In alignment with SAMHIN’s mission to foster open dialogue around mental health within the South Asian community and recognize those advancing this important work, we invited Dr. Bhumika Shah—who is deeply committed to increasing mental health awareness in South Asian communities—to share her insights on anxiety in successful individuals.
Priya is a lawyer at a reputable firm. As a child, she was the one who did everything right. She did well academically, was responsible and was well liked. She coped with thoughts of not being enough or falling short by staying busy and productive. Even now, long days at work and evenings spent with her family, her mind rarely rests. She replays conversations, worries about mistakes that haven’t happened yet and only feels relieved when everything on her list is crossed off. To her, peace feels earned and fragile.
Priya’s experience reflects a pattern common in high‑functioning anxiety. It often hides in plain sight, carried by people who are very good at getting things done. Productivity becomes a way to manage internal unease, which can make the anxiety easy to miss.
This pattern is planted right from childhood. The child who feels uncomfortable playing until all their homework is done, the one who notices adults’ distress and adjusts their behavior to avoid adding to it or the one who rarely gets into trouble and is described as “easy”. As they grow older, these patterns are reinforced. For example, being praised more for grades than for effort or curiosity, receiving approval for being busy and reliable, or not being corrected when rest or play is skipped. Over time, self-worth is linked with performance.
While aspects of this are positive and help with drive and motivation, when left unchecked, it can also lead to burnout, depression and other mental health consequences. What often goes unseen is the mental vigilance that accompanies it, showing up in the body, in relationships and one’s sense of self.
At the center of this pattern is the belief that slowing down or resting will lead to unproductivity which then feels tied to self-worth. In my work with patients, I emphasize that this isn’t a failure of character, but a learned and reinforced way of coping. Recognizing these patterns is often the first step toward improving wellbeing.
By Bhumika Shah, M.B.B.S., M.D.
Child and Adolescent Psychiatry Fellow, Duke University and a dedicated SAMHIN volunteer.
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