When anxiety shows up in your body
Over time, anxiety does not always just stay in your thoughts. You might find your body responding before your mind has a chance to catch up. Physical symptoms of anxiety can include:
racing heart, chest pain or pressure​
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shortness of breath or rapid breathing
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insomnia, difficulty falling or staying asleep​​
​​​stomach upset, nausea, or vomiting​
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muscle tension, headaches, jaw pain​
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fatigue, exhaustion, restlessness or "brain fog"​​
Understanding How Your Anxiety Shows Up
If you've ever wondered why you can't stop overthinking, you probably already know that telling yourself to stop doesn't work. Anxiety doesn't show up the same way for everyone. For some people it's a mind that won't quiet down at night. For others it's a tight chest before an ordinary phone call, or replaying a conversation for days afterward. Therapy starts with understanding how it shows up for you and what keeps it going.
Overthinking & Rumination: Getting stuck in self-doubt or going over the same decisions, conversations, or mistakes again and again.
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Panic Attacks & Panic Disorder: Sudden waves of intense fear, physical symptoms, or a sense that something is physically wrong in your body.
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Social Anxiety: Worrying about how you came across, replaying interactions, or feeling drained after being around others.
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ADHD and Anxiety: If you have ADHD, anxiety may feel like a low-level urgency. It's often tied to time blindness, difficulty starting or finishing tasks, the pressure of feeling behind, or the exhaustion of masking.
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Perfectionism and Pressure: Anxiety can also look like constantly trying to stay ahead, avoid mistakes, or keep everything from falling apart, even when no one else can see how much effort it takes.
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Trauma-Related Activation: Sometimes anxiety is a learned response, a way your system learned to stay alert and manage uncertainty based on past experiences.​
How I think
about anxiety
I don't see anxiety as only a symptom to reduce. I want you to feel relief, and I'm also interested in why you get anxious in these particular situations, with these particular people. Anxiety is often protecting something: a relationship, your sense of being a good person, or a way of avoiding consequences that were once very real. It isn't always just an exaggerated prediction.
Underneath it, there are usually rules. They tend to sound something like this:
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“I can’t disappoint anyone.”
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“I have to get it right.”
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“I should be able to handle this.”
Looking at the rules
​Those rules usually made sense when you learned them. Rather than only helping you follow them with less distress, we look at whether they're fair, or even possible, to keep following.
Making the
work concrete
Many of the people I work with already understand their patterns. They can explain exactly why they over-prepare for a conversation or can't let a misunderstanding go. Explaining it one more time doesn't make it easier to act differently. So the work gets concrete: saying what you'd prefer, letting a misunderstanding stay unresolved, setting a limit, or approaching something you've been avoiding, and paying attention to what happens when you do.
​​Part of the work is also practical
This might include learning how to interrupt a panic response, get out of overthinking loops, work with perfectionism and self-pressure, or use nervous system regulation skills when your body feels stuck on high alert.​​
Panic responses
Overthinking loops
Perfectionism
Nervous system regulation
Relief matters.
What I'm also aiming for is more room to be yourself and make your own choices, without spending so much energy meeting the same exhausting expectations.
When it isn't only anxiety
Sometimes what feels like anxiety has something else underneath it. You feel on edge, overwhelmed, and unable to settle, so anxiety seems like the obvious name for it. But if you've spent years keeping up through effort, pressure, and masking, the problem may be closer to burnout: a system that has been running past its capacity for a long time.
This is especially common for people with ADHD or autism, including those who've never been diagnosed or are only starting to wonder. It can look like:
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dreading tasks you used to handle without much thought
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needing more time alone to recover
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losing patience with noise or people faster than you used to
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feeling behind no matter how much you get done
Rest helps for a day, maybe two. Then you're right back where you started.
When burnout is driving the anxiety, more coping strategies can turn into one more thing to keep up with. What helps is figuring out what has been draining you, what you've been compensating for, and what would need to change for your days to feel sustainable.
You don't have to decide right away whether it's anxiety, burnout, or some combination. We can start with what you're noticing and work from there.
If any of this sounds familiar, I'd be glad to talk with you about what's been going on.