The Anxiety of Choosing: Why Decision-Making Feels So Exhausting for High Achievers
- Jennifer Olson-Madden, PhD
- May 28
- 6 min read
There is a particular kind of exhaustion that doesn’t come from doing too much. It comes from trying to choose correctly. You see it in people who spend weeks researching a decision they already emotionally understand. People who replay conversations in their heads searching for the “right” response. Professionals who feel paralyzed by career pivots, relationships, parenting choices, or financial decisions, not because they are incapable, but because the emotional weight of choosing feels unbearable.
In therapy, many high-achieving adults describe this experience as anxiety. But underneath the anxiety is often something more nuanced: a profound fear of uncertainty, regret, and irreversible consequences. This is often because we live in a culture that treats decision-making like optimization. We are taught that if we gather enough information, work hard enough, or become self-aware enough, we should be able to eliminate mistakes from our lives.
But human life does not work that way.
And for people already struggling with burnout, perfectionism, and chronic stress, the pressure to “choose correctly” can quietly become psychologically consuming.
Why Modern Decision-Making Feels So Emotionally Heavy
In his work on regret, Daniel Pink argues something deeply important: regret is not evidence that we are failing at life. It is evidence that we are human. Yet many people have developed a relationship with regret that feels intolerable. They experience even the possibility of future regret as something catastrophic to avoid at all costs.
This creates a subtle but powerful trap:
"If I make the wrong decision, I will ruin things."
"If I regret something later, it means I failed."
"If I choose incorrectly, I may not recover emotionally."
For perfectionistic individuals, decision-making stops being about values or growth and becomes about emotional self-protection. And burnout intensifies this process.
When people are chronically depleted, their nervous systems often lose flexibility. Ambiguity begins to feel threatening. Small choices start carrying enormous emotional weight because the brain is already overwhelmed.
This is one reason burnout frequently shows up as:
chronic overthinking
inability to commit
emotional paralysis
reassurance-seeking
compulsive research
fear of closing doors
avoidance disguised as “being responsible”
Many clients assume the problem is indecisiveness. Often, the deeper issue is that they no longer trust themselves to survive discomfort.
The Hidden Relationship Between Burnout and Uncertainty
In The Good Enough Job, Simone Stolzoff explored the emotional consequences of tying identity too tightly to achievement and productivity. One of the most psychologically important ideas in his work is that modern culture increasingly demands certainty from people living in fundamentally uncertain conditions.
We are expected to:
have a five-year plan
know our purpose
optimize our careers
make perfect parenting decisions
build ideal relationships
prevent burnout while remaining highly productive
create meaningful lives without wasting time
The result is that uncertainty starts feeling like failure. But psychologically healthy decision-making has never required certainty. It requires tolerance for uncertainty. This distinction matters enormously.
Many anxious, perfectionistic, or burned-out individuals spend years trying to achieve emotional certainty before acting. It may look like:
“I just need to know this is the right choice.”
“I need to feel fully confident first.”
“What if I regret it later?”
“What if there’s a better option?”
The nervous system interprets uncertainty as danger, and the brain responds by attempting to eliminate ambiguity entirely. But uncertainty cannot be eliminated from human life, only avoided. And unfortunately, avoidance often becomes the very thing that deepens anxiety.
Why High Achievers Struggle With Decisions
Many high-achieving adults were rewarded early in life for being thoughtful, responsible, insightful, prepared, and successful. These strengths become part of identity. But over time, those same strengths can become fused with fear. You might tell yourself, "If I make a mistake, I lose safety." You may believe you will lose worth if you disappoint someone. Perhaps you believe at a core level that you will lose identity if you fail. Or maybe you say, "If I choose wrong, I lose control."
Decision-making then becomes emotionally loaded far beyond the actual decision itself.
