How Anxiety Shows Up for High-Achieving Women (and When to Seek Therapy)

If you’re a high-achieving woman, anxiety doesn’t always look like panic attacks or constant worry. Often, it feels like a heavy responsibility, a constant need for productivity, and always being the one who holds everything together. Women carry a lot on their shoulders, from work deadlines to family responsibilities, and anxiety can show up quietly at first. If you’re wondering how to find the right therapist, my guide walks you through the steps to choose a therapist who fits your unique needs.

Many of the women I work with in my Cary, NC, counseling practice don’t initially describe themselves as anxious. Instead, they say things like:

  • “I can’t shut my brain off.”

  • “I feel tense all the time.”

  • “I’m always behind, even when I’m doing everything.”

  • “I’m exhausted, but I don’t feel like I’ve earned rest.”

Anxiety in high-achieving women often hides behind competence and reliability. And because it doesn’t always look like what we expect anxiety to look like, it can go unrecognized for years.

Why Anxiety Often Goes Unnoticed in High Achievers

High-achieving women are often praised for being dependable, driven, and capable. These traits are valuable, but they can also mask emotional strain.

Instead of anxiety showing up as fear, it may show up as:

  • Perfectionism

  • Over-preparing

  • Over-functioning in relationships

  • Difficulty delegating

  • Constant mental planning

From the outside, things may look successful. Inside, there’s often pressure, self-criticism, and a sense that you can’t ever fully relax.

Many women I work with have spent years telling themselves, “This is just how I am,” without realizing that anxiety has slowly become the background noise of their lives.

The Link Between Anxiety, Overfunctioning, and Resentment

One pattern I see frequently in professional women is the connection between anxiety and overfunctioning. Women cope with issues by doing more than their share at work, at home, and in relationships.

When anxiety is driving the system, it can feel safer to:

  • Anticipate everyone’s needs

  • Fix problems before they escalate

  • Take responsibility for outcomes that aren’t fully yours

In the short term, this can create stability. In the long term, it often leads to resentment, emotional exhaustion, and feeling invisible in your own life.

Women often tell me they feel frustrated with the very people they care about most and then feel guilty for feeling that way. Anxiety keeps the cycle going by convincing you that slowing down or setting boundaries would somehow make things worse. You feel your worth is tied to what you do for others, so it feels impossible to shift anything. 

When Anxiety Starts to Affect Your Quality of Life

Everyone experiences stress. But anxiety may be playing a bigger role when you notice:

  • You’re constantly on edge, even during downtime

  • Small problems feel overwhelming

  • You struggle to enjoy things you used to like

  • You feel disconnected from yourself or others

  • Your inner dialogue is harsh and critical

Anxiety doesn’t always announce itself loudly. Sometimes it quietly reshapes how you think about yourself, your worth, and your responsibilities.

At this point, many women start searching for ways to feel better: reading books, listening to podcasts, or trying to manage things on their own. Those tools can be helpful, but they don’t always address the deeper patterns that keep anxiety in place. One key sign it’s time to reach out is when DIY strategies: meditation, self-help books, or talking with friends aren’t enough to relieve the anxiety. My guide on choosing the right therapist for you explains what to look for in a professional, including therapy approaches and fit, so you can take the first step toward support confidently instead of spinning your wheels, feeling defeated. 

How Therapy Helps High-Achieving Women with Anxiety

Therapy for anxiety is not just about calming symptoms. It’s about understanding what’s driving the anxiety and learning how to relate to yourself and others differently.

In my work with professional women, therapy often focuses on:

  • Identifying internal pressure and unrealistic expectations

  • Understanding where people-pleasing and perfectionism began

  • Learning how to set boundaries without guilt

  • Rewriting unhelpful self-beliefs

  • Creating sustainable ways of coping with stress

Using approaches like Cognitive Behavioral Therapy (CBT), Narrative Therapy, Internal Family Systems, and Motivational Interviewing, we look at both current thought patterns and the stories you’ve carried about who you need to be in order to be valued.

Over time, clients often notice they feel less reactive, more grounded, and more able to make choices that align with their values and who they are instead of who they feel their circumstances are making them be. 

When to Consider Working with a Counselor in Cary, NC

You don’t have to wait until you’re in crisis to benefit from therapy. Many women begin counseling when they realize that:

  • They’re functioning, but not thriving

  • They’re tired of carrying everything alone

  • They want more ease and connection in their lives

If anxiety, overwhelm, or chronic stress are part of your daily experience, working with a counselor in Cary, NC who specializes in anxiety and high-achieving women can help you understand what’s happening and how to change it.

Your struggles are not a personal failure; they are a healthy signal that something needs attention. Seeking therapy is a proactive step, not a sign of weakness. If you’re ready for a change, my step-by-step guide to finding the right counselor can help you navigate the process and choose a therapist who truly fits your goals.

You Don’t Have to Do This Alone

High-achieving women are often very good at pushing through discomfort. But constantly pushing is not the same as healing or growing.

Therapy offers a space where you don’t have to perform, fix, or prove anything. You get to slow down, be honest about what’s hard, and learn how to create a life that doesn’t require constant self-sacrifice.

If you’re exploring counseling in Cary, NC, and want support for anxiety, boundaries, or life transitions, working with the right therapist can make a meaningful difference.

Author Bio

Megan Giroux, LCSW, is a Licensed Clinical Social Worker in Cary, NC, and the founder of Megan Giroux, LLC. She specializes in anxiety treatment for professional women using Cognitive Behavioral Therapy (CBT), Narrative Therapy, and Motivational Interviewing to help clients reduce overwhelm, strengthen boundaries, and reconnect with their values. Megan provides in-person therapy at her Cary, NC office and is passionate about helping women move out of survival mode and into lives that feel sustainable and fulfilling.

Learn more about Megan and her counseling services in Cary, NC

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The Step-by-Step Guide to Finding the Right Anxiety Counselor in Cary, NC