My Anxiety Made Me an Overachiever Until It Almost Killed Me - A Recovery Story

By Alex Thompson, MBA - Former Fortune 500 executive, anxiety recovery advocate, and founder of Sustainable Success Consulting

Content Warning: This article discusses panic attacks, suicidal thoughts, and the relationship between anxiety and overachievement.

Picture this: You’re 28 years old, making $180,000 a year as a senior marketing director at a Fortune 500 company. You have an MBA from a top-tier school, a luxury apartment in downtown Seattle, and colleagues who describe you as “the person who gets things done.”

Everyone thinks you have your life together.

What they don’t see: You’ve been having panic attacks in bathroom stalls for six months. You work 70-hour weeks not because you love your job, but because the thought of anyone discovering you’re not perfect literally makes you hyperventilate. You haven’t had a full night’s sleep in three years, and you’re consuming 600mg of caffeine daily just to function through the constant exhaustion.

This was my life at the peak of my “success.”

This is also the story of how high-functioning anxiety turned me into a high achiever, then nearly destroyed me, and what I learned about building a life that’s successful AND sustainable.

If you’re someone who excels on the outside while struggling with anxiety on the inside, this story is for you. Because the path to healing isn’t about achieving less—it’s about achieving differently.

The Overachiever’s Origin Story: When Anxiety Becomes Your Engine

My relationship with anxiety started early, though I didn’t recognize it as anxiety for years.

Age 7: I stayed up until 2 AM redoing a book report because I got a B+ and was convinced my parents would be disappointed.

Age 12: I memorized every possible answer for our social studies test, including chapters we weren’t even covering, “just in case.”

Age 16: I was president of student council, captain of debate team, maintaining a 4.0 GPA, and volunteering 15 hours per week—because what if I didn’t get into a good college?

Age 22: I graduated summa cum laude, immediately started business school, and worked part-time at a consulting firm because “gaps in my resume would look bad.”

Everyone’s response: “Wow, Alex is so driven! So ambitious!”

My reality: I was driven by pure, unrelenting fear.

Fear of failure. Fear of disappointing people. Fear of being “found out” as someone who wasn’t actually that smart or capable. Fear of not being enough.

I didn’t have goals—I had escape routes from the constant anxiety.

Achievement became my drug of choice. Every promotion, every perfect presentation, every glowing performance review gave me a temporary break from the voice in my head saying “You’re not good enough, you’re going to fail, everyone will find out you’re a fraud.”

But like any drug, I needed bigger and bigger hits to get the same relief.

The Anatomy of High-Functioning Anxiety

Here’s what high-functioning anxiety looked like in my daily life:

The External Performance

At work:

• First person in the office (7 AM), last to leave (9 PM)
• Never missed a deadline, often delivered projects weeks early
• Volunteered for extra assignments, committees, leadership roles
• Known as the “go-to person” who could handle anything
• Consistently exceeded performance targets by 20-30%

In relationships:

• The friend who remembered everyone’s birthdays and organized all social events
• Always available to help with moves, career advice, emotional support
• Remembered details about people’s lives that they’d forgotten mentioning
• The person others came to when they needed something done right

Personal habits:

• Apartment always spotless and Instagram-ready
• Exercised 6 days a week, meal prepped every Sunday
• Read personal development books, listened to productivity podcasts
• Maintained detailed calendars, budgets, and goal-tracking systems

The Internal Reality

Physical symptoms I normalized as “just stress”:

• Heart palpitations during important meetings
• Chronic tension headaches and neck pain
• Digestive issues—stomach always in knots
• Grinding my teeth so badly I cracked two molars
• Insomnia—mind racing with tomorrow’s to-do lists
• Constant fatigue despite drinking 4-6 cups of coffee daily

Mental/emotional patterns:

• Catastrophic thinking: Every small mistake meant certain failure
• Perfectionism paralysis: Spending 6 hours on emails that should take 30 minutes
• Impostor syndrome: Convinced I was fooling everyone about my capabilities
• People-pleasing: Unable to say no to any request, no matter how overwhelmed I was
• Hypervigilance: Constantly scanning for signs of disapproval or criticism

The thought loops: “If I don’t check this email one more time, I might have made a mistake and everyone will think I’m incompetent.”

