Understanding Anxiety: When Worry Takes Over Your Life

Key takeaways

Anxiety is your brain's threat-detection system working overtime—it's not weakness, and it's not something you can just switch off
High-functioning anxiety is real: you can appear competent and successful while internally running on adrenaline and dread
Anxiety affects your body as much as your mind—the racing heart, tight chest, and churning stomach are not "all in your head"
Understanding what drives your anxiety (not just managing its symptoms) is where lasting change happens
Counselling can help you understand the roots of your anxiety and develop a different relationship with it

Anxiety is the most common reason people come to see me. More than depression, more than relationship issues, more than anything else. And yet almost everyone who walks through the door—or, more often, joins the video call—starts by apologising for it.

"I know other people have it worse." "I should be able to handle this." "I don't even know why I'm anxious—there's nothing actually wrong."

Let me say something about that last one. Anxiety doesn't need a reason. It doesn't require a crisis or a logical trigger. Sometimes the very absence of an obvious cause makes it worse, because then you're anxious and confused about why you're anxious. Which, naturally, makes you more anxious.

If that cycle sounds familiar, keep reading. This guide is about what anxiety actually is, why it takes hold the way it does, and what can help.

What anxiety actually is

Anxiety is your nervous system's response to perceived threat. The key word there is perceived—your brain doesn't distinguish between a genuine danger and something it has learned to interpret as dangerous. A looming deadline, a social situation, an unanswered text, a vague sense that something bad is about to happen: your body responds to all of these with the same ancient alarm system it would use if you were being chased by a predator.

That alarm system—the fight-or-flight response—floods your body with adrenaline and cortisol. Your heart rate increases. Your muscles tense. Your breathing becomes shallow. Your digestive system shuts down (it's not a priority when you're supposedly running for your life). Your brain narrows its focus to the threat, making it hard to think about anything else.

This is incredibly useful if you're actually in danger. The problem is that for people with anxiety, this system fires too easily, too often, or doesn't switch off properly afterwards. You end up living in a state of chronic low-level alarm—or sudden spikes of panic—without a corresponding danger to justify it.

It's exhausting. And because the physical symptoms are real (your heart genuinely is racing, your chest genuinely is tight), it can feel like something is medically wrong. Many of my clients have been to A&E convinced they were having a heart attack, only to be told it's "just anxiety." That word "just" does a lot of damage.

The different faces of anxiety

Anxiety isn't one thing. It shows up in different ways for different people, and understanding your particular pattern matters more than a generic label.

Generalised anxiety

A constant background hum of worry that attaches itself to whatever is available. Health. Money. Relationships. Work. The future. You might recognise it as a feeling of dread that's always there, even on good days. A sense that you're waiting for something bad to happen. Difficulty relaxing, even when there's nothing specific to worry about.

People with generalised anxiety often describe feeling "tired but wired"—exhausted from the mental effort of worrying, but unable to switch off.

Not shyness—though it's often dismissed as such. Social anxiety is a genuine fear of being judged, embarrassed, or found wanting in social situations. It can range from discomfort at parties to complete avoidance of situations where you might be observed or evaluated.

What people on the outside don't see is the preparation. The rehearsing of conversations beforehand. The post-mortem afterwards, replaying everything you said and convincing yourself it was wrong. The exhaustion of performing ease when you feel anything but.

Panic

Sudden, overwhelming surges of fear that seem to come from nowhere. Racing heart, difficulty breathing, tingling, dizziness, a feeling of unreality, the conviction that something catastrophic is happening right now. Panic attacks are terrifying, and the fear of having another one can become its own source of anxiety—a vicious cycle that progressively narrows your world as you avoid situations that might trigger one.

Health anxiety

A preoccupation with the possibility that something is seriously wrong with your body. Checking symptoms. Seeking reassurance. Interpreting normal bodily sensations as evidence of illness. The relief of a clear test result lasts hours, not days, before the worry attaches to something new.

The quiet kind

And then there's the anxiety that doesn't look like anxiety at all. The perfectionism. The people-pleasing. The over-preparing. The need to control every variable. The inability to delegate because nobody will do it right. The avoidance disguised as preference ("I just don't like parties" when the truth is they terrify you).

