Why Anxiety Shows Up Differently in High-Achieving Black Women
Understanding the invisible load, the nervous system, and pathways to relief
As a psychologist based in the East Bay who works closely with high-achieving Black women, I see every day how often anxiety goes unrecognized—even in women who appear to have everything “handled.” On the outside, life may look stable and successful, but internally, it can feel like your mind is running faster than your body or your spirit can keep up. Many of my clients describe feeling like they’re holding a dozen threads at once, always in motion, always anticipating the next need or responsibility. Even when they pause, their thoughts don’t always slow with them. What looks like composure to the outside world can mask a nervous system that has been operating above its natural capacity for years.
Anxiety doesn’t always show up as panic or visible distress. Sometimes it looks like keeping everything together while quietly unraveling on the inside, or like feeling stretched thin but still being the person everyone relies on. In many cases, Black women have learned to move through anxiety so efficiently that no one—not even those closest to them—can detect how much effort it takes to keep going. This skill of “carrying it well” is often praised, which can make it harder to recognize when you’re actually carrying too much. Inside, the cost may be mounting: irritability that surprises you, a constant mental replay of conversations, or a deep fatigue that sleep doesn’t quite solve.
The Quiet Reality: “I’m High-Functioning… Until I’m Not”
Many Black women come to therapy only after years—sometimes decades—of privately managing anxiety. The early signs may have been there all along, but they were easy to rationalize: It’s just a busy season. This is what leadership looks like. Everyone I know is tired. But eventually, something shifts. The strategies that used to work—over-preparing, powering through, taking care of everyone else—start to feel less effective or more draining. That’s often when women notice that what they’ve been carrying is not just stress but a nervous system pushed beyond its natural limits.
Outwardly, everything looks stable:
You excel in your career.
You show up for your family.
You maintain your friendships.
You rarely miss a commitment.
But anxiety can be present even when life is “working.” It might feel like a constant hum in the background, like your mind is buffering even when you’re sitting still. It might look like waking up tired, feeling responsible for things that aren’t yours to hold, or needing to double- and triple-check your work even though it’s always been excellent. For many women, anxiety slips into the small moments: checking your email before bed just in case, replaying conversations to make sure you didn’t offend anyone, or feeling guilty for resting when there’s still more to do.
High-functioning anxiety can be especially invisible in Black women because it often develops in environments where strength, wearing many hats, and self-sufficiency are rewarded—and expected. The world is quick to applaud your resilience, even when that resilience comes at the cost of your emotional bandwidth.
Why Anxiety Shows Up Differently in Black Women
1. The Cultural Script: Be Strong, Be Capable, Don’t Rest
From a young age, many Black women internalize the idea that they must be strong for everyone. Even without explicit messaging, the roles you may have been placed into—caretaker, mediator, high achiever—taught you that your emotional needs come second. This “strength script” can feel like armor: protective, necessary, and sometimes even empowering. But over time, armor gets heavy.
This creates what researchers call an “emotional double shift”:
You hold your life together externally while also managing the emotional lives of others internally.
In families, workplaces, and communities, many Black women become the person who anticipates needs, smooths conflict, comforts others, and absorbs emotional spillover. This constant internal labor increases cognitive load and can keep the nervous system in a heightened state. It becomes harder to distinguish between real urgency and the habit of urgency. Over time, anxiety becomes less about fear and more about conditioning—your body learns to stay ready because it’s what life has demanded.
This environment is fertile ground for anxiety, but it can also make it difficult to recognize when you deserve gentleness or when you’ve been carrying more than is humanly possible.
2. High Achievement as a Survival Strategy
Many Black women develop a high-achieving identity as a way to create access, stability, or protection. Excellence becomes a tool for survival in environments where being underestimated, dismissed, or overlooked is common. Success isn’t just ambition—it becomes a buffer, a way to ensure safety and minimize harm.
But when achievement becomes intertwined with survival, slowing down can trigger anxiety rather than relieve it. You might know you’re exhausted, but feel pulled to push a little harder, hold a little longer, or outperform expectations because the stakes feel high. Many Black women describe the sensation of being “driven by something deeper”—a mix of responsibility, ancestral memory, opportunity, and the desire to create a different life for themselves or their families.