“I need to stay late to make sure this presentation is perfect, or my boss will realize I don’t deserve this job.”

“I should volunteer for that project even though I’m overwhelmed, otherwise they’ll think I’m not committed.”

The Breaking Point: When Achievement Stops Working

For years, overachievement successfully managed my anxiety. Every accomplishment gave me temporary relief and validation that I was, in fact, worthy of existing.

But by my late twenties, the system was breaking down.

The demands kept escalating:

• Promotion to senior director meant managing a team of 12 people
• Budget responsibility increased from $2M to $15M annually
• Travel increased to 60% of my time
• Stakeholder management across 5 different countries
• MBA thesis due (I was doing my MBA part-time while working full-time)

The stakes felt higher:

• Student loans: $127,000
• Mortgage on my apartment: $4,800/month
• Team members depending on me for leadership and career guidance
• Company expecting continuous growth in an increasingly competitive market

The achievement hits were getting smaller:

• Promotions felt like “finally catching up” rather than celebration
• Positive feedback felt like “temporary relief from being fired”
• Success felt like “dodging failure” rather than actual accomplishment

Then came the panic attack that changed everything.

The Bathroom Stall Breakdown: When Your Body Says “Enough”

It was March 15th, 2024, during our quarterly board presentation. I’d prepared for weeks—rehearsed every slide 50 times, memorized all the financial projections, anticipated every possible question.

The presentation went perfectly. The CMO complimented our team’s work. The board approved our strategy unanimously.

I should have been celebrating.

Instead, 20 minutes later, I was locked in a bathroom stall, hyperventilating so badly I thought I was having a heart attack.

The physical symptoms:

• Heart racing at what felt like 200 BPM
• Chest pain so severe I googled “heart attack symptoms women”
• Sweating through my suit jacket in a 72-degree office
• Shaking hands so violently I couldn’t unlock my phone
• Feeling like I couldn’t get enough air, no matter how deeply I breathed

The mental experience:

• Overwhelming sense of impending doom
• Thoughts racing: “I’m dying, I’m having a heart attack, I need to call 911”
• Simultaneous thoughts: “I can’t call 911, everyone will think I’m weak”
• Complete disconnection from reality—like watching myself from outside my body

The duration: 45 minutes of pure terror.

After it passed, I sat in that bathroom stall for another hour, trying to understand what had just happened. I’d given a successful presentation. I’d received praise. I should have felt good.

Instead, I felt like my body was betraying me.

That night, I googled “heart attack symptoms” for 3 hours before finally searching “panic attack symptoms.” The checklist matched my experience perfectly.

That’s when I realized: The very anxiety that had driven my success was now threatening to destroy it.

The Research That Explained My Experience

Understanding the science behind what I was experiencing was crucial to my recovery. Here’s what I learned:

The Anxiety-Achievement Connection

Research shows that anxiety and high achievement often go hand-in-hand:¹

Optimal anxiety levels can enhance performance by:

• Increasing focus and attention to detail
• Motivating thorough preparation
• Enhancing sensitivity to potential problems
• Driving persistence in the face of obstacles

But chronic anxiety becomes counterproductive when:

• Fear of failure overrides intrinsic motivation
• Perfectionism leads to procrastination and burnout
• Hypervigilance creates tunnel vision and poor decision-making
• Physical symptoms interfere with cognitive function

The Neuroscience of Overachieving Anxiety

When you live in chronic anxiety, your brain gets stuck in threat-detection mode:²

Amygdala hyperactivity: Your brain’s alarm system is constantly scanning for danger Prefrontal cortex suppression: The rational thinking part of your brain gets overridden Chronic stress hormone elevation: Cortisol and adrenaline become your baseline

This creates a vicious cycle:

1. Anxiety drives overachievement to avoid feared outcomes
2. Success provides temporary relief but raises the stakes for next time
3. Higher stakes increase anxiety about potential failure
4. More anxiety drives even more compulsive achievement

The result: What starts as motivation becomes a prison.

High-Functioning vs. Traditional Anxiety

Traditional anxiety presentations often involve obvious impairment—avoiding work, social situations, or responsibilities.