I see this clinically in my private practice and It is particularly common in people experiencing:
high-functioning anxiety
executive dysfunction or ADHD overwhelm
caregiving stress
identity shifts
chronic emotional exhaustion
The issue is rarely that these individuals are incapable of making good decisions. The issue is that they are trying to make decisions without emotional permission to be imperfect, uncertain, or human.
ACT and the Psychology of Choosing
One of the most powerful frameworks from Acceptance and Commitment Therapy (ACT) is the idea that values—not certainty—guide meaningful action. ACT does not ask: “What choice guarantees no pain?” Instead we explore: “What choice moves you toward the kind of life you want to build?”
This changes decision-making dramatically. Because psychologically flexible people understand the following:
every decision includes tradeoffs
uncertainty is unavoidable
discomfort is survivable
regret does not invalidate a life
identity is not determined by one choice
clarity often emerges after movement—not before it
In therapy, this often means helping clients move away from impossible questions like:
“What if this is wrong?”; “How do I know for sure?”; or, “What if I regret this?” towards questions like: “What matters to me here?”; “What kind of person do I want to be?”; “What choice aligns with my values?”; and, “Can I tolerate uncertainty while still moving forward?”
The Truth About Regret
One of the most meaningful insights from Daniel Pink’s work is that people often regret inaction more deeply than imperfect action. Not every time. But often.
He found that the most common things that people regret are:
not saying what mattered
staying too long in environments that depleted them
abandoning creativity
waiting for certainty that never arrived
choosing safety over authenticity
postponing rest, joy, or connection indefinitely
This does not mean impulsivity is the answer, but it surely means that avoidance is not neutrality. Indeed, avoidance is still a choice. And many burned-out individuals remain stuck not because they lack intelligence, but because they have learned to equate uncertainty with danger.
Learning to Trust Yourself Again
Burnout recovery is not just about stress reduction. Often, it is about rebuilding self-trust.
In therapy, I help my clients realize that they can and do survive discomfort, that they can recover from their mistakes, they can tolerate ambiguity and make decisions without perfect certainty, and that they don't have to "optimize" themselves to deserve a meaningful life. As Pink reminds us, you can feel regret without collapsing, and moreover regret can move you towards what matters to you.
This is deeply countercultural work, especially in environments that reward overthinking, productivity, and constant self-improvement. Emotionally healthy decision-making is not about becoming perfectly certain, it is about becoming more psychologically flexible. This means that we get more values-oriented, more willing to live fully inside the reality that uncertainty is part of being human. And perhaps most importantly: we that your worth does not depend on always choosing correctly.
Therapy for Anxiety, Burnout, and Perfectionism in Denver, CO
If decision-making has begun to feel emotionally exhausting, therapy can help you better understand the patterns beneath anxiety, perfectionism, chronic overthinking, and burnout.
At Dr. Jennifer Olson-Madden, PhD, LLC, I work with high-achieving adults navigating anxiety, burnout, identity shifts, perfectionism, and chronic stress using evidence-based approaches including ACT, CBT, mindfulness, and integrative psychological care.
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FAQ Section
Why do anxious people struggle with decisions?
Anxiety often increases intolerance of uncertainty, making decisions feel emotionally threatening rather than simply practical.
Can burnout affect decision-making?
Yes. Burnout can impair cognitive flexibility, increase emotional overwhelm, and contribute to decision fatigue, overthinking, and avoidance.
What is decision paralysis?
Decision paralysis occurs when fear, overwhelm, perfectionism, or uncertainty make it difficult to choose or take action.
How does ACT help with decision-making?
ACT helps individuals make choices based on values rather than fear or certainty-seeking, improving psychological flexibility and reducing avoidance.
Why do perfectionists overthink decisions?
Perfectionists often fear mistakes, regret, criticism, or loss of control, causing decisions to feel emotionally high-stakes.
About the Author
Dr. Jennifer Olson-Madden is a licensed psychologist in Denver, CO specializing in anxiety treatment and burnout recovery. For more information about her work, visit www.drolsonmadden.com or visit her blog and resources page for helpful information about these and other topics.
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