Signs Your Anxiety Is Showing Up as Overworking, Not Panic
Gabrielle Smith LCSW,
When people imagine anxiety, they usually picture panic attacks, racing hearts, shallow breaths, and visible distress. Anxiety that interrupts. Anxiety that looks like anxiety. But many of the most anxious people I work with have never had a panic attack in their lives. Instead, they answer emails at midnight. They stay late. They say yes when their body is screaming no. They organize, anticipate, prepare, and over-function their way through life. Their anxiety doesn’t shut them down-it keeps them relentlessly moving.
This is anxiety as overworking, and it is one of the most socially sanctioned forms of distress we have.
A Familiar Story (Or Several)
Consider this composite vignette-a combination drawn from years of clinical work:
Jordan is a high-performing professional. Well-liked. Trusted. The person everyone turns to when something needs to get done. On paper, Jordan’s life looks stable, even enviable. But Jordan hasn’t taken a real break in years. Rest feels uncomfortable. Silence feels loud. When things slow down, anxiety rushes in, so Jordan speeds back up.
Jordan doesn’t describe feeling “anxious.” Jordan describes feeling responsible.
This distinction matters.
Many individuals with high-functioning anxiety don’t identify with the word anxiety at all. Instead, they describe themselves as driven, disciplined, or simply “someone who likes to stay busy.” Their distress is camouflaged by competence.
Hyperfunctioning as a Coping Strategy
Clinically, this pattern is often referred to as hyperfunctioning, a relational and behavioral stylemin which individuals manage anxiety and uncertainty by taking on more responsibility, control, and action (Karpman, 1968; Minuchin, 1974).
From a cognitive-behavioral perspective, overworking at times can be negatively reinforced. Each time productivity reduces anxiety, even briefly, the behavior is strengthened (Beck, 2011). The relief doesn’t last, but the learning sticks.
From a trauma-informed lens, hyperfunctioning often develops early. When environments are unpredictable, emotionally unavailable, or demand premature maturity, children learn that being capable is safer than being needy. Over time, doing becomes regulation.
In adulthood, this shows up as:
Chronic overcommitment
Difficulty delegating
A sense that everything is urgent
Discomfort when others take the lead
Not because the person enjoys control, but because letting go activates threat.
When Productivity Replaces Emotional Regulation
Here’s where things get tricky.
Overworking doesn’t just mask anxiety; it regulates it.
Staying busy keeps the nervous system occupied. It limits opportunities for introspection. It provides structure, predictability, and a steady drip of dopamine and validation. For a system accustomed to sympathetic activation (Fight-or-Flight), this can feel stabilizing.
Polyvagal Theory suggests that when someone’s nervous system has learned to associate movement and productivity with safety, slowing down or being still can actually increase distress because it removes that familiar sense of security. As a result, gentle grounding practices are important to help re-establish a sense of safety before attempting more advanced mindfulness techniques.
This is why rest often triggers:
Guilt
Restlessness
Irritability
A sudden surge of intrusive thoughts
Clients will say things like, “I try to relax, but I just feel worse.”
They’re not failing at rest. Their nervous system has not yet learned to integrate the belief that rest can be safe.
The Beliefs That Keep the Cycle Going
Cognitively, overworking anxiety is often maintained by deeply held core beliefs:
“If I don’t stay on top of things, everything will fall apart.”
“I can’t afford to slow down.”
“My value comes from what I contribute.”
These beliefs rarely appear dramatic or non-factual. They sound reasonable. Responsible, even. But over time, they create an internal economy where worth is earned through exhaustion.
Aaron Beck’s cognitive model reminds us that beliefs shape behavior, which, in turn, reinforces those beliefs (Beck, 2011). When overworking is rewarded with praise, stability, or professional success, people often find it difficult to question their habits. However, research highlighted by Medina-Garrido and colleagues shows that emotional well-being can play a significant role in interrupting these patterns, sometimes resulting in absenteeism as the body responds to chronic stress.
The Body Eventually Sends the Bill
Anxiety managed through overworking is not benign.
Chronic sympathetic activation (Fight or Flight) has well-documented physiological consequences, including elevated cortisol, disrupted sleep, impaired immune functioning, and increased risk for mood disorders (McEwen, 2007).
Emotionally, individuals may experience:
Burnout
Emotional blunting
Resentment
A creeping sense of disconnection from self and others
Often, people enter therapy not because they are failing, but because they are no longer willing to pay the cost of always holding it together.
Why This Pattern Is So Hard to Let Go Of
Overworking anxiety is difficult to change because it is intertwined with identity.
For many high achievers, productivity is not just what they do; it has become who they are. It provides stability, recognition, and often survival. Asking someone to loosen this strategy without offering alternatives can feel like asking them to step into danger.
This is why effective treatment goes beyond telling people to “slow down.”
Therapeutic work often includes:
Gradual nervous system regulation
Cognitive restructuring of worth-based beliefs
Somatic awareness and tolerance for stillness
Trauma processing to uncouple safety from output (EMDR, somatic therapies)
Change happens not by removing productivity, but by expanding the system’s capacity for rest, flexibility, and responsiveness.
A Reflective Pause
If anxiety didn’t show up as panic, but as productivity, how would you know?
And if you stopped proving your worth through overworking, what would you have to feel instead?
These are not questions to answer quickly.
They are invitations.
Further Reading & Research
Beck, J. S. (2011). Cognitive behavior therapy: Basics and beyond (2nd ed.). Guilford Press.
Herman, J. L. (1997). Trauma and recovery: The aftermath of violence—from domestic abuse to political terror. Basic Books.
McEwen, B. S. (2007). Physiology and neurobiology of stress and adaptation: Central role of the brain. Physiological Reviews, 87(3), 873–904.
Porges, S. W. (2011). The polyvagal theory: Neurophysiological foundations of emotions, attachment, communication, and self-regulation. W. W. Norton.
Van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Viking.
Medina-Garrido, J. A., Biedma-Ferrer, J. M., & Sánchez-Ortiz, J. (2020). I can’t go to work tomorrow! Work-family policies, well-being and absenteeism. Sustainability, 12(14), 5519.