Why Successful People Often Feel More Anxious

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Why Successful People Often Feel More Anxious Than Everyone Else

Operation Resiliency • Clinical Commentary June 2026

Author: Michael Murphy, MSN, PMHNP-S

Introduction

It is a familiar pattern in clinical practice: the patient who presents as composed and accomplished describes a private experience of near-constant apprehension. The executive who has never missed a deadline lies awake rehearsing tomorrow’s meeting; the attending physician trusted with the most complex cases double-checks orders she has already verified. By most external measures these individuals are performing well, yet they report a baseline of worry that does not match their record. Anxiety is most often framed as pathology, and for good reason—anxiety disorders are the most prevalent psychiatric conditions and cause meaningful suffering. But framing anxiety exclusively as disease obscures a more accurate picture. At its core, anxiety is a threat-detection and preparation system. At moderate levels it can support vigilance, anticipatory planning, risk assessment, and sustained effort—the same behaviors that often accompany achievement. The clinically useful question is therefore not whether anxiety is good or bad, but where it sits on a continuum. Distinguishing anxiety that is mobilizing and time-limited from anxiety that is chronic and corrosive matters, because the two require different responses and because conflating them either over-pathologizes accomplished patients or tells them to tolerate a symptom that is quietly degrading their health.

About the Study

The commentary’s primary source is an ESRC-funded experimental program by Michael Eysenck and Nazanin Derakshan, popularized under the heading Anxiety’s Hidden Cost in Academic Performance and later formalized as Attentional Control Theory (Eysenck, Derakshan, Santos, & Calvo, 2007). Design and population. The work comprised controlled laboratory experiments comparing higher- and lower-anxiety adults on cognitive tasks. In one, eye movements were tracked as participants read passages seeded with irrelevant “distractor” words; in another, participants alternated between arithmetic operations such as multiplication and division to force task-switching.

Key findings. Higher-anxiety participants dwelled longer on irrelevant words and read more slowly, an effect that intensified under perceived evaluation. On the arithmetic task, anxiety did not reduce the number of correct answers but slowed completion, particularly when switching between operations.

Anxiety and performance. The central observation is a dissociation between performance effectiveness (the quality of output) and processing efficiency (the effort and time it requires). Anxiety impaired efficiency more than effectiveness: anxious individuals frequently matched their peers’ accuracy but paid a higher cognitive cost to do so.

Attention control. Eysenck and Derakshan attributed this to reduced attentional control—weaker inhibition (filtering out distraction) and weaker shifting (redirecting attention between tasks)—as anxiety tilts the balance from goal-directed toward stimulus-driven attention.

What can and cannot be concluded. The data support the claim that anxiety imposes a hidden effort cost that performance scores alone may not reveal. They do not establish that anxiety causes long-term achievement gains or losses, nor that laboratory effects transfer cleanly to careers. These were correlational group-comparison studies in non-clinical trait anxiety, not tests of clinical anxiety disorders.

What Else Do We Know?

The broader literature from 2021–2026 is largely consistent with this framework. The classic Yerkes–Dodson relationship—performance rising with arousal to an optimum, then declining—remains a useful heuristic, though contemporary work stresses that the curve depends on task complexity and on whether a situation is appraised as challenge or threat (Brady, Hard, & Gross, 2018). Attentional Control Theory continues to be supported and refined, including neurocognitive accounts of how trait anxiety shifts prefrontal attentional networks (Eysenck et al., 2023; Sun & Zhang, 2021). A 2025 systematic review of executive function in generalized anxiety disorder found impairments that are often domain-specific rather than global, with preserved accuracy alongside slowed processing—again pointing to efficiency over effectiveness (Majeed et al., 2023).

Perfectionism research clarifies the divide between productive and maladaptive forms. A large meta-analysis (Lunn et al., 2023; 416 studies, over 113,000 participants) found perfectionistic concerns—fear of failure and harsh self-evaluation—moderately correlated with anxiety, depression, and OCD symptoms, while perfectionistic strivings showed weaker, more mixed associations. Striving for perfection at work likewise yields marginal performance gains at significant well-being cost (Bellam et al., 2025).

Across professions, the picture is one of elevated burden rather than uniform pathology. Entrepreneurs report anxiety, depression, or burnout at high rates. Physicians and trainees show prevalence well above the general working population (Obeng Nkrumah et al., 2025; Shanafelt et al., 2025). Military and veteran research has shifted toward building psychological flexibility as a buffer, with acceptance-based training showing promise for resilience (Peterson et al., 2024).