In these cases, anxiety can be woven into the very habits that helped you succeed. You may not notice the strain until your body signals that it can’t keep operating this way.
3. Workplace Pressures That Intensify Anxiety
Black women in professional roles often describe a level of vigilance that extends beyond the job itself. This may include:
Being conscious of how you’re perceived
Managing subtle exclusions
Navigating microaggressions
Holding yourself to a higher standard to avoid scrutiny
Carrying unspoken responsibilities
These experiences create a kind of “background stress” that doesn’t always rise to the level of crisis but never fully turns off. Your nervous system learns to stay alert because your environment requires it. Over time, that alertness becomes baseline anxiety—even when you’re “used to it.” It’s like your body has learned to run a marathon at the pace of a sprint, and eventually the imbalance shows up physically, emotionally, or spiritually.
What Anxiety Can Look Like in High-Achieving Black Women
1. Internal restlessness
A sense of being “on alert” even during downtime. You might sit down to watch a show and still feel your mind ticking.
2. Difficulty slowing down
Resting feels uncomfortable or guilt-filled, as if there’s always something else you should be doing. “Doing nothing” might feel unsafe or unfamiliar.
3. Over-responsibility
Feeling like everything depends on you—at work, at home, in friendships. You may feel uneasy delegating or asking for help.
4. Racing thoughts
A constant hum of planning and anticipating, running through scenarios, preparing for possibilities others haven’t even considered.
5. Irritability or emotional exhaustion
This often gets dismissed as “just being tired,” but it’s also a sign that your system is carrying more than it can process.
6. Emotional disconnect
Losing touch with your own needs because you’re used to functioning through stress, productivity, or caretaking.
If you’d like to learn more about how therapy can support anxiety, visit my Therapy for Anxiety page.
The Nervous System Side: Your Body Isn’t Meant to Run Like This Forever
When the body learns to operate in a state of heightened alert, it adapts. It becomes efficient at scanning for danger, bracing for impact, and moving through the world with a quiet hum of vigilance. High achievement can mask this—because you are functioning, you’re meeting deadlines, you’re showing up for people. But the body keeps its own score, and eventually it will let you know the pace isn’t sustainable. These signals aren’t failures; they’re invitations to tune in.
Common signs your nervous system is asking for support include:
Tight shoulders or jaw
Difficulty sleeping
Trouble concentrating
Shallow breathing
Emotional fatigue
Feeling disconnected from pleasure or ease
Anxiety isn’t just a mental experience. It’s a full-body state, a physiological response shaped by history, pressure, identity, and environment. It affects breathing patterns, digestion, attention, and even the ability to feel joy or ease. And it can shift—but only with conditions that help your system down-regulate: care that feels culturally attuned, pace that honors your capacity, and space to breathe without performing.
This is where mind-body therapy begins—not by pushing harder, but by teaching your nervous system that it no longer has to live in survival mode. In therapy, you learn what safety feels like in the body, not just conceptually. That shift can open the door to rest, clarity, and emotional spaciousness.
Healing Begins When You Have Permission to Slow Down
Therapy offers a rare space where high-achieving Black women don’t have to perform strength or hold everything together. It’s a space where the pressure drops, where the nervous system can breathe, and where you can explore who you are beyond resilience. In our work, the goal is not to become less capable—it’s to reconnect with the parts of you that have been overshadowed by pressure, expectation, or survival-mode habits.
Healing anxiety often looks like:
Relearning how to rest without guilt
Building boundaries that protect your energy
Softening internal pressure
Calming an overworked nervous system
Creating a life paced for your wellbeing, not just your responsibilities
This work can be slow, gentle, and deeply restorative. Many women describe feeling like they’re meeting themselves again—discovering the version of themselves that existed before constant urgency became the norm.
If Anxiety Is Showing Up for You, You’re Not Alone
For women—especially those carrying the weight of being the first, the only, or the most relied-upon—anxiety can feel like a private struggle. But you don’t have to navigate it by yourself. You deserve support that sees the full picture: your brilliance, your responsibilities, your history, your hopes, and your humanity.
If you’re curious about therapy, you’re welcome to book a consultation so we can explore whether we’re a good fit.