DeShields Behavioral Wellness

Anxiety & High-Functioning Anxiety Therapy in Louisville, KY + Telehealth in 43 States

Therapy for Adults Who Feel “Fine” on the Outside and Overwhelmed on the Inside
If you’re used to being the responsible one, the reliable one, the person who keeps everything moving even when you’re exhausted, high-functioning anxiety may feel familiar. You may look “fine” to everyone else, yet inside you’re juggling chronic worry, overthinking every decision, feeling guilty for needing anything at all, or quietly bracing for something to go wrong.

For many people navigating anxiety and perfectionism, these patterns began long before adulthood. They often trace back to childhood roles like the helper, the peacemaker, the achiever, or the one who didn’t want to be a burden. Now, those old survival strategies show up as pushing yourself past exhaustion, hiding your feelings, trying not to be “too much,” or feeling responsible for everyone around you.

My approach is grounded, collaborative, and focused on helping you understand the deeper roots of your anxiety, not just the surface symptoms. Together, we’ll work to understand where these patterns began, what they’re protecting, and how they show up in your daily life.

Learn more about healing the roots of anxiety:
→ People-Pleasing & Boundary Setting
→ Trauma Therapy

What High-Functioning Anxiety Looks Like
The Anxiety No One Sees But You Feel Every Day

High-functioning anxiety can look like:

  • Overthinking even simple decisions
  • Always preparing for worst-case scenarios
  • Feeling guilty when you rest
  • Feeling like your best is never good enough
  • Worrying about disappointing others
  • People-pleasing to avoid conflict
  • Burnout that returns again and again
  • Trouble setting boundaries or saying no

It’s anxiety wrapped in competence, masked by capability, hidden behind “I’m fine.” And it’s exhausting.

Explore how burnout and anxiety overlap: → Burnout Therapy

Why You Feel This Way
Your Anxiety Makes Sense

Many adults who appear calm and capable now were once children who had to hold a lot emotionally or relationally. Maybe you grew up in a family where:

  • Your feelings were labeled too much
  • You learned to stay agreeable or small
  • Success earned approval
  • You became the easy child who never rocked the boat
  • You felt responsible for keeping peace or stability

These early experiences can create an internal world where you take on pressure, work hard to avoid letting others down, and feel responsible for everyone else’s needs.

Your anxiety isn’t a flaw. It’s a long-standing strategy that once kept you safe.

Read more about Dr. Katie DeShields’ approach: → Learn More About Me

What Therapy Looks Like
A More Intentional, In-Depth Kind of Support That Helps You Shift Long-Standing Patterns

In therapy, we create space to understand what your anxiety is protecting, holding, or anticipating. Together we explore:

  • The pressure you carry internally
  • The guilt that appears when you set boundaries
  • The parts of you that still brace for criticism or rejection
  • The perfectionism that feels impossible to turn off
  • The burnout cycle that keeps resurfacing

This work isn’t about fixing you. It’s about helping the anxious part of you feel understood, supported, and less alone.

We work at a pace that feels safe and grounding for your nervous system.

Learn more about how relationships influence anxiety: → Relationship Issues & Attachment Patterns

Explore how burnout affects high-functioning adults: → Burnout Therapy

Begin Working With Your Anxiety Differently in Louisville, KY + Telehealth Across 43 States
You don’t have to keep pushing through the same patterns. Therapy is a chance to understand what your anxiety has been trying to protect you from and to learn new ways of relating to it. Over time, you’ll gain the tools to meet stress with more understanding and less self criticism.

Call (502) 681-7330 or book a → free 15-minute consultation to take the next step.

Prefer meeting from home or need to meet outside of Kentucky? → Learn more about telehealth therapy.

FAQ: Anxiety & High-Functioning Anxiety
What’s the difference between regular anxiety and high-functioning anxiety?
High-functioning anxiety often hides behind productivity, perfectionism, or people pleasing. You might look calm and capable on the outside while feeling tense, restless, or critical of yourself inside. It’s still anxiety. It just wears a more polished mask.

Learn more about the deeper patterns behind anxiety: → Individual Therapy for Adults

How can therapy help with high-functioning anxiety?
Therapy helps you understand what your anxiety has been trying to protect you from rather than simply trying to make it go away. Over time, you learn to relate to anxious thoughts and sensations with more curiosity and less judgment.

Explore Dr. Katie DeShields’ approach: → Learn More About Me

Do I have to feel “anxious enough” to start therapy?
Not at all. Many of my clients come in feeling “not bad enough” for therapy, yet they’re exhausted from holding everything together. If anxiety, guilt, or burnout are affecting your quality of life, therapy can help.

Start with a free 15-minute consultation: → Contact Me

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Contact me today to book your consultation

(502) 681-7330
Free 15-min Consultation