I see a lot of this in my practice. People who appear to have everything together—successful careers, busy social lives, immaculate homes—while running on pure adrenaline underneath. Which brings us to something important.

High-functioning anxiety

This isn't a clinical diagnosis. You won't find it in the DSM. But it describes something very real that many of my clients recognise instantly.

High-functioning anxiety is what happens when your anxiety drives you to perform rather than freeze. You don't miss deadlines—you meet them obsessively, often days early, because the alternative is unbearable. You don't avoid social situations—you prepare for them meticulously and then collapse afterwards. You don't appear anxious—you appear capable, reliable, and together.

The problem is that this version of anxiety gets rewarded. You're praised for your work ethic. You're valued for your reliability. Nobody suggests you might need help because, from the outside, you're thriving.

From the inside, the picture is different:

A constant inner critic that is never satisfied, no matter how well things go
Difficulty saying no, because letting people down feels catastrophic
Restlessness and an inability to relax without guilt
Physical symptoms you've normalised—jaw clenching, stomach problems, insomnia, tension headaches
A deep fear that if you stop pushing, everything will fall apart
The sense that you're one bad day away from everyone discovering you're a fraud

If this sounds like you, you're not imagining it. And the fact that you're functioning doesn't mean you're fine.

Anxiety and the body

One thing I wish more people understood about anxiety: it is a physical experience as much as a mental one. The thoughts are only part of it. Your body is doing things—real, measurable, physiological things—that create the sensations you feel.

The racing heart and tight chest are your cardiovascular system responding to adrenaline. Your heart is preparing to pump blood to your muscles for fight or flight.
The churning stomach, nausea, and appetite changes happen because your digestive system deprioritises itself during a stress response. Chronic anxiety means chronic disruption to digestion. IBS and anxiety are frequently linked.
The muscle tension—particularly in your jaw, neck, shoulders, and back—is your body bracing for impact. Some people carry this tension for so long they stop noticing it until it becomes pain.
The difficulty breathing is often a shift to shallow, rapid chest breathing rather than slow, deep belly breathing. This actually maintains the anxiety cycle, because shallow breathing signals to your brain that you're still in danger.
The exhaustion is the cost of running your nervous system at high alert. You're not lazy. You're depleted. Your body is using enormous resources on threat management, leaving less for everything else.

Understanding the physical dimension matters because it means anxiety isn't something you can think your way out of. Your body needs to feel safe, not just your mind. This is why approaches that include the body—grounding techniques, breathing work, movement—can be as important as talking.

Where anxiety comes from

This is the question most people really want answered. Why am I like this? Why can't I just stop worrying?

There isn't one answer, and it's usually a combination of factors. But understanding what feeds your anxiety can change your relationship with it.

Your nervous system's baseline

Some people's nervous systems are simply more reactive. You might have been a sensitive child—easily startled, slow to warm up, alert to changes in your environment. This isn't a disorder. It's a neurological variation. But it means your threshold for triggering the anxiety response is lower than average, and that's been true your whole life.

Early experiences

This is where I spend a lot of time in sessions. The anxiety you feel now often has roots in much earlier experiences.

If you grew up in an environment that was unpredictable—a parent's mood you had to constantly read, conflict that erupted without warning, a household where you learned to stay vigilant—your nervous system learned that the world requires constant monitoring. That lesson doesn't expire when you leave home. It becomes your default setting.

If your emotional needs weren't consistently met, you may have learned that depending on others is risky. That you need to handle everything yourself. That being needed is how you earn love. All of these beliefs feed anxiety.

If you experienced any kind of trauma—and that includes the quieter forms, like emotional neglect or chronic invalidation—your threat-detection system may be calibrated to a world that is more dangerous than the one you actually live in now.

Life circumstances

Sometimes anxiety is a reasonable response to unreasonable circumstances. Financial pressure. A demanding job with no boundaries. A relationship that's eroding your confidence. Caring responsibilities you can't step back from. Health worries. The state of the world.

I don't think it's helpful to pathologise anxiety that makes sense in context. Sometimes the most important work isn't managing the anxiety—it's changing the situation that's causing it.

