Anxiety

Anxiety is the body’s response to perceived threat, a mix of worry, physical tension and unease that shows up when the mind expects danger that may not be there. For some people it passes quickly. For others it settles in, colouring decisions, sleep and relationships until it becomes hard to separate from daily life.

Everyone feels anxious sometimes. A job interview, a difficult conversation, a health scare all produce a spike of nerves that fades once the situation resolves. Anxiety becomes a clinical concern when it is disproportionate to the actual risk, when it persists well beyond the trigger, or when it starts to shrink the things you feel able to do. That distinction, between ordinary worry and a pattern that has taken hold, is usually the starting point for any assessment.

Symptoms of anxiety

Anxiety shows up differently from person to person, but it tends to cluster into three areas.

Physical symptoms

A racing heart, tight chest, shallow breathing, muscle tension, restlessness, nausea and disturbed sleep are all common. Many people experiencing anxiety for the first time go to their GP or A&E convinced something is physically wrong, only to be told the cause is anxiety.

Thinking patterns

Anxious thinking often involves overestimating danger and underestimating your ability to cope with it. This can look like constant “what if” scenarios, difficulty concentrating, a mind that won’t settle, or a persistent sense of dread that has no obvious source.

Behaviour

Over time, anxiety tends to shape behaviour. People avoid situations, places or conversations that trigger it, seek frequent reassurance from others, or develop small rituals meant to feel safer. These responses bring short-term relief but usually keep the anxiety going.

Types of anxiety

Anxiety is not one condition but a family of related presentations.

Generalised anxiety disorder

Persistent, free-floating worry about several areas of life at once, work, health, money, relationships, that is difficult to control and often has no single clear trigger.

Social anxiety

A marked fear of being judged, embarrassed or scrutinised in social or performance situations, strong enough to affect work, study or friendships.

Panic disorder

Recurrent, sudden surges of intense fear accompanied by physical symptoms such as breathlessness or dizziness, often followed by a fear of the next attack.

Health anxiety

Persistent worry about having or developing a serious illness, frequently accompanied by checking behaviours or repeated reassurance-seeking from doctors.

Phobias

A marked, specific fear of a particular object or situation, such as flying, injections or enclosed spaces, that leads to avoidance out of proportion to the real danger.

These types often overlap. It is common to meet the pattern for more than one, and a proper assessment helps identify what is actually driving things for you rather than relying on a single label.

How therapy can help

Anxiety responds well to psychological treatment. Cognitive behavioural therapy, or CBT, is the approach recommended by NICE for generalised anxiety disorder, social anxiety, panic disorder and phobias, and it has one of the strongest evidence bases of any psychological treatment. CBT works by examining the thoughts that fuel anxiety and the behaviours, like avoidance, that keep it in place, then building alternatives gradually and testing them out.

Acceptance and commitment therapy, or ACT, is another approach with a growing evidence base for anxiety, particularly where the aim is to change your relationship with anxious thoughts and feelings rather than eliminate them entirely. Which approach fits best depends on your history, your goals and what has or hasn’t helped before.

Therapy does not remove the capacity to feel anxious, and it would be misleading to suggest it could. What it offers is a way of understanding your particular pattern, loosening its grip on your choices, and building skills that keep working after sessions end.

Our approach

Our clinical psychologists work online with adults across Greenwich and south east London, including Blackheath, Charlton, Deptford, Lewisham, New Cross and Maze Hill, and further afield. Sessions run over secure video, which means the geography around Cutty Sark, Greenwich Park and the Old Royal Naval College, or the DLR and Southeastern lines that connect this part of London to everywhere else, does not determine who can get support.

Work is grounded in NICE-recommended approaches and adapted to the person in front of us, not applied as a fixed script. We will update this site as the practice develops.

What does anxiety therapy involve?

Therapy usually opens with an assessment, a conversation about what you’re experiencing, when it started, what makes it better or worse, and what you want to be different. From there, you and your psychologist agree a way of working, often CBT or ACT, and set out what sessions will focus on.

Early sessions tend to involve mapping your particular pattern of anxious thoughts, physical sensations and behaviours, so that the specific mechanism keeping things going is clear rather than assumed. Later sessions introduce practical strategies, which might include noticing and questioning anxious thoughts, reducing safety behaviours, or gradually approaching avoided situations at a pace you help set. Sessions are held over video, at a regular time, with progress reviewed periodically so the work stays matched to how things are actually going, not to a fixed plan set on day one.

When to seek help

There is no single threshold that marks the point at which anxiety needs professional support. A reasonable guide is whether it is affecting your work, relationships, sleep or day-to-day decisions, or whether the strategies you already use to manage it no longer feel like enough. Anxiety that has lasted for weeks rather than days, or that is getting harder rather than easier to manage on your own, is generally worth talking to someone about.

If anxiety ever tips into thoughts of harming yourself or feeling unable to keep yourself safe, that is a different situation and needs a faster response than a course of therapy can provide. In that case, contact your GP, call NHS 111, or reach the Samaritans on 116 123. In an emergency, go to A&E or call 999.