Why So Many “High-Functioning” Kids Are Actually Struggling
By Mary Dobson, LMFT, CEDS
From the outside, many kids in Westport look like they’re doing just fine: They get good grades. Show up to practice. They’re polite, responsible, rarely disruptive. Teachers describe them as motivated. Coaches call them disciplined. Parents may even hear, “You’re lucky; your child is easy.
”Inside my therapy office, I hear a different narrative. Increasingly, the kids and teens who appear the most “high-functioning” are struggling, more than ever. They are anxious, exhausted, self-critical, and deeply afraid of falling short, even when they’re objectively succeeding. These are not kids who lack resilience or work ethic. In fact, they often have a surplus of both these qualities.
Many of the young people I work with have internalized the belief that their worth is innately tied to performance. They don’t just want to do well; they feel they must. Mistakes feel catastrophic. Slowing down feels dangerous. Rest feels undeserved. And, most critically, asking for help feels like failure.
This pattern is especially common in high-achieving communities, where opportunities are abundant, and expectations (even unspoken ones) are high. Kids absorb cultural messages around them early, and the message they are receiving loud and clear goes something like: success matters, competition is real, and falling behind is not an option. Even well-meaning praises (“You’re such a hard worker,” “You’re the smart one”) can unintentionally reinforce the idea that love and approval are predominantly earned through achievement.
What makes these struggles hard to spot is that they don’t always outwardly present like distress. Instead of acting out, these kids frequently over-control. They push harder, hide their feelings, strive for perfection. By the time their adults notice something is off, the child may already be dealing with significant anxiety, panic, burnout, disordered eating, or depression.
Parents often tell me they feel confused and scared. What’s important to know is that nothing has suddenly gone wrong. These kids have simply been coping in unsustainable ways.
In therapeutic treatment, we utilize modalities designed for this temperament, such as RO-DBT. Our goal is not to take away ambition or drive. These qualities are strengths that serve our young people well, once healthfully balanced with flexibility alongside discipline, self-compassion alongside effort, and an identity that extends beyond grades, rankings, and accolades.
Sometimes, the most supportive thing caregivers can do is to simply shift the conversation. Instead of centralizing outcomes, ask about experience. Listen non-reactively, validate, and avoid the desire to quickly fix. Check in, even (especially) when things look ‘fine.’ Remember, ‘high-functioning’ does not necessarily mean ‘well-supported.’ Kids who appear strong do not need less from us. Often, they need more.
Contact us today to schedule a consultation and begin your path toward lasting mental health and wellness.
Mary Dobson, LMFT, CEDS is a licensed marital and family therapist and CEO/Founder of LiftWell IOP-PHP and Lift Wellness Group, Westport CT-based intensive mental health programs serving children, adolescents, adults, and families. She specializes in anxiety, perfectionism, eating disorders, and high-achieving individuals. Mary presents and consults nationally to schools, treatment centers, parents, and youth. She lives locally with her husband and two children.
