A personal essay by Nysa Lilani — published in partnership with Shakti Therapy & Healing Services, Los Angeles
Written by: Nysa Lilani | Publisher: Shakti Therapy & Healing Services
Key Takeaways
- Looking okay is not the same as being okay. High-functioning anxiety often hides behind achievement, busyness, and the ability to keep going, especially for South Asian students navigating academic pressure, family expectations, and cultural identity simultaneously
- Imposter syndrome and burnout are not character flaws. For many first-generation and South Asian premed students, the pressure to perform is not just personal, it is relational and cultural. The exhaustion underneath is real, even when nothing technically shows
- Healing starts with honesty, not more output. Recognizing that you do not have to earn rest by burning out first is not weakness, it is the beginning of a different relationship with yourself. Support is available, including culturally responsive therapy in Los Angeles
When Ambition and Anxiety Look the Same from the Outside
For a long time, I believed that feeling overwhelmed was simply part of being ambitious.
At UCLA, my life seemed full in the best possible way. I was juggling tough premed classes, UCLA Nashaa, two jobs, internships, lab work, competitions, family, friends, and always thinking about the future. On my resume, it looked impressive. It looked like discipline, drive, and passion. And in many ways, I really thought it was. I couldn’t deny that I enjoyed what I was doing. I loved to dance, loved to bond with patients, loved to contribute to meaningful research, and loved to study.
But just because you love something does not mean it cannot wear you out.
Some days, I went from class to work to rehearsal to studying without ever really stopping to check in with myself. I simply got good at checking items off my agenda without stopping to consider why I did them in the first place. I answered messages, kept my commitments, smiled when I was supposed to, and made it seem like I was fine. The constant productivity became its own kind of armor. Even when I felt tired, stressed, or unsure if I belonged in the places I had worked so hard to reach, I still tried to act like everything was normal.
That might have been the hardest part: not just carrying everything, but doing it without anyone noticing.
The Hidden Cost of Comparison Culture in Competitive Academic Spaces
Being premed often means dealing with a quiet culture of comparison. There is always someone doing more: more research, more clinical hours, more leadership, better grades, or just more confidence. Even when I was busy, I still felt like I was behind. Surrounded by the most academically driven, ambitious, and goal-driven students made me question whether I was capable enough to make it out. That overthinking, replaying every interaction, every grade, every missed opportunity, was not a study habit. It was high-functioning anxiety wearing the costume of ambition. Imposter syndrome made every achievement feel short-lived and every mistake feel like proof that I was not enough.
At the same time, dance and competition brought their own kind of pressure. Nashaa gave me community, creativity, and joy, but it also took a lot of time, energy, leadership, and emotional effort. I wanted to be dependable for my team. I wanted to be there for my friends and family. I wanted to do well in lab, at work, in internships, and in class. The people pleasing was constant, not because I was a pushover, but because disappointing anyone felt genuinely dangerous. The fear of disappointing family ran underneath everything, even when they never said a word. I wanted to be everything for everyone, while still trying to be okay myself.
Why Staying Busy Is Not the Same as Being Okay
But mental health does not go away just because you are busy. In fact, it can be easier to ignore when there is always something else to do.
Over time, I realized that looking okay is not the same as actually being okay.
Getting things done does not mean you are at peace.
Being busy does not mean you are handling everything well.
The inability to rest, not just physically but mentally, was one of the clearest signs something was off. Even when I had a free hour, my brain was already rehearsing what came next. And just because you are grateful for your opportunities does not mean you cannot feel overwhelmed by them. Accepting this was difficult, but at the end of the day, necessary.
What High-Functioning Anxiety Actually Looks Like. It Is Not Always What You Expect
I also learned that mental health struggles are not always obvious or dramatic. Sometimes they show up as exhaustion, sometimes they look irritable or even quiet, sometimes it is the overthinking at 2am about a conversation that happened three days ago, or the perfectionism that makes you redo something four times even when the first version was fine. It might look like complete silence or crying over something small, because it is really about something bigger. Sometimes it means doing everything you are supposed to do, but feeling disconnected from yourself truly.
What Healing Has Actually Looked Like for Me
For me, healing has meant being more honest with myself. It means admitting when I am doing too much, even if I can still manage it. It means realizing that I do not have to earn rest by burning out first, that the inability to rest is not a personality trait, it is something that can change. It also means letting the people close to me see more than just the put-together version of myself. It means I can say no to opportunities when I know I don’t have the bandwidth anymore.
You Are Worthy Beyond What You Achieve
I am still figuring out how to balance ambition with self-kindness. I still care a lot about my goals, my family, my friends, my education, and the communities I belong to. But I am trying to remind myself that I have value even when I feel like I am not achieving, being the best premed, the best dancer, the best employee, or the best daughter. The perfectionism that once felt like a superpower has slowly started to feel like a cage, and I am learning the difference. I am not only worthy when I am helpful, impressive, or calm. I am worthy at my highest peaks and my lowest troughs, and accepting that has redefined my perspective on life.
Sometimes, the bravest thing you can do is not keep pushing. Sometimes, it stops long enough to say, “I am not okay right now, but I want to be.”
Where Mental Health Really Starts: Not Performing Wellness, But Telling the Truth
Maybe that kind of honesty is where mental health really starts, not by pretending everything is fine, but by letting ourselves be human beneath all the roles we try so hard to fill. Maybe we consider breaking the stigmas around mental health and therapy for ourselves instead of trying to fix others. Maybe it’s by scheduling free consultations with South Asian therapists like the ones at Shakti Thearpy at their Redondo Beach and Culver City locations. Maybe it’s saying, it’s okay to not be okay.
Therapist Perspective — Why High-Functioning Anxiety Is So Common Among South Asian Students
What Nysa describes is something we recognize immediately, not just clinically, but personally at Shakti Therapy. As a South Asian woman who immigrated to the United States, I grew up in environments where achievement was not just encouraged. It was the primary language of love and belonging.
For many South Asian students navigating competitive academic paths, high-functioning anxiety is not a disorder that arrives from nowhere. It is a nervous system response that was shaped over years by households where rest felt selfish, by cultural messaging that tied worth to output, and by the quiet but constant weight of knowing that other people’s sacrifices made your opportunity possible. The fear of disappointing family is not irrational. For many of our clients, it was once a very rational response to a very real set of stakes.
What makes this pattern particularly difficult to recognize is that it looks so much like success. Perfectionism, constant productivity, overthinking, and people pleasing are not red flags in premed culture, they are rewarded. Students are praised for exactly the behaviors that are quietly exhausting them.
Clinically, what I see most often is an inability to rest that goes beyond time management. It is not that these students cannot find a free hour. It is that when they do, their nervous system does not know how to downshift. The body stays alert, scanning for the next threat, the next expectation, the next thing that needs doing. That is a nervous system pattern, not a character flaw and it responds well to therapy when the approach matches where the pattern actually lives.
At Shakti Therapy in Los Angeles, we work with South Asian students, premed and graduate students, first-generation professionals, and high achievers who are functioning at a high level externally while quietly running on empty. Our approach is culturally responsive, meaning you do not need to spend your first three sessions explaining your family dynamics, your cultural context, or why you feel guilty for being here. We already understand that landscape. The work can begin from a much deeper starting point.
If Nysa’s words landed somewhere in you, that recognition is worth paying attention to. A free 15-minute consultation is available at, no commitment, no pressure, just a conversation about whether we are the right fit.
About the Author:
Nysa Lilani is a premed student at UCLA navigating the intersection of ambition, identity, and mental wellness. This essay reflects her personal experience. It is published in partnership with Shakti Therapy & Healing Services, where clinicians specialize in high-functioning anxiety, burnout, and culturally responsive care for South Asian and first-generation individuals in Los Angeles.
Frequently Asked Questions (FAQ)
Q: What is high-functioning anxiety and how does it show up in students?
High-functioning anxiety describes a pattern where anxiety coexists with high performance. For students, especially those in competitive academic environments like premed programs, it often looks like checking every box while feeling chronically overwhelmed, exhausted, or like you are never doing enough. It is not the same as a formal anxiety disorder diagnosis, but the internal experience is real and worth taking seriously. Common signs include inability to rest without guilt, constant comparison to peers, difficulty saying no, and feeling disconnected from yourself despite appearing capable to everyone around you.
Q: Is it normal to feel burned out as a high-achieving student even when you love what you do?
Yes, and this is one of the most important things to understand about burnout. Loving what you do does not protect you from exhaustion. In fact, passion can make it harder to notice or name burnout, because the internal narrative often says “I chose this” or “I should be grateful.” For South Asian students carrying the weight of family expectations alongside academic and extracurricular demands, this is especially common. Burnout is not about weakness or ingratitude, it is about a nervous system that has been running without adequate rest for too long.
Q: How does imposter syndrome affect South Asian and first-generation students?
Research consistently shows that imposter syndrome is particularly prevalent among students from minority backgrounds, including Asian American and first-generation students, who face the additional pressure of cultural and family expectations tied to academic success. The experience of doubting your own achievements while simultaneously feeling like you need to do more is not a personal failing, it is a predictable response to environments where the stakes feel extraordinarily high and the cost of falling short feels deeply personal.
Q: When should a student consider therapy for anxiety or burnout?
If you are consistently functioning but feeling disconnected from yourself, unable to rest, cycling through the same self-critical thoughts, or carrying a sense that something is wrong even when nothing is technically falling apart, those are all meaningful signals worth paying attention to. You do not need to be in crisis to seek support. Therapy can help before things reach a breaking point, and culturally responsive care, where you do not have to spend sessions explaining your background, is available in Los Angeles at Shakti Therapy & Healing Services.
Q: Does Shakti Therapy offer support for South Asian students dealing with anxiety or burnout?
Yes. Shakti Therapy in Los Angeles specializes in culturally responsive care for South Asian individuals, first-generation adults, and high achievers navigating the intersection of ambition, identity, and mental health. We offer in-person therapy in Culver City and Redondo Beach, and virtual sessions throughout California. A free 15-minute consultation is available to help you find the right fit.
Q: How do I book a consultation or therapy session?
You can easily schedule your journey by booking a consultation call directly through our website’s booking links. We offer specialized appointments for individual therapy, including sessions with our founder, Ektha Aggarwal, and our dedicated team members.
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