**High-functioning anxiety is different:**³

• Outward competence masks internal distress
• Anxiety symptoms are channeled into productivity
• Social and professional functioning appears normal or superior
• The person receives positive reinforcement for anxiety-driven behaviors
• Often goes undiagnosed because the person “doesn’t look anxious”

This makes it particularly insidious: The very behaviors that seem healthy (working hard, being reliable, striving for excellence) can become compulsive and unsustainable.

The Wake-Up Call: When Success Becomes Survival

After the bathroom stall panic attack, I tried to go back to “normal.” I told myself it was just stress from the big presentation, that I needed to push through, that successful people don’t let anxiety stop them.

But my body had other plans.

Over the next month, the panic attacks became regular:

• Triggered by emails from senior leadership
• Before every important meeting
• While working late (which was every night)
• Sometimes for no identifiable reason at all

I developed panic about panic: The fear of having a panic attack became almost as debilitating as the attacks themselves.

The accommodations I made to my anxiety:

• Started declining speaking opportunities (despite loving public speaking)
• Avoided certain colleagues whose approval felt most important
• Worked even later hours to compensate for time lost to anxiety
• Cancelled social plans to have more time for “recovery”
• Stopped exercising because my heart rate monitor triggered panic about my racing heart

The irony: In trying to manage my anxiety by controlling everything, I was making it worse.

The breaking point: I was offered a promotion to VP level—the exact goal I’d been working toward for five years.

My response: I had a panic attack so severe during the offer conversation that I had to excuse myself and never came back to finish the discussion.

That night, I called my mom and said: “I think I need help.”

Finding Treatment: The Hardest Part Was Starting

Barriers to seeking help:

Time: “I don’t have time for therapy. I work 70 hours a week.” Money: “Therapy is expensive, and I have student loans.” Professional image: “What if someone from work finds out?” Perfectionist pride: “I should be able to handle this myself.” Fear of medication: “I don’t want to be dependent on pills.” Minimization: “Other people have real problems. I’m just stressed.”

What finally motivated me: I realized that untreated anxiety was going to destroy everything I’d worked so hard to build.

Finding the Right Therapist

What I was looking for:

• Someone who understood high-achieving professionals
• Experience with anxiety and panic disorders
• Could see me during non-traditional hours
• Wouldn’t immediately suggest I needed to quit my job

I found Dr. Jennifer Walsh through Psychology Today’s therapist finder, filtering for:

• Anxiety specialization
• Cognitive Behavioral Therapy (CBT) experience
• Evening/weekend availability
• Professional adults as specialty population

Our first session:

Dr. Walsh: “What brings you to therapy?”

Me: “I have panic attacks, but I’m successful, so I don’t think it’s that serious.”

Dr. Walsh: “Success and mental health aren’t mutually exclusive. Let’s talk about what success actually means to you.”

That question broke something open in me.

The Treatment Plan That Actually Worked

Dr. Walsh didn’t try to cure my anxiety—she taught me to work with it instead of against it.

Phase 1: Crisis Management (Weeks 1-8)

Primary goals:

• Stop the panic attack cycle
• Develop immediate coping strategies
• Address the worst physical symptoms

Interventions that helped:

Panic attack protocol:

1. Grounding technique: 5-4-3-2-1 method (5 things you can see, 4 you can touch, etc.)
2. Breathing technique: Box breathing (4 counts in, 4 hold, 4 out, 4 hold)
3. Reality checking: “I’m having a panic attack. It feels dangerous but it’s not. It will pass.”
4. Movement: If possible, walk or do gentle stretching

Daily practices:

• 10-minute morning meditation using Headspace
• Evening “worry time”—15 minutes of scheduled worry followed by transition ritual
• Sleep hygiene: No screens 1 hour before bed, bedroom temperature at 68°F

Medication consultation: Started on a low-dose SSRI (Lexapro 5mg) after fighting it for months. The physical symptoms improved dramatically within 6 weeks.

