The Hidden Overlap Between High Achievers, Athletes, Eating Disorders, and Perinatal Mental Health
On the surface, these groups may not seem connected.
A driven executive. A competitive athlete. Someone struggling with disordered eating. A new mother navigating postpartum anxiety.
But in my years of experience as a licensed mental health therapist, the overlap between these experiences in the therapy room is often profound.
Many individuals in these populations share common personality traits, coping mechanisms, and nervous system patterns that can leave them vulnerable to anxiety, burnout, depression, body image distress, and emotional exhaustion.
The Pressure to Perform
High achievers and athletes are often praised for discipline, productivity, self-control, and perseverance. These traits can absolutely be strengths. But over time, they can also become tied to self-worth or lead people to push themselves to the point of exhaustion or burn out.
Many people begin to internalize messages such as:
“I’m valuable because I always perform well.” or “there is no room for mistakes”
“Rest means laziness.”
“I should always be able to push through.”
“If I’m struggling, I’m failing.”
Pregnancy and parenthood can suddenly disrupt these identities. The body changes. Energy changes. Productivity changes. Control becomes less predictable. I always tell my clients, no amount of doing things “perfectly” will give you a baby that sleeps through the night or doesn’t have waves of fussiness or sickness. For individuals who are used to excelling, this transition can feel deeply destabilizing.
Similarly, eating disorders often develop in environments where control, achievement, appearance, or perfectionism become emotionally loaded or reinforced. Restriction, overexercise, or obsessive behaviors can begin as attempts to cope with stress, anxiety, uncertainty, or feelings of inadequacy.
Perfectionism as a Coping Strategy
Perfectionism is one of the strongest threads connecting these populations.
Perfectionism is not simply “wanting to do well.” It often involves:
Fear of failure
Fear of disappointing others
Harsh self-criticism
Difficulty tolerating mistakes
Constant comparison
Feeling “never good enough”
Athletes may feel pressure to optimize performance and not make any mistakes. High achievers may tie identity to success or career growth. Individuals with eating disorders may pursue impossible standards around food or body image. New parents may feel crushing pressure to be the “perfect” mother, partner, or “do it all” with an impossible expectation of work-life balance.
In all of these cases, perfectionism can become a way to manage anxiety and create a sense of safety or control.
The Body Becomes the Battleground
Another common overlap is hyperawareness of the body.
Athletes are trained to monitor and evaluate their bodies constantly. Their body is their tool and often a focus of constant improvement whether that’s skill, strength, endurance. It can be their greatest strength as well as feel like the enemy or hindrance at times like injury.
People with eating disorders or disordered eating may become preoccupied with body image, food, or physical control.
For pregnant and postpartum individuals, dramatic body and identity changes can trigger grief, shame, identity confusion, or vulnerability, particularly if previous self-worth was connected to appearance, fitness, or performance.
High achievers under chronic stress often disconnect from bodily needs entirely. They are used to pushing themselves to the limit whether that’s a lack of rest, fuel, or play.
Many people in these groups struggle to experience their body as something to listen to rather than something to manage, discipline, or “fix.”
This can create a difficult relationship with:
Hunger and fullness cues
Rest
Recovery
Weight changes
Physical limitations
Hormonal shifts
Injury or illness
Identity and Loss of Control
One of the most emotionally difficult experiences for many high-functioning individuals is encountering situations where effort alone cannot solve the problem. We are used to being able to work our way through a challenge and at least to some degree, the more effort leading to better outcomes.
Pregnancy, postpartum recovery, infertility, injury, burnout, anxiety, depression, and eating disorder recovery all involve large amounts of uncertainty and a loss of control. For someone whose identity has long been built around achievement or resilience, this can feel terrifying.
Therapy often becomes a space to explore questions like:
Who am I when I’m not performing?
Am I allowed to have needs?
What happens if I slow down?
Can I still be worthy if I’m struggling?
How do I care for myself without guilt?
Why These Struggles Often Go Unnoticed
Because many people in these populations appear “high functioning,” their suffering is often minimized or just not noticed by others and by themselves. In fact, suffering is probably not even a term they would use. Many become experts at masking. They may continue succeeding academically, professionally, athletically, or socially while privately experiencing:
Anxiety
Obsessive thoughts
Emotional numbness
Burnout
Depression
Shame
Disordered eating
Postpartum distress
In fact, the same traits that help people excel externally like discipline, endurance, independence, and high standards can sometimes make it harder to recognize when support is needed because they are the same traits that are praised by society and what has allowed them to achieve great things in their career, sport, and build full lives.
What Does Therapy for a High Achiever Look Like?
Recovery and healing are rarely about becoming less motivated, less successful, or less driven.
Instead, therapy often helps people develop:
Self-compassion (it’s okay if this feels silly right now, I promise its important though)
Flexibility (this is a hard one, but cognitive and behavioral flexibility is one of the greatest predictors of psychological well-being)
Emotional awareness (High achievers are often used to monitoring those around them and using external cues to measure how they are doing, so turning inwards and practicing noticing and naming our emotions can sound simple, but have a profound impact on one’s ability to meet their own needs)
Healthier boundaries (and tolerating the discomfort that comes with this and the people pleasing part that is screaming internally)
Nervous system regulation (let’s find a new baseline and practice slowing down and taking care of our body)
Sustainable ambition (love the ambition! Let’s just find ways to make it last and not burn out)
A more peaceful relationship with the body (this means practicing, acceptance, gaining insight into and challenging internalized diet culture messaging, expanding exposure to body diversity)
Permission to rest and receive support (once again, slowing down and accepting support even when it's uncomfortable or you might be capable of doing it on your own)
The goal is not to eliminate achievement or ambition or the parts of you that have gotten you to where you are today. It’s to build a life where worth is not entirely dependent on performance/success. The goal is to appreciate and honor the qualities that have served you well and identify times where there is room to let other parts of you that get less time or praise, shine through too, like playfulness, rest, joy, curiosity, compassion, and trust!
You Don’t Have to Earn Support
Many high achievers wait until they are completely overwhelmed before seeking help, or maybe you are so used to being on the grind of self-improvement that you have been in therapy many times before.
But therapy is not only for crises. It can also be a place to better understand longstanding patterns, reconnect with yourself, and build healthier ways of coping before burnout takes over.
If you see yourself in any of these experiences, you are not alone and you do not have to keep carrying it all by yourself.
Why Do I Care About Working with High Achievers in Philadelphia?
Not only do these populations have underlying overlap in the qualities these individuals have and the challenges they face, for me it's personal. In some way, I am passionate about serving each of these populations.
I was a college athlete myself. I have recovered from an eating disorder and am still working to dismantle diet culture messaging in a culture where thinness is more prevalent than ever. I deeply resonate with being an independent, driven, high-achiever and have worked to both value these parts of me and functions they have served and am still constantly working on allowing these parts to take a step back in aspects of my life. My feminist values and strong desire to support moms and their relationship with themselves in a world that devalues them is stronger than ever.
If you resonate with one or more of these traits and want to work with someone who gets it, reach out here!
Services offered:
Therapy for Eating Disorders/Disordered Eating in Philadelphia
Therapy for Women and High Achievers
Therapy for Perinatal Mental Health: Pregnancy
Therapy for Perinatal Mental Health: Postpartum
Therapy for Perinatal Mental Health: Perinatal Loss