Three categories should be kept distinct. Productive anxiety is situational, proportionate, and resolves with the stressor. Chronic anxiety is sustained activation that persists beyond the triggering context. Clinical anxiety disorders meet diagnostic thresholds for distress and impairment. Crucially, most of this evidence is correlational; it cannot tell us that anxiety produced success or that success produced anxiety.

What This Means

For executives, business owners, healthcare professionals, athletes, veterans, first responders, and parents carrying heavy responsibility, the practical implication is that many of the habits supporting their roles—anticipation, accountability, contingency planning—draw on the same circuitry that generates worry. This helps explain why such individuals often remain chronically “on”: when responsibility is continuous and the consequences of error feel personal and visible, the threat-detection system has little reason to stand down. Perceived accountability and uncertainty, rather than workload alone, frequently sustain the activation

The cost compounds through recovery. Sustained anxiety and short sleep are bidirectionally linked; poor sleep precedes and worsens anxiety, and blunts the brain’s overnight emotional regulation (Chai et al., 2023). The same evidence base points toward what helps: protected sleep, regular physical training, deliberate recovery, structured stress management, cognitive flexibility, and social support. None of these abolishes anxiety, and they should not be framed as a way to eliminate it; they keep arousal within the range where it remains useful rather than depleting.

The Bottom Line

Anxiety is neither purely an asset nor purely a defect. Many traits associated with achievement—responsibility, vigilance, preparation, and future-oriented thinking—overlap with the mechanisms that produce anxiety. At moderate, situational levels these can support performance; when chronic, excessive, or poorly managed, they erode efficiency, recovery, and health. Accomplished people are not necessarily suffering more than everyone else, but the evidence suggests their work often extracts a hidden cost that outcomes alone conceal. The clinical task is to recognize that cost early and to manage arousal and recovery before productive anxiety hardens into something maladaptive.

Sources (2021–2026 and Foundational)

1. Eysenck, M. W., Derakshan, N., Santos, R., & Calvo, M. G. (2007). Anxiety and cognitive performance: Attentional control theory. Emotion, 7(2), 336–353. (Foundational source underlying the primary article.) 2. Eysenck, M. W., et al. (2023). A neurocognitive account of attentional control theory: How does trait anxiety affect the brain’s attentional networks? Cognition and Emotion, 37(2). 3. Sun, P., & Zhang, S. (2021). Application and developments of attentional control theory. (Review of ACT mechanisms.) 4. Majeed, N. M., et al. (2023). Reduced processing efficiency in generalized anxiety: A reanalysis within attentional control theory. (As cited in 2025 EF/GAD systematic review.) 5. Systematic review of executive functioning in generalized anxiety disorder. (2025). Journal of Affective Disorders, S0165032725011255. 6. Brady, S. T., Hard, B. M., & Gross, J. J. (2018). Reappraising test anxiety increases academic performance of first-year college students. Journal of Educational Psychology, 110(3), 395–406. (Challenge-vs-threat appraisal and the modernized Yerkes–Dodson view.) 7. Lunn, J., Greene, D., Callaghan, T., & Egan, S. J. (2023). Relationships between perfectionism and symptoms of depression, anxiety and OCD in adults: A systematic review and meta-analysis. Cognitive Behaviour Therapy, 52(2), 121–132. 8. Bellam, S., et al. (2025). Perfectionism and work performance: A meta-analysis. Journal of Occupational and Organizational Psychology. 9. Obeng Nkrumah, S., et al. (2025). Prevalence and correlates of depression, anxiety, and burnout among physicians and postgraduate trainees: A scoping review of recent literature. Frontiers in Public Health, 13, 1537108. 10. Shanafelt, T. D., et al. (2025). Changes in burnout and satisfaction with work–life integration in physicians and the general US working population, 2011–2023. Mayo Clinic Proceedings. 11. Fortune / Founder well-being analyses on entrepreneurial anxiety, depression, and burnout. (2025). 12. Entrepreneurs’ mental health and daily recovery experiences. (2025). Small Business Economics. 13. Peterson, A. L., et al. (2024). Enhancing resiliency and optimizing readiness in military personnel through psychological flexibility training: Design and methodology of a randomized controlled trial. Frontiers in Psychiatry, 14, 1299532. 14. Acceptance and commitment therapy for enhancing mental health in military personnel: A review and meta-analysis. (2025). World Journal of Psychiatry, 15(3). 15. Chai, Y., et al. (2023). Enhanced amygdala–cingulate connectivity associates with better mood after sleep deprivation. PNAS, 120(26), e2214505120. (Sleep–anxiety regulation.)

This commentary is intended for educational and informational purposes and does not constitute medical advice or establish a clinician–patient relationship.