Phase 2: Understanding the Patterns (Weeks 9-20)

Primary goals:

• Identify anxiety triggers and thought patterns
• Understand the function anxiety served in my life
• Develop alternative coping mechanisms

Key insights:

Insight #1: My anxiety wasn’t random—it had specific triggers

• Situations where I could be judged or evaluated
• Uncertainty about outcomes or timelines
• Feeling responsible for things beyond my control
• Comparing my performance to others

Insight #2: Anxiety had been my primary motivational system

• Without anxiety, I didn’t know how to motivate myself
• I’d never learned to pursue goals from excitement or interest
• Rest felt dangerous because it meant I wasn’t producing value

Insight #3: My self-worth was completely external

• My value as a person depended entirely on achievement and approval
• I had no sense of inherent worth independent of accomplishment
• Any criticism or setback felt like a threat to my entire identity

Phase 3: Rebuilding Success Without Anxiety (Weeks 21-ongoing)

Primary goals:

• Develop internal motivation and self-worth
• Create sustainable work habits
• Build anxiety tolerance for unavoidable stress

The mindset shifts that changed everything:

From: “I need to be perfect to avoid criticism” To: “Criticism is information, not condemnation”

From: “My anxiety keeps me motivated”
To: “I can be motivated by curiosity and growth”

From: “Rest is laziness” To: “Rest is required for sustainable performance”

From: “I have to say yes to prove my worth” To: “Boundaries are necessary for quality work”

The Practical Strategies That Transformed My Career

Here are the specific changes I made that allowed me to maintain high performance while managing anxiety:

Work Boundary Revolution

Before: Worked 70+ hours, available 24/7, said yes to everything Now: Work 45-50 hours with clear boundaries

Boundaries I implemented:

• Email curfew: No work emails after 8 PM or before 8 AM
• Weekend protection: One full day completely off work
• Meeting limits: Maximum 6 hours of meetings per day
• Project load: Maximum 3 major projects at once
• Travel restrictions: No more than 2 overnight trips per month

The script I used: “I’ve found I do my best work when I maintain these boundaries. This ensures I can give my full energy to our priorities.”

The result: My productivity actually increased because I wasn’t wasting time on anxiety, perfectionism, and burnout recovery.

Perfectionism Management

The 80% rule: For non-critical tasks, I aim for 80% rather than 100%.

• Emails: One proofread instead of five
• Presentations: Focus on key messages rather than perfect transitions
• Reports: Comprehensive but not exhaustive

Time boxing: I give myself specific time limits for tasks:

• Routine emails: 5 minutes maximum
• Presentation prep: 2 hours per presentation maximum
• Report writing: 4 hours maximum

“Good enough” evaluation:

• Will this 20% improvement change the outcome? If no, ship it.
• Am I avoiding shipping because it’s not ready, or because I’m anxious? If anxiety, ship it.

Anxiety-Informed Career Decisions

I learned to distinguish between:

• Growth challenge anxiety: Nervous but excited about learning
• Misalignment anxiety: Persistent dread about fit or values
• Overwhelm anxiety: Too much, too fast, need to adjust pace

Questions I ask before taking on new opportunities:

1. Am I saying yes from excitement or fear of saying no?
2. Do I have the bandwidth to do this well?
3. Does this align with my actual goals or just look impressive?
4. Can I succeed at this without sacrificing my mental health?

Performance Without Panic

Before important presentations or meetings:

• Preparation without over-preparation: 90 minutes of prep maximum
• Visualization: Imagine it going well, not just preparing for disasters
• Physical preparation: Good sleep, light exercise, proper nutrition
• Reality check: “This feels big, but it’s one conversation/presentation in my career”

During high-stress situations:

• Breathing: Conscious breath work before speaking
• Grounding: Feel my feet on the floor, notice my surroundings
• Perspective: “I’m here to contribute value, not to be perfect”

The Financial Reality of Managing High-Functioning Anxiety

Let’s be honest about the financial aspects of treatment and career changes:

Annual treatment investment:

• Therapy: $7,200 (weekly sessions at $150 each)
• Medication: $480 (generic Lexapro with insurance)
• Massage/bodywork: $1,800 (helps with physical tension)
• Meditation app: $96 (Headspace subscription)
• Total: $9,576

Career impact calculations:

• Promotion I didn’t take: Would have increased salary by $40K but required 80-hour weeks
• Travel I declined: Lost probably $10K in bonuses but gained mental health
• Consulting opportunities: Started doing weekend consulting to make up income difference

The ROI of treatment:

• Productivity increase: Working fewer hours but accomplishing more
• Medical cost savings: No more ER visits for panic attacks, fewer sick days
• Career longevity: Building sustainable success instead of burning out
• Life quality: Priceless improvement in daily experience

How I afforded treatment on a tight budget:

• Used Employee Assistance Program for initial sessions (3 free sessions)
• Found sliding-scale therapist after initial crisis period
• Generic medications are affordable with most insurance
• Many anxiety management techniques are free (breathing, meditation, exercise)

How My Relationships Changed (For the Better)

What I was afraid would happen:

• People would see me as weak or unstable
• I’d lose my reputation as someone reliable
• My team would lose confidence in my leadership
• Dating would become impossible (who wants an anxious partner?)

