Clinically reviewed by Dr John Ahern
This guide was written and clinically reviewed by Dr John Ahern, founder of Insight Psychology in Newtown, Sydney. Dr Ahern is a Registered Psychologist (AHPRA) and a member of the EMDR Association of Australia (EMDRAA), and works with adults experiencing anxiety, panic, OCD, health anxiety, depression, stress, burnout and trauma, using evidence-based approaches including CBT, EMDR, ACT, DBT and Schema Therapy.
Last reviewed: [Month Year] · Next review due: [Month Year]
What Is Anxiety?
Anxiety is the body's natural response to perceived threat or uncertainty. It shows up as a mix of physical tension, worried thoughts, and a strong urge to avoid or prepare for danger.
Everyone feels anxious from time to time: before an exam, a job interview, or a difficult conversation. This kind of anxiety is short-lived and often useful, sharpening focus and preparing the body to respond. Anxiety becomes a concern when it is persistent, out of proportion to the situation, or starts getting in the way of work, relationships, or day-to-day life.
How Anxiety Can Show Up
Physical
Racing heart, tight chest, shallow breathing, muscle tension, restlessness, disrupted sleep.
Cognitive
Racing or intrusive worried thoughts, difficulty concentrating, expecting the worst outcome.
Behavioural
Avoiding certain situations, seeking constant reassurance, checking or over-preparing.
Anxiety can present as generalised worry, social anxiety, panic attacks, specific phobias, health anxiety, or Obsessive Compulsive Disorder (OCD). It is worth speaking with a psychologist if anxiety has lasted more than a few weeks, feels disproportionate to what is actually happening, or is starting to shrink your world.
How Do Panic Attacks Work?
A panic attack is a sudden, intense wave of fear or physical discomfort that peaks within minutes. It happens when the body's fight-or-flight response switches on even though there is no real danger present.
In a genuine emergency, this response is protective: adrenaline surges, the heart beats faster, breathing quickens, and blood shifts toward the major muscles ready for action. A panic attack is the same system firing when there is nothing to fight or flee from, which is what makes it feel so frightening and confusing.
Common sensations during a panic attack
What tends to keep the cycle going is the interpretation of these sensations. A racing heart gets noticed, read as a sign that something is seriously wrong, and that fear itself produces more adrenaline and more physical symptoms. The attack usually peaks within about ten minutes and then eases as the body's stress response settles.
Each step feeds the next, which is what makes an attack escalate so quickly.
Once other causes have been ruled out, therapy focuses on understanding the panic cycle and reducing the fear of the sensations themselves, so attacks lose their grip over time.
What Is Health Anxiety?
Health anxiety, clinically known as illness anxiety disorder, is a persistent and distressing preoccupation with having or developing a serious illness, despite little or no medical evidence to support it.
It is different from simply being health-conscious. Someone with health anxiety might notice an ordinary bodily sensation, such as a headache or a skin mark, and immediately fear it signals something serious. This can lead to frequent body-checking, researching symptoms online, repeated medical appointments, or, for some people, avoiding doctors and check-ups altogether out of fear of what might be found.
Reassurance eases worry only briefly, so the cycle repeats — often about a new symptom.
Reassurance from a doctor, a scan, or a loved one tends to only ease the worry for a short while. This is not a sign of weakness or attention-seeking; it reflects a threat system that has become fixed on illness. Health anxiety responds well to therapy, particularly approaches that work directly with the checking and reassurance-seeking cycle.
What Is OCD?
Obsessive Compulsive Disorder (OCD) involves a cycle of unwanted, intrusive thoughts, images, or urges, called obsessions, and repetitive behaviours or mental acts, called compulsions, performed to reduce the distress those thoughts cause.
Obsessions are not the same as everyday worries. They are intrusive, often distressing, and can involve themes of contamination, causing harm, symmetry and order, or unwanted taboo thoughts. People with OCD usually recognise these thoughts do not reflect what they actually want or believe, which is part of what makes them so distressing.
Compulsions are the actions taken to reduce that distress or to prevent a feared outcome. These can be physical, such as washing or checking, or mental, such as counting, silently repeating phrases, or mentally reviewing events.
Relief is brief, so the obsession returns, often more strongly. ERP helps break the loop.
OCD is often misunderstood as simply liking things clean or orderly. In reality, it is driven by genuine distress rather than preference, and it can attach to almost any theme. The most well-supported treatment is Exposure and Response Prevention (ERP), a specific form of Cognitive Behavioural Therapy (CBT) that helps break the link between the obsession and the compulsive response.
How Therapy Can Help With Anxiety
Anxiety, panic attacks, health anxiety, and OCD all respond well to evidence-based psychological therapy, most commonly Cognitive Behavioural Therapy (CBT), Exposure and Response Prevention (ERP), and Acceptance and Commitment Therapy (ACT).
Therapy for anxiety generally focuses on three things: understanding the specific cycle that is keeping the anxiety going, gradually and safely reducing the avoidance and safety behaviours that maintain it, and building the capacity to tolerate uncertainty and discomfort without it taking over. This is practical, collaborative work rather than simply talking about the problem.
At Insight Psychology, the approach is tailored to the person rather than the diagnosis. Dr John Ahern draws on CBT, ACT, Schema Therapy, DBT, and EMDR depending on how anxiety is presenting and what sits underneath it, which matters particularly where anxiety is connected to earlier stress or trauma rather than being a standalone issue.
A first session usually focuses on understanding your history, how anxiety is currently affecting you, and what you want to get out of therapy. From there, sessions are structured and goal-directed, with regular review of progress along the way.
Frequently Asked Questions
Is anxiety a mental illness, or just stress?
Occasional stress and worry are a normal part of life. Anxiety is generally considered a mental health concern when it is persistent, disproportionate to the situation, and interferes with daily functioning, at which point it may meet criteria for an anxiety disorder.
How do I know if I'm having a panic attack and not a heart attack?
Panic attacks and cardiac events can feel similar, which is exactly why any sudden or unusual chest pain needs medical assessment first. Once serious causes have been ruled out by a doctor, a psychologist can help you understand and manage the panic cycle itself.
Can health anxiety be treated?
Yes. Health anxiety responds well to therapy that targets the checking and reassurance-seeking cycle directly, most often Cognitive Behavioural Therapy. Many people see a meaningful reduction in symptoms within a course of structured sessions.
Is OCD just about being tidy or liking cleanliness?
No. OCD is driven by genuine distress, not preference, and can attach to many different themes beyond contamination, including harm, order, or unwanted intrusive thoughts. Liking a tidy space is not the same as living with obsessions and compulsions.
How long does therapy for anxiety usually take?
This