When Anxiety Strikes High-Achieving Women: How Therapy Helps Build Emotional Resilience
Feeling overwhelmed, stressed, or like you’re barely holding it together? If so, you’re not alone. For high-achieving women, anxiety can feel like an ever-present shadow, even when things appear successful on the outside. It’s exhausting and, at times, can leave you questioning your worth or capacity to keep going. It’s important to know that your feelings are valid and there is nothing wrong with you—anxiety is not a reflection of weakness, but a sign that you’re carrying a heavy emotional load.
As a high-achieving woman, you’ve likely internalized the idea that you should be able to "handle everything" with ease. Society often glorifies ambition while dismissing the hidden emotional toll it takes. Understanding how anxiety impacts women like you is crucial to challenging the harmful myths surrounding achievement and emotional health. Anxiety is not simply a temporary hurdle you need to "get over"—it’s a complex experience that deserves acknowledgment and care.
Unfortunately, myths abound that high-achieving women “have it all together” or “don’t struggle like others do.” These narratives can silence your struggles and make it harder to seek support. The reality is that anxiety manifests in ways that go beyond occasional worry—it can deeply affect your emotional, physical, and relational well-being.
In fact, PhD psychologists have identified eight distinct ways that anxiety commonly presents in high-achieving women and how it can negatively impact them. These include challenges like perfectionism, imposter syndrome, burnout, and strained relationships. As you continue reading, we’ll unpack each of these struggles in detail and explore strategies to help you build emotional resilience and thrive—not in spite of anxiety, but by addressing it directly and compassionately.
1. The Perfectionism Trap
Perfectionism is one of the most pervasive ways anxiety manifests in high-achieving women. The drive to excel can become an all-consuming force, turning every task into a pressure-filled quest for flawlessness. While this pursuit might lead to accolades or outward success, it often comes at the cost of emotional well-being. The fear of failure looms large, creating a cycle of procrastination, self-criticism, and chronic stress. Over time, this unrelenting pressure erodes confidence, leaving you feeling stuck and never “good enough.”
The connection between perfectionism and anxiety runs deep. High-achieving women may feel their worth is tied to their accomplishments, making even small missteps feel catastrophic. This constant striving often stems from deeply ingrained beliefs or early experiences that equated love and approval with success. Breaking free from this cycle is essential for emotional resilience and personal growth.
To overcome perfectionism and build resilience, mindfulness-based techniques can be incredibly helpful. Self-compassion meditations and mindfulness exercises encourage the acceptance of imperfections and reduce self-criticism. Reflecting on what truly gives life meaning, through an existential lens, can help redefine success in terms of fulfillment and alignment with personal values, rather than external achievements. Schema therapy can also play a vital role by identifying and challenging the deeply held belief, often rooted in childhood, that worth is tied to achievement. Additionally, psychodynamic approaches offer an opportunity to unpack how early life experiences shaped perfectionistic tendencies, fostering greater self-forgiveness and the ability to develop healthier patterns.
By addressing the roots of perfectionism and adopting these strategies, high-achieving women can transform their relationship with anxiety, embracing imperfection as a natural part of life and reclaiming their sense of self-worth.
2. Overworking and Burnout
For high-achieving women, the pressure to constantly perform can lead to overworking, a behavior driven by anxiety and a deep-seated fear of falling short. While hard work is often celebrated, relentless overworking often comes at a steep cost: emotional exhaustion, physical fatigue, and the eventual onset of burnout. Anxiety fuels this cycle, whispering that success is fleeting and demanding ever-higher levels of productivity. This drive can leave little room for rest or personal fulfillment, creating an unsustainable pattern that undermines both mental health and long-term success.
Addressing overworking and burnout begins with recognizing the underlying beliefs that drive this behavior. Mindfulness-based strategies can help cultivate awareness of these thought patterns, allowing you to pause and reflect before succumbing to the urge to overdo it. Deep breathing exercises and body scans can also help you tune into physical signs of burnout, encouraging rest and recovery. From a trauma-informed perspective, exploring the roots of overworking—often tied to early experiences where love or approval was conditional on achievement—can foster a sense of self-worth that isn’t reliant on constant productivity.
Emotion regulation skills, such as setting boundaries and prioritizing self-care, are essential for breaking the cycle of overwork. Scheduling regular downtime and celebrating progress instead of perfection can help reframe success in healthier terms. By addressing both the emotional and practical aspects of burnout, high-achieving women can build resilience and embrace a more balanced approach to success.
3. Imposter Syndrome
Imposter syndrome is a common struggle for high-achieving women, marked by persistent feelings of inadequacy and a belief that success is undeserved. Despite accomplishments and external validation, anxiety whispers that it’s only a matter of time before others discover you’re not as capable as they think. This internalized self-doubt creates a cycle of overcompensation and fear, leading to emotional exhaustion and a diminished sense of self-worth. Imposter syndrome often intensifies with career progression, leaving even the most successful women questioning their abilities.
