that increases with each achievement
6. Relationship difficulties despite social and professional accomplishment
7. Inability to enjoy achievements or take time off without guilt

The unique pressures of professional life – from high-stakes deals to competitive career trajectories – can amplify these symptoms. Our clients often describe feeling like they’re constantly “on,” whether presenting to their board or meeting friends for dinner in the West Village.

The Hidden Impact on Professional Life

While high-functioning anxiety might seem to fuel success initially, we’ve seen how it ultimately undermines both professional and personal fulfillment. Common patterns we observe include:

1. Procrastination despite high capability
2. Excessive preparation that cuts into personal time
3. Difficulty making decisions without excessive analysis
4. Strained workplace relationships due to perfectionist tendencies
5. Physical exhaustion from constant mental activation

Our Treatment Approach

At The Midtown Practice, we take an integrative approach to treating high-functioning anxiety. Our team of therapists and psychiatrists work collaboratively to provide:

Individual Therapy: We tailor therapeutic approaches to your professional demands and personal style. For example, we might help a finance executive develop mindfulness techniques they can use between meetings or work with a lawyer to establish boundaries that protect their mental health without compromising their career trajectory.

Medication Management: When appropriate, our psychiatrists can evaluate whether medication might be helpful as part of your treatment plan. We understand the importance of maintaining mental clarity and professional performance while addressing anxiety symptoms.

Combination Treatment: Many of our clients benefit from combining therapy and medication, allowing them to address immediate symptoms and underlying causes. This comprehensive approach often provides the most sustainable results.

NYC-Specific Solutions

Living in New York presents unique challenges and opportunities for managing anxiety. Based
on our experience, we recommend:

1. Strategic Scheduling
2. Building in “buffer time” between meetings
3. Creating designated worry-free zones in your day
4. Using your commute time strategically for decompression
5. Environmental Management
6. Finding quiet spaces in the city for reflection
7. Creating a calming home environment
8. Utilizing NYC’s parks and cultural spaces for stress relief
9. Professional Boundary Setting
10. Developing realistic response times for emails and calls
11. Creating sustainable work-life integration strategies
12. Building support systems within your professional network

Making Progress While Maintaining Success

Our goal isn’t to diminish your drive or success – it’s to help you achieve your goals without the constant internal struggle. We’ve seen countless clients learn to:

1. Maintain their professional edge while reducing internal pressure
2. Build more authentic relationships with colleagues and partners
3. Enjoy their achievements rather than immediately seeking the next goal
4. Create sustainable success without sacrificing mental health

Taking the Next Step

If you recognize these patterns in yourself, know that many of our clients have successfully learned to manage their high-functioning anxiety while maintaining their professional success. Our offices in Midtown Manhattan are designed to accommodate busy schedules, and we offer both in-person and virtual sessions to provide support that fits your lifestyle.

Contact us today to schedule a consultation:

1. Call or text: 212.286.8801
2. Email: info@midtownpractice.com

Our team will work to match you with a clinician who understands the unique challenges of managing anxiety while pursuing professional success.

Frequently Asked Questions

Q: How is high-functioning anxiety different from regular anxiety?

A: High-functioning anxiety refers to experiencing significant anxiety symptoms while still maintaining high performance in work and life. Unlike more visible forms of anxiety, people with high-functioning anxiety often appear successful and put-together externally while struggling internally.

Q: Can therapy help without affecting my work performance?

A: Absolutely. Our therapeutic approaches are designed to enhance rather than diminish your professional capabilities. Many clients report improved focus, decision-making, and leadership skills after addressing their anxiety.

Q: How long does treatment typically take for high-functioning anxiety?

A: Treatment duration varies based on individual needs and goals. Some clients see improvement in 8-12 sessions, while others benefit from longer-term support. We’ll work with you to develop a timeline that fits your objectives.

Q: Will medication make me less sharp or motivated at work?

A: When properly prescribed and monitored, anxiety medications typically improve rather than impair cognitive function by reducing the mental energy spent on worry and anxiety. Our psychiatrists specialize in finding medications that support both mental health and professional performance.

Q: Can I maintain my competitive edge while treating anxiety?

A: Yes. Treatment often enhances your competitive edge by reducing the mental exhaustion that comes with constant worry, improving decision-making clarity, and helping you channel your drive more effectively.

Sources

American Psychological Association. (2022). Stress in America: Money, inflation, and the war in Ukraine. Retrieved from https://www.apa.org/news/press/releases/stress/2022/march-2022-survival-mode

Anxiety and Depression Association of America. (2023). High-functioning anxiety: When perfectionism becomes a problem. Retrieved from https://adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/stress/physical-activity-reduces-stress

Curran, T., & Hill, A. P. (2019). Perfectionism is increasing over time: A meta-analysis of birth cohort differences from 1989 to 2016. Psychological Bulletin, 145(4), 410-429.

Hewitt, P. L., & Flett, G. L. (1991). Perfectionism in the self and social contexts: Conceptualization, assessment, and association with psychopathology. Journal of Personality and Social Psychology, 60(3), 456-470.

Limburg, K., Watson, H. J., Hagger, M. S., & Egan, S. J. (2017). The relationship between perfectionism and psychopathology: A meta-analysis. Journal of Clinical Psychology, 73(10), 1301-1326.

New York City Department of Health and Mental Hygiene. (2023). Mental health in NYC: Annual report on stress and anxiety in urban professionals. Retrieved from https://www1.nyc.gov/site/doh/health/health-topics/mental-health.page

Stoeber, J., & Otto, K. (2006). Positive conceptions of perfectionism: Approaches, evidence, challenges. Personality and Social Psychology Review, 10(4), 295-319.