Anxiety & High-Functioning Anxiety Therapy in Louisville, KY + Online
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.
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.
When You’re No Longer Trapped in the Anxiety Cycle
Move From…
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Constant overthinking and second-guessing yourself
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Feeling tense or on edge most of the day
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Pushing through exhaustion because resting feels unsafe or selfish
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Feeling panicked or overwhelmed
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Saying yes when you want to say no to avoid conflict or disappointing people
To…
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Feeling more grounded and confident in your decisions
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Your body finally feeling relaxed
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Making your needs a priority and allowing yourself to slow down without guilt
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Being able to calm yourself when anxiety hits
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Setting boundaries without over-explaining or apologizing
Meet Dr. Katie DeShields: Anxiety Therapist in Louisville, KY
I help people who look capable on the outside but feel overwhelmed on the inside. These are people who appear high-functioning but are constantly second-guessing themselves, overworking, or struggling to set boundaries. As a Certified Anxiety Treatment Professional, I bring specialized training in evidence-based anxiety treatment. That means I know what actually works for chronic worry, racing thoughts, and the physical toll anxiety takes on your body.
We work together to understand why your anxiety shows up the way it does and how those patterns are connected to what you learned growing up about being safe, valued, or good enough. The goal is to move from being controlled by fear, guilt, or what you think you should do to building a life based on what you actually want and value.
Get to know Dr. Katie DeShields → About Me
How We’ll Work Together
Understanding Your Anxiety
We get curious about what anxiety protects you from and trace it back to what you learned about safety growing up. It’s not about blame, it’s about understanding why survival patterns are now keeping you stuck.
Changing Your Relationship With It
We’ll help you respond to anxiety with more flexibility and less fear. You’ll see anxiety as information, not a character flaw, and build skills to interrupt the cycles of overthinking and self-criticism that keep you exhausted.
Building New Patterns
As anxiety takes up less space, you’ll focus on what matters. Set boundaries without guilt, make decisions without second-guessing, and stop abandoning yourself for others’ comfort. The result is a steadier, more aligned life.
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
You may have also learned early on that hat being flexible, helpful, or “low-maintenance” avoided conflict or criticism. Over time, this can create an internal world where asking for support feels uncomfortable, saying no brings guilt, and you worry that your needs might burden others.
Your anxiety isn’t a flaw. It’s a long-standing pattern your system learned to rely on. And those same patterns often shape how anxiety shows up in your relationships, boundaries, and sense of responsibility today.
How Anxiety Shows Up as People-Pleasing and Boundary Guilt
These early experiences don’t just stay in the past. They shape how anxiety shows up in your adult relationships, boundaries, and sense of responsibility today. What once helped you stay safe can turn into patterns of people-pleasing, over-functioning, and feeling responsible for others’ comfort at your own expense.
Anxiety-driven people-pleasing often looks like:
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Saying yes when you’re already overwhelmed
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Taking responsibility for how other people feel
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Replaying conversations to make sure you didn’t upset anyone
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Feeling guilty for resting or slowing down
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Feeling intense discomfort at the thought of disappointing someone
For many people, this way of relating to others began long before adulthood. If you grew up being the “easy one,” the helper, or the child who kept the peace, your nervous system learned that being flexible or low-maintenance protected you from conflict, criticism, or unpredictability. People-pleasing became a way to stay safe.
Now, that same pattern shows up as boundary guilt, putting others first at your own expense, or fear that your needs will be “too much.”
Learn more about how anxiety can impact relationships → Relationship Issues & Attachment Patterns
Begin Working With Your Anxiety Differently in Louisville, KY + Telehealth Across 43 States
A More Intentional, In-Depth Kind of Support That Helps You Shift Long-Standing Patterns
You don’t have to keep pushing through the same patterns. Therapy offers space to understand what your anxiety has been trying to protect you from and to learn new ways of relating to it. You’ll learn to meet stress with more understanding and less self criticism, opening the door to a calmer inner world and a life that feels more aligned with who you are.
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.
Does anxiety often increase during major life transitions?
Yes. Life transitions — like career changes, relationship shifts, becoming a parent, caregiving, or other role changes — can intensify anxiety, especially if you’re already used to holding a lot internally. During times of change, old coping patterns like over-responsibility, people-pleasing, or perfectionism often get louder as your system tries to regain a sense of control.
Learn more about support during life changes → Life Transitions Counseling
How can therapy help with anxiety and 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. You’ll begin 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?
Start with a free 15-minute consultation: → Contact Me
therapy for perfectionism, therapy for burnout, therapy for chronic anxiety, stress management therapy, insight-oriented therapy, people-pleasing therapy
Contact me today to book your consultation