The maintaining cycle

Whatever started the anxiety, what keeps it going is usually a cycle. You feel anxious, so you avoid the thing, which provides short-term relief but teaches your brain that the thing was genuinely dangerous, which increases the anxiety next time. Or you cope through control—preparing, checking, seeking reassurance—which works temporarily but reinforces the belief that without those behaviours, disaster would follow.

Breaking these cycles is possible. But it requires understanding them first.

Anxiety and neurodivergence

Something I see frequently in my practice: people who've been treated for anxiety for years, and it hasn't shifted, because the anxiety is actually a secondary effect of undiagnosed ADHD or autism.

If you have ADHD, anxiety may be driven by the constant effort of managing executive function difficulties—the fear of forgetting something, missing a deadline, or being exposed as disorganised. The anxiety isn't the primary problem; it's a response to living with an unrecognised neurological difference.

If you're autistic, what gets labelled as anxiety may partly be sensory overload, the exhaustion of masking, or a reasonable response to navigating a world that isn't designed for your brain. Standard anxiety treatment may not help much because it's treating the wrong thing.

This doesn't mean all anxiety in neurodivergent people is secondary. You can have ADHD and generalised anxiety. You can be autistic and have panic disorder. But understanding what's driving what matters enormously for working out what actually helps.

If anxiety treatments haven't worked for you despite genuine effort, it's worth considering whether something else might be going on underneath.

How counselling can help

I won't pretend that counselling makes anxiety disappear. Anyone who promises that is overselling. What it can do—what I've seen it do, consistently—is change your relationship with anxiety so that it stops running your life.

In my work with anxious clients, the most important shift is usually this: moving from "I need to get rid of this anxiety" to "I need to understand what this anxiety is trying to tell me." Anxiety is always a signal. It's often a distorted signal, amplified beyond what the situation warrants, but there's usually something real underneath—a need that isn't being met, a boundary that isn't being held, a feeling that's been pushed down for too long.

Practically, our work together might involve:

Understanding your particular pattern. Not anxiety in general—your anxiety. What triggers it, what maintains it, what it's protecting you from, where it started.
Working with the body. Learning to recognise the physical signs early and developing grounding techniques that actually work for you (not just the ones on every wellness website).
Exploring the roots. If your anxiety connects to earlier experiences—and it very often does—we can work with that material carefully. Not to dredge up the past for its own sake, but because understanding why your nervous system learned to be this vigilant is often what allows it to recalibrate.
Examining the beliefs that fuel it. The stories anxiety tells—I'm not coping, something bad will happen, I'm not enough—feel like truths. Examining where those stories came from, and whether they still hold up, can gradually loosen their grip.
Building tolerance for uncertainty. This is often the hardest and most important work. Anxiety wants certainty. Life doesn't provide it. Learning to tolerate the discomfort of not knowing—without reaching for control or avoidance—is a skill that grows with practice.

I don't have a one-size-fits-all approach. What works depends on you—your history, your temperament, your circumstances. Some clients benefit from exploring childhood patterns. Others need practical tools first and deeper work later. We figure it out together.

When to consider getting support

You don't need to be in crisis to benefit from talking to someone. But if any of these feel familiar, it might be time:

Anxiety is limiting what you do, where you go, or who you see
You're exhausted from the effort of appearing fine
Physical symptoms—sleep problems, stomach issues, tension, fatigue—have become your normal
You've tried managing it on your own and it isn't shifting
You rely on alcohol, overwork, or other strategies to get through
You're starting to avoid things that used to be fine
The worry feels disproportionate to the situation, and you know it, but you can't stop

About the author

Nadia Wilkinson is a BACP registered counsellor (Member No. 394901) and HCPC registered Educational Psychologist specialising in supporting adults with anxiety, ADHD, autism, and emotional wellbeing. She offers online counselling across the UK.

References:

Mind: Anxiety and panic attacks
NHS: Generalised anxiety disorder in adults
Porges, S. (2011). The Polyvagal Theory
Clark, D.A. & Beck, A.T. (2011). Cognitive Therapy of Anxiety Disorders