Anxiety Therapy for High Achievers

No, though it's a very real experience. High-functioning anxiety isn't in the DSM-5; it's an informal term for anxiety that stays hidden behind strong performance. What's underneath it sometimes meets criteria for generalized anxiety disorder, social anxiety disorder, or panic disorder, and sometimes it doesn't meet criteria for anything while still taking a real toll. A clinical psychologist can assess which is happening.

There isn't one right answer for everyone, and it depends partly on what you've already tried. Structured approaches like CBT teach skills for managing anxious thoughts and have strong research support. We offer psychodynamic therapy, which looks at where the anxiety came from and what it's been doing for you, and it tends to suit people who already know the coping skills and want to understand why the anxiety keeps coming back anyway.

It can be treated. Even when someone has a naturally anxious temperament, how much of their life the anxiety runs is usually far more changeable than they assumed. For many people, the vigilance started as a sensible way to stay safe or approved of early in life, and patterns that were learned can be understood and revised.

This is one of the most common worries we hear, and we're not trying to make you less ambitious. Drive and anxiety often feel fused because they've shown up together for so long, but they aren't the same thing. What we work on is the scanning and self-punishment that keep going when nothing's actually wrong; what you do with your ambition after that is yours to decide.

Stress is usually a response to a specific pressure, and it eases once the pressure passes. Anxiety tends to outlast its trigger or appear without an obvious one, and it often attaches itself to the next thing as soon as the last one resolves. If you feel just as keyed up after the deadline as you did before it, that's closer to anxiety.

Yes. Overthinking and rumination are some of the most common reasons high achievers come to us. Rather than trying to argue you out of the replaying, we look at what it's trying to accomplish, which is often certainty about how you were seen, and what feeling it's helping you avoid. Once that's clearer, the loop usually has less of a grip.

Yes. We're licensed clinical psychologists, and we treat generalized anxiety, panic attacks and panic disorder, social anxiety and performance anxiety, and anxiety that overlaps with depression, burnout, perfectionism, or OCD. If what you need is a higher level of care than weekly outpatient therapy, we'll tell you honestly and help you find it.

Yes, and they often do. Years of running on vigilance can wear down into exhaustion, flatness, or a sense that nothing you achieve really registers, and some people move from anxious to numb without noticing the shift. We assess for both and treat them together, because they're usually part of the same story.

Medication can help a lot of people with anxiety, and medication and therapy often work well together. We're psychologists, so we don't prescribe. If it seems like medication could help, we'll say so, and you can talk it through with a psychiatrist or your own physician; therapy then works on the patterns that medication alone doesn't usually address.

CBT is well supported for anxiety, and for plenty of people it's the right choice. Many of our clients have already done structured, skills-based work and found that they understood the tools but the anxiety kept finding its way back. Psychodynamic therapy works on the origins and functions of the anxiety, including how it shows up between us in the session. Both are legitimate, and which fits depends on what you've tried and what you're looking for.

We won't pretend to know on day one. This is longer-term depth work, and most of our clients stay with us for at least a year, many considerably longer, because the patterns we're working on usually took decades to form. We pay attention the whole way to whether the work is working, and we talk about it with you directly.

There's no threshold of suffering you need to clear first. Almost nobody who calls us is in crisis; most are doing well by every external measure, which is a big part of why they waited so long. If something in you keeps raising the question, that's reason enough for a consult call.

Yes. Medicine asks you to hold real uncertainty about real patients and then trains you to look unbothered while you do it, so anxiety often hides inside thoroughness: the extra test you order just in case, the chart you reopen at home, the case you're still replaying weeks after M&M. Dr. Annia Raja is married to a physician in a demanding specialty, and Dr. Chaim Rochester works with physicians across a wide range of specialties. Our physicians page covers this in more detail, including the fear of being seen seeking help.

Yes. For executives, anxiety often shows up as the decision you keep relitigating long after it's made, the team you can't fully hand things to, and the sense that you can't let anyone see you uncertain, because everyone's reading your face to decide how worried they should be. Our executives page has more.

Yes. Finance pays you to sit with uncertainty, in a culture where visible nerves read as weakness and your number gets judged every bonus season, so anxiety can live inside the job for years without anyone noticing, including you. Dr. Annia Raja worked in investment banking at Morgan Stanley and knows how that environment shapes people. Our finance and investment professionals page has more.

Yes. As a founder, you often hold the company's risk in your own body: the investor update you've rewritten four times, the hire you're not sure about, and the decisions nobody else can make for you. The anxiety tends to merge with responsibility, so letting any of it go can feel irresponsible. Our entrepreneurs page has more.

Yes. Law rewards anticipating every way something could go wrong, which makes it a very comfortable home for anxiety, and the same habit that wins the case keeps running at dinner, on vacation, and at 3am before a filing. Our lawyers page has more.

Yes. Everything discussed in our sessions is protected by strict confidentiality laws, with a few very narrow legal exceptions (primarily situations involving imminent risk of serious harm), which we'll walk you through before we begin. Because we don't bill insurance directly, we aren't required to send diagnoses or session information to an insurer for authorization; if you choose to pursue out-of-network reimbursement, a diagnosis code appears on the claim, and that's your choice to make.

No. Helm Psychology is a cash-pay practice. We can provide documentation for out-of-network reimbursement if your plan offers it, and our main FAQs page has more on how that works.

Yes. All of our anxiety therapy is online. Dr. Annia Raja sees clients in California, Texas, Virginia, and the 40+ PSYPACT states and DC, and Dr. Chaim Rochester sees clients in California, Texas, and Virginia. You don't need to live in Los Angeles, and most of our clients don't.

A free 15-minute consult call. You describe what's been happening, we tell you honestly whether we're the right fit and which therapy format makes sense, and you ask whatever you want about how we work. If we aren't the right practice for you, we'll say so and point you somewhere else.