Anxiety can affect a person’s thoughts, emotions, body, and behaviour.

Common experiences may include:

• Persistent worry that feels difficult to control
• Frequently anticipating that something will go wrong
• Overthinking decisions or conversations
• Repeatedly seeking reassurance
• Difficulty tolerating uncertainty
• Feeling tense, restless, or unable to relax
• Irritability
• Difficulty concentrating
• Problems sleeping
• Muscle tension
• Increased heart rate or palpitations
• Shortness of breath
• Dizziness or light-headedness
• Sweating or trembling
• Stomach discomfort or nausea
• Avoiding situations that trigger anxiety
• Excessively preparing for situations to prevent something going wrong
• Difficulty making decisions because of fear of making the wrong choice

For some people, anxiety is present almost constantly. For others, it occurs in particular situations.

The important question is not simply whether you experience anxiety, because everyone does. Rather, we consider how frequently it occurs, what triggers it, how you respond to it, and how much it interferes with your life.

“Anxiety” describes a broad range of experiences rather than a single condition.

Generalised Anxiety

Some people experience excessive and difficult-to-control worry across multiple areas of life, such as work, health, finances, family, relationships, or the future.

The topic of worry may change, but the underlying pattern of anticipating problems and attempting to obtain certainty remains persistent.

Social Anxiety

Social anxiety involves significant fear of social situations in which a person believes they may be judged, embarrassed, rejected, or negatively evaluated by others.

This may lead to avoiding social interactions, presentations, meetings, dating, eating in public, or other situations involving perceived scrutiny.

Panic Attacks and Panic Disorder

A panic attack involves a sudden surge of intense fear or discomfort accompanied by physical and psychological symptoms.

After experiencing panic attacks, some people become increasingly concerned about having another one. They may begin monitoring bodily sensations or avoiding places and situations where they fear panic might occur.

Specific Fears and Phobias

Some people experience intense anxiety in response to particular objects or situations, such as animals, heights, flying, medical procedures, or enclosed spaces.

When avoidance begins significantly interfering with everyday life, psychological treatment may be helpful.

Different anxiety presentations require different formulations and treatment strategies. This is one reason why psychological treatment should involve more than simply learning generic relaxation techniques.

At People Psychological Solutions, our clinical psychologists work with individuals experiencing anxiety, excessive worry, panic, avoidance, and related difficulties.

The first step is understanding how anxiety operates for the individual.

Depending on your circumstances, this may involve:

• Understanding the situations, thoughts, or sensations that trigger anxiety
• Exploring the content and pattern of worry
• Identifying avoidance and other coping behaviours
• Understanding reassurance seeking or checking
• Exploring responses to uncertainty
• Assessing panic symptoms where relevant
• Understanding physical symptoms associated with anxiety
• Exploring the impact on work, relationships, studies, and everyday functioning
• Using standardised psychological measures where clinically appropriate
• Understanding relevant life circumstances and stressors
• Considering other psychological or medical conditions
• Developing an individualised psychological formulation and treatment plan

Two people experiencing anxiety may have very different processes maintaining their difficulties.

Understanding those processes allows therapy to target what is keeping the anxiety going, rather than simply trying to make the person feel less anxious temporarily.

Anxiety disorders are treatable.

Cognitive Behavioural Therapy (CBT) is among the most extensively researched psychological treatments for anxiety disorders and is recommended within major evidence-based clinical guidelines. Depending on the particular anxiety difficulty, treatment may incorporate cognitive strategies, behavioural experiments, exposure, and other interventions.

At People Psychological Solutions, treatment is individualised according to the person’s difficulties and treatment goals.

Therapy may involve:

• Understanding patterns that maintain anxiety
• Identifying unhelpful predictions and assumptions
• Developing more balanced ways of evaluating feared situations
• Reducing avoidance
• Gradually approaching feared situations
• Developing greater tolerance of uncertainty
• Reducing excessive reassurance seeking
• Reducing behaviours used primarily to prevent feared outcomes
• Learning different ways of responding to worry
• Developing strategies for managing panic symptoms
• Improving problem-solving where concerns involve problems that can realistically be addressed
• Re-engaging with activities that anxiety has restricted
• Developing strategies for maintaining progress

Treatment does not necessarily aim to eliminate anxiety altogether.

Some anxiety is a normal and useful part of life. Instead, psychological treatment can help people respond differently to anxiety so that fear and worry exert less control over the choices they make.

Avoidance makes sense when something feels threatening.

If giving a presentation makes someone extremely anxious, cancelling it provides immediate relief. If travelling alone causes panic, staying home reduces anxiety. If uncertainty about a relationship becomes unbearable, repeatedly asking for reassurance may temporarily provide certainty.

The difficulty is that short-term relief can reinforce the same response.

The person has fewer opportunities to discover whether the feared outcome would actually occur or whether they could cope with anxiety without escaping or seeking reassurance.

Over time, the range of situations that feel manageable can become increasingly restricted.

For this reason, evidence-based treatments for several anxiety disorders involve gradually approaching rather than continually avoiding feared experiences. This is undertaken collaboratively and according to the individual’s formulation and treatment plan.

The goal is not to force someone into overwhelming situations. It is to help them gradually learn that anxiety can be experienced and managed without allowing it to dictate their behaviour.

Medication can be appropriate for some anxiety disorders and some individuals.

The decision to use medication depends on factors including the particular anxiety disorder, severity, previous treatment, other health considerations, and the person’s preferences.

Clinical psychologists do not prescribe medication.

Where medical assessment or medication may be beneficial, we may recommend consultation with a psychiatrist or another appropriately qualified medical practitioner.

Psychological therapy can also take place alongside medical treatment where appropriate.

Anxiety commonly occurs alongside other psychological difficulties, including:

• Depression
• OCD
• Trauma-related difficulties
• ADHD
• Autism
• Substance-use difficulties
• Sleep difficulties
• Relationship difficulties

Anxiety symptoms can also occur within several other psychological conditions.

For example, repetitive worry in Generalised Anxiety Disorder is not necessarily the same psychological process as obsessions in OCD, while social difficulties associated with autism are not necessarily explained by social anxiety.

Understanding these distinctions can be important because the appropriate treatment may differ.

Our psychologists therefore consider the person’s broader psychological functioning rather than treating every experience of anxiety in the same way.