What It’s Really Like to Be a High-Functioning, Anxious 20-Something in NYC

Per my last email… I’m barely holding it together

At 5:30 a.m., her alarm goes off—but she’s already been awake, tossing and turning since 5. Her mind is racing: deadlines, meetings, unread emails, things she might have missed overnight. (She hasn’t missed anything urgent, but it doesn’t matter. In her world, even the small things feel monumental.)

She checks her phone before she even gets out of bed. Her body’s still half-asleep, but her brain is sprinting. And yet, she snoozes the alarm. She’s supposed to get to a 6 a.m. workout class, but her body and mind feel stuck.

“Ugh, I just want to stay in bed all day.”

Still, somehow, she makes it to class.

By 7:30 a.m., she’s showered, hair blown out in the gym bathroom, dressed in something sharp. Coffee in hand, she sprints to the subway, already calculating how much she needs to get done before noon just to stay afloat. She’s good at this. Efficient. Strategic. Respected.

But she’s not at ease. And the endorphins from her workout have already worn off.

From the outside, it looks like she’s killing it.

On the inside, she feels like a hot mess.

She’s smart and capable—and constantly afraid someone’s about to find out she has no idea what she’s doing.

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She works in a high-expectation, high-performance field—tech, finance, law, consulting, media. Everyone’s busy. Everything’s urgent. Rest isn’t a right—it’s something you have to earn.

She’s incredibly smart. Ambitious. Reliable. But it feels like walking a tightrope. She over-prepares. Overthinks. Over-functions.

A simple email takes her an hour to send. A quick call gets pushed off for days. She replays conversations, second-guesses how she came off, hesitates to ask for help—afraid she’ll seem incompetent.

Did I say too much? Not enough?

Her thoughts race toward worst-case scenarios:

“Why can’t I figure this out?”

“I should already know this.”

“They’re going to realize I don’t belong here—and I’ll get fired.”

“I’ll lose my apartment. I’ll end up with nothing.”

Even in her proudest moments—closing the deal, launching the product, winning the case—the pride doesn’t last. It’s quickly replaced by the hum of “what’s next?” and “don’t fall behind.”

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At first—back in high school—her anxiety mostly lived in her mind. The pressure to be perfect. The fear of failure. The constant replaying of conversations. The mental gymnastics of second-guessing herself. Overcommitting to avoid disappointing anyone.

Now, it’s in her body, too.

At work, her shoulders are tense. Her stomach hurts. She gets headaches. She goes to acupuncture, gets cupping, tries cold plunges and massages—nothing helps for long. She sees a Slack from her manager and suddenly she can’t breathe. Her hands shake. Her chest tightens. Sometimes she has to cry in the bathroom. Sometimes she forces herself to take a walk. Other times, she’s frozen—staring blankly at her screen, unable to move.

Which only fuels the anxiety more.

“I just wasted 30 minutes doing nothing.”

Despite all of it, no one at work has a clue. Her work is excellent. She’s up for a promotion.

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She’s the kind of person people describe as “impressive.” She’s made it in a cutthroat industry. She’s articulate. Organized. Proactive. Her boss praises her. Her friends say she’s the one who has it all together.

But she doesn’t feel that way.

She’s anxious. And she’s lonely.

She questions her worth constantly. Her value feels tied to what she produces, what she achieves.

4.0 GPA. Varsity athlete as a freshman. Perfect SATs. Ivy League. Prestigious internships. Big-name job. And still, the voice says: “Not good enough.”

Confidence, it turns out, doesn’t come from checking every box.

And she’s starting to wonder if she even knows what confidence is—because everyone else seems to have it. And she just… doesn’t.

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She shares all of this with her therapist—for the first time in her life.

Not all at once. It takes a few sessions to get past the polished explanations, the “I know I’m lucky, I just…” disclaimers. But slowly, it all comes out. The pressure. The fear. The feeling that one small misstep will undo everything.

Her therapist doesn’t flinch.

Instead, they say something simple. Something she hadn’t considered:

“What if nothing’s wrong with you?”

“What if the overworking, overthinking, overachieving—what once helped you survive—isn’t working anymore?”

“What if it’s not that you’re broken… but that you’re exhausted from always having to prove yourself?”

Therapy becomes the first place she doesn’t have to perform.

A space where she can finally question the stories she’s been telling herself about success, worth, and what it means to be “enough.”

It’s slow work. Sometimes uncomfortable. But for the first time, she starts to feel a little different. 

Not fixed.

But free.

She starts to feel like herself.

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If you’re a high-achieving, anxious twenty-something in NYC struggling to manage stress and burnout, you’re not alone.
I specialize in helping young professionals like you stop just holding it together and start building sustainable mental health and confidence.
You don’t have to face anxiety and pressure on your own—reach out to learn how therapy can support your journey to balance and well-being.