What actually happened:

At Work:

My team respected the boundaries: When I started leaving at reasonable hours, it gave them permission to do the same. Productivity actually improved.

Leadership appreciated the honesty: When I told my boss I was working on anxiety management, she shared her own mental health story and offered support.

Colleagues felt more comfortable opening up: Multiple coworkers confided their own struggles with anxiety, depression, and work-life balance.

In Personal Relationships:

Friends appreciated the real me: Instead of the perfect, always-available version, they got to see my vulnerabilities and struggles.

Dating improved dramatically: I attracted partners who valued authenticity over achievement. My current partner says my openness about mental health was one of the things that drew her to me.

Family relationships deepened: My parents had always worried I was pushing too hard. They were relieved when I started taking care of my mental health.

The Myths About High-Functioning Anxiety I Had to Unlearn

Myth #1: “Anxiety is what makes me successful”

Reality: Skills, intelligence, and work ethic make you successful. Anxiety might provide short-term motivation, but it’s not sustainable.

What I learned: I could be just as successful (actually more successful) when motivated by curiosity, growth, and contribution rather than fear.

Myth #2: “If I manage my anxiety, I’ll become lazy”

Reality: People don’t suddenly lose all drive and ambition when they address anxiety. You just channel that energy more efficiently.

What I learned: I still have high standards and ambitious goals. I just pursue them from a healthier place.

Myth #3: “High-functioning anxiety isn’t that serious”

Reality: Any anxiety that significantly impacts your life quality, relationships, or physical health is serious, regardless of how well you’re “functioning.”

What I learned: Just because you can push through doesn’t mean you should have to.

Myth #4: “Successful people don’t have mental health problems”

Reality: Success often comes with increased pressure, visibility, and stakes—all of which can exacerbate mental health challenges.

What I learned: Many highly successful people struggle with anxiety, depression, and other mental health issues. It’s not a character flaw or sign of weakness.

What High-Functioning Anxiety Recovery Actually Looks Like

Recovery doesn’t mean:

• Never feeling anxious again
• Becoming less ambitious or driven
• Accepting mediocre performance
• Not caring about outcomes

Recovery means:

• Feeling anxious sometimes without it controlling your decisions
• Being ambitious about things that genuinely matter to you
• Performing at a high level sustainably
• Caring about outcomes without tying your worth to them

My Life Now (18 Months After Treatment Started):

Professional status:

• Senior Director at the same company (turned down VP role for now)
• Leading a high-performing team of 15 people
• Exceeding targets while working 45-hour weeks
• Speaking at industry conferences again (something I’d stopped due to anxiety)

Mental health status:

• Still take medication (no shame about this)
• Therapy every other week for maintenance
• Occasional anxiety but rarely panic attacks
• Can recognize and manage anxiety before it becomes overwhelming

Lifestyle changes:

• Regular exercise (not compulsive, just enjoyable)
• Hobbies outside of work (pottery, hiking, reading fiction)
• Dating someone wonderful who understands my mental health journey
• Genuine downtime without guilt

The unexpected benefits:

• Better decision-making: Without constant anxiety, I can think more clearly
• Improved leadership: My team performs better because I’m not anxiously micromanaging
• Enhanced creativity: Anxiety was actually limiting my innovative thinking
• Authentic confidence: Based on genuine competence rather than fear of failure

Red Flags: When to Seek Help for High-Functioning Anxiety

If you recognize yourself in my story, please consider getting help if you’re experiencing:

Physical symptoms:

• Panic attacks or severe anxiety symptoms
• Chronic insomnia or sleep disturbances
• Unexplained physical symptoms (headaches, digestive issues, muscle tension)
• Relying on substances (caffeine, alcohol, medication) to function

Work-related patterns:

• Working excessively to avoid anxiety about performance
• Unable to delegate or take time off without extreme guilt
• Perfectionism that significantly slows your productivity
• Physical symptoms triggered by work situations

Relationship impacts:

• Cancelling social plans due to work anxiety
• Inability to be present with family/friends due to work preoccupation
• Romantic relationships suffering due to anxiety or overwork
• Feeling like people only value you for what you produce

Emotional indicators:

• Never feeling satisfied with achievements
• Constant worry about future failures or criticism
• Self-worth entirely based on external validation
• Feeling like you’re “fooling everyone” about your competence

Resources for High-Functioning Anxiety

Therapy options:

• Cognitive Behavioral Therapy (CBT): Excellent for anxiety and perfectionism
• Acceptance and Commitment Therapy (ACT): Helps with anxiety tolerance and values-based living
• EMDR: If anxiety stems from past trauma or negative experiences

Self-help resources:

• “The Anxiety and Perfectionism Workbook” by Taylor Newendorp
• “High-Functioning Anxiety” by Dr. Jennifer Shannon
• Headspace app (meditation specifically for work stress)
• Calm app (sleep stories and anxiety management)

Professional support:

• Employee Assistance Programs (EAPs) often provide free counseling
• Many therapists offer sliding scale fees or evening/weekend hours
• Online therapy platforms (BetterHelp, Talkspace) for convenience

Crisis resources:

• National Suicide Prevention Lifeline: 988
• Crisis Text Line: Text HOME to 741741
• SAMHSA National Helpline: 1-800-662-4357

A Letter to My Fellow High-Functioning Anxiety Warriors

If you’re reading this and seeing yourself in my story, I want you to know:

Your struggles are valid. Just because you’re successful doesn’t mean your mental health challenges aren’t real or serious.

You don’t have to earn the right to feel better. You don’t need to hit rock bottom or lose everything to deserve help and healing.

Success without sustainability isn’t really success. If your achievements are costing you your health, relationships, and peace of mind, something needs to change.

You can be ambitious and mentally healthy. These aren’t mutually exclusive. In fact, addressing your anxiety will likely make you more effective, not less.

Getting help is a sign of intelligence, not weakness. You wouldn’t try to perform surgery on yourself—don’t try to treat your anxiety alone.

You are not your anxiety. You’re a capable, intelligent person who happens to have anxiety. Treatment can help you access your full potential without the constant fear.

The Bottom Line

18 months ago, I thought anxiety was the price I had to pay for success.

Today, I know that anxiety was actually preventing me from being as successful as I could be.

The difference isn’t that I stopped being anxious—it’s that I learned to succeed without anxiety being in the driver’s seat.

I still have ambitious goals. I still work hard. I still care deeply about doing excellent work.

But now I pursue those goals from excitement rather than terror. I work hard because I love what I do, not because I’m afraid of what happens if I don’t. And I care about excellence without attaching my entire sense of worth to every outcome.

If you’re currently where I was 18 months ago—successful on the outside but struggling with anxiety on the inside—please know that there’s another way.

You don’t have to choose between achievement and peace of mind. You can have both.

But first, you have to be willing to get help.

Your anxiety has probably served you in some ways—it’s kept you striving, working hard, paying attention to details. But if it’s also costing you sleep, relationships, health, and happiness, it’s time to find a better way.

You deserve to be successful AND peaceful. You deserve to achieve your goals without constant fear. You deserve to feel good about your life, not just look good on paper.

The path to sustainable success starts with taking care of your mental health. I promise you, it’s worth it.

About the Author: Alex Thompson holds an MBA from Northwestern Kellogg and spent eight years in corporate marketing before founding Sustainable Success Consulting, which helps high-achieving professionals build careers that are both successful and sustainable. Alex speaks nationally about high-functioning anxiety, workplace mental health, and sustainable performance. When not working, Alex enjoys hiking, pottery classes, and learning to cook without burning down the kitchen.

References

1. Yerkes, R. M., & Dodson, J. D. (1908). The relation of strength of stimulus to rapidity of habit‐formation. Journal of Comparative Neurology and Psychology, 18(5), 459-482.

2. LeDoux, J. E. (2000). The synaptic self: How our brains become who we are. Penguin Books.

3. Shannon, J. (2009). The anxiety survival guide for teens. New Harbinger Publications.