Breaking free from imposter syndrome involves addressing its roots and reshaping the narrative around self-worth. Mindfulness-based approaches encourage awareness of critical self-talk, allowing women to recognize and detach from these negative patterns. Exercises such as self-compassion meditations can also help replace judgment with kindness, fostering a more supportive inner dialogue. Psychodynamic therapy offers the opportunity to explore how early experiences, such as critical feedback or unmet emotional needs, may have contributed to feelings of inadequacy.
Schema therapy can also be instrumental, particularly in addressing the "Defectiveness" schema, which reinforces the belief that one is fundamentally flawed. By identifying and challenging these deeply held beliefs, women can begin to rewrite their personal narratives. Additionally, reflecting through an existential lens can help shift focus from perfection to purpose, emphasizing growth and authenticity over external validation. These strategies empower high-achieving women to embrace their achievements without fear, creating a foundation of resilience and self-confidence.
4. Physical Symptoms
For many high-achieving women, anxiety doesn’t just reside in the mind—it makes its presence known in the body. Physical symptoms such as headaches, muscle tension, digestive issues, and chronic fatigue are common manifestations of underlying anxiety. These symptoms are often dismissed or attributed to a busy lifestyle, but they can significantly impact daily functioning and overall well-being. Anxiety-related physical symptoms can serve as a constant reminder of stress, making it harder to focus, recharge, or enjoy life.
The mind-body connection is a critical area for healing when addressing these physical manifestations of anxiety. Mindfulness-based practices, such as body scans and diaphragmatic breathing, can help high-achieving women reconnect with their bodies and notice early signs of tension or fatigue before they escalate. These techniques foster a sense of presence and calm, reducing the physiological impact of anxiety.
From a trauma-informed perspective, unresolved stress or past trauma often manifests physically. Exploring these connections in therapy can uncover the roots of somatic symptoms, allowing for deeper healing. Emotion regulation strategies, like grounding exercises or progressive muscle relaxation, offer practical tools to release physical tension and restore balance. By addressing both the emotional and physical dimensions of anxiety, high-achieving women can create space for healing, allowing their bodies to become allies rather than battlegrounds in their journey to emotional resilience.
5. Emotional Suppression
High-achieving women often suppress their emotions, believing that vulnerability is a weakness or that expressing feelings will hinder their success. This emotional suppression is frequently fueled by anxiety, which drives the need to maintain composure and avoid any appearance of “losing control.” Over time, bottling up emotions can lead to emotional dysregulation, strained relationships, and even physical symptoms such as chronic stress or fatigue. By ignoring their emotional needs, women may feel disconnected from themselves and others, further exacerbating their anxiety.
Addressing emotional suppression begins with creating space to recognize and process feelings in a healthy, nonjudgmental way. Mindfulness-based strategies, such as journaling or practicing the “RAIN” technique (Recognize, Allow, Investigate, Nurture), can help women reconnect with their emotions, breaking the cycle of avoidance. From a psychodynamic perspective, exploring the origins of emotional suppression—often rooted in early experiences where expressing feelings was discouraged—can foster greater self-awareness and acceptance.
Emotion regulation skills, such as learning to identify and name emotions, are vital for developing healthier coping mechanisms. Trauma-informed approaches can further address unresolved emotional pain, offering a safe space to process feelings that may feel overwhelming. By embracing their full range of emotions, high-achieving women can move toward greater authenticity and resilience, reducing the emotional toll of anxiety and enhancing their overall well-being.
6. Difficulty Setting Boundaries
For high-achieving women, anxiety often manifests as difficulty setting boundaries, driven by a fear of disappointing others or being perceived as uncooperative. This challenge is compounded by the pressure to constantly prove oneself, leading to overcommitment and an overwhelming workload. When boundaries are unclear or nonexistent, it’s easy to feel resentful, exhausted, and stretched too thin, perpetuating the cycle of anxiety and stress.
Overcoming this pattern starts with understanding the root causes. Often, boundary-setting difficulties stem from deeply ingrained beliefs formed during childhood or early relationships, such as the need to be accommodating to gain approval. Schema therapy can help identify and challenge schemas like “Subjugation,” where the individual prioritizes others' needs over their own, and replace these patterns with healthier perspectives.
Mindfulness practices play a crucial role in boundary-setting by fostering self-awareness and creating space to pause before saying “yes” to every request. Trauma-informed approaches can help uncover unresolved experiences that contribute to people-pleasing tendencies, allowing women to build the confidence needed to assert their needs. Interpersonal strategies, such as role-playing boundary-setting conversations, can provide practical tools for expressing limits in a way that feels empowering. By learning to honor their time and energy, high-achieving women can reduce anxiety and cultivate a more balanced and fulfilling life.
7. Strained Relationships
High-achieving women often find that anxiety can strain their relationships, making it challenging to connect emotionally or communicate their needs effectively. The high expectations they set for themselves can extend to their interactions with others, sometimes leading to feelings of isolation or frustration when those expectations aren’t met. Anxiety can also cause women to avoid vulnerability, fearing that revealing their struggles might diminish how others perceive them. Over time, this avoidance can create emotional distance, hindering authentic and meaningful connections.
Healing strained relationships begins with fostering emotional awareness and practicing vulnerability in safe spaces. Mindfulness-based approaches, such as practicing present-moment awareness during conversations, can help women stay engaged and connected rather than letting anxiety drive interactions. Trauma-informed therapy can explore past relational wounds that may contribute to difficulties in trusting others or sharing emotions, creating a foundation for healthier dynamics.
Interpersonal strategies, such as active listening and expressing needs assertively, are essential tools for building stronger relationships. Emotion regulation techniques can help women navigate conflicts without becoming overwhelmed or defensive. Additionally, psychodynamic therapy can uncover and address patterns rooted in early attachment experiences, fostering greater emotional intimacy and trust. By addressing the impact of anxiety on their relationships, high-achieving women can nurture connections that support and sustain their emotional resilience.
8. Negative Self-Talk
Negative self-talk is a pervasive way anxiety manifests in high-achieving women, undermining confidence and creating a relentless cycle of self-criticism. Despite external accomplishments, the internal dialogue often focuses on perceived shortcomings, amplifying feelings of inadequacy. This harsh inner voice can erode self-esteem, making it difficult to celebrate successes or take risks for fear of failure. Over time, this pattern of negativity not only fuels anxiety but also diminishes emotional resilience and overall well-being.
Addressing negative self-talk requires cultivating greater self-awareness and challenging these ingrained thought patterns. Mindfulness-based strategies, such as cognitive diffusion exercises, can help women observe their thoughts without becoming entangled in them. This approach fosters a shift from identifying with critical inner voices to recognizing them as transient mental events. Psychodynamic therapy can delve into the origins of negative self-talk, exploring how early experiences or relationships may have shaped these internalized messages.
Schema therapy is particularly effective in identifying and restructuring the "Defectiveness" schema, which reinforces feelings of unworthiness. By reframing these beliefs, women can begin to replace self-criticism with self-compassion. An existential perspective also encourages high-achieving women to shift their focus from perfection to purpose, emphasizing personal growth and authenticity over unattainable standards. By addressing negative self-talk at its roots, women can build the emotional resilience needed to quiet anxiety and embrace a kinder, more supportive relationship with themselves.
Resources from a Female Therapist
For high-achieving women seeking to understand and manage anxiety, the following research-based books offer valuable insights and strategies:
1. "The Happy High Achiever: 8 Essentials to Overcome Anxiety, Manage Stress, and Energize Yourself for Success—Without Losing Your Edge" by Dr. Mary E. Anderson. This book provides cognitive-behavioral therapy (CBT) strategies to address burnout, anxiety, perfectionism, and imposter syndrome, aiming to optimize mental health for sustainable success.
2. "Wander Woman: How High-Achieving Women Find Contentment and Direction" by Dr. Marcia Reynolds. Reynolds explores the restlessness often experienced by high-achieving women and offers guidance on finding fulfillment and purpose beyond traditional success metrics.
3. "High-Octane Women: How Superachievers Can Avoid Burnout" by Dr. Sherrie Bourg Carter. This book examines the unique challenges faced by high-achieving women and provides practical advice to prevent burnout and achieve a healthy work-life balance.
Final Thoughts from a Therapist for Women
Navigating anxiety as a high-achieving woman can feel like an overwhelming and lonely journey, but it doesn’t have to be. By understanding how anxiety manifests—whether through perfectionism, overworking, strained relationships, or negative self-talk—and addressing it with mindfulness-based, trauma-informed, and schema-focused strategies, you can begin to build emotional resilience and reclaim your sense of balance and fulfillment. Healing is not about perfection but about embracing your humanity and giving yourself permission to grow with compassion.
As a PhD psychologist, I’ve walked alongside many women on this journey and understand the courage it takes to confront these challenges. I also understand, from personal experience, how challenging it can be to confront anxiety and work through its effects. The process of healing is deeply personal but profoundly transformative, and I want you to know that there is hope. With the right tools and support, it’s possible to live a life that honors your ambitions and nurtures your well-being.
With the right tools and support, you can create a life where your achievements coexist with peace, purpose, and joy.
If you’re feeling overwhelmed by the weight of anxiety and the challenges discussed in this post, you’re not alone. High-achieving women often face these struggles silently, but healing is possible with the right support.
I help women who feel trapped by anxiety and perfectionism reclaim their confidence and build emotional resilience. Together, we’ll explore strategies tailored to your needs and create a path toward balance and fulfillment.
