Balancing Excellence and Well-being: An Occupational Perspective on Anxiety Among Elite Performers

Abstract

Background: Elite performers, such as business executives, athletes, and surgeons, face distinctive role demands that contribute to anxiety and psychological stress. Although prior research has explored anxiety within these groups individually, little is known about anxiety among high performers collectively or from an occupational lens. Aims/Objectives: This narrative review synthesizes current evidence on how individuals in high-performance occupations experience anxiety and examines the impact on occupational engagement, role fulfillment, and well-being. Methods: Twenty-eight peer-reviewed articles published between 2015 and 2025 were analyzed from CINAHL, PubMed, and Google Scholar, focusing on executives, elite athletes, and surgeons. Key Findings: Across domains, anxiety emerged as a pervasive and consequential experience shaped by perfectionism, role imbalance, and continual evaluation inherent to high-stakes performance. Effective strategies identified include adaptive coping strategies, such as mindfulness and mastery coping, as well as supportive work environments and engagement in restorative or serious leisure occupations. Conclusions: These findings highlight the potential for occupational therapy to address the contextual and role-based contributors to anxiety, promoting optimal performance and psychological well-being in high-demand professions.