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They might appear calm, capable and
driven, but beneath the surface, many high-functioning individuals are silently
battling anxiety—and often rely on substances to keep going. From alcohol and
nicotine to prescription pills, these coping tools help them manage the
invisible pressure they carry each day. According to Dr Gorav Gupta, CEO and
senior psychiatrist at Tulasi Healthcare, Gurgaon, high- functioning anxiety is a hidden struggle where people look
outwardly successful but constantly battle chronic worry, perfectionism and
self-doubt. What does high-functioning anxiety
look like in real life? Dr Gupta explained that
high-functioning anxiety often shows up in professionals, students and
caregivers as: Overachievement Relentless busyness Fear of Underperformance Burnout masked as dedication These individuals may be excelling at
work or in academics while silently fighting an intense mental battle they rarely disclose. Why are high-functioning individuals
prone to substance use? The pressure to maintain control,
appear perfect and never show weakness can push people toward unhealthy coping
mechanisms. Dr Gupta explained that substances often become a disguised
‘crutch’: Alcohol: to unwind, socialise or fall
asleep Nicotine: to calm nerves or stay alert Prescription medications:
benzodiazepines for anxiety, stimulants for focus Cannabis: for emotional escape These habits often pass as casual
routines—an evening drink, a post-meeting cigarette, or a pill during crunch
times—but they signal dependence. Are there differences in substance use
by gender and age? Yes, patterns vary, said Dr Gupta: Women often turn to alcohol or
sedatives for relief Men may lean on stimulants or tobacco
to remain focused Young adults (of any gender) commonly
misuse cannabis or ADHD drugs for quick relief People tend to choose what feels
socially acceptable or easily accessible—but the risks remain the same across
groups. What are the signs someone may be
silently struggling? People with high-functioning anxiety
are skilled at masking their distress. Still, some red flags can signal
underlying problems: Mood swings or unexplained
irritability Reliance on daily ‘de-stress’ habits
(like drinking or smoking) Insomnia or erratic sleep patterns Intense periods of productivity
followed by burnout If someone’s ability to function
appears dependent on their next smoke, drink or pill, it could be a sign of
self-medication. What are healthier ways to manage
high-functioning anxiety? There are effective and sustainable alternatives to substance use. Dr Gupta recommended: Therapy: Cognitive Behavioural Therapy
(CBT) or Acceptance and Commitment Therapy (ACT) Mindfulness practices: including
meditation and breathwork Exercise: to regulate mood and manage
stress Consistent sleep routines Emotional openness: with trusted
friends, family or therapists Short-term supervised medication:when
prescribed by a mental health professional These strategies help build resilience and
promote long-term emotional wellbeing. Why early intervention and support are
critical The sooner anxiety and substance use
are identified, the easier it is to intervene without major life consequences.
Compassion—not judgment—is key. “These are people who already hold themselves to impossible standards,” said Dr Gupta. “What they need most is empathy, understanding, and safe spaces to ask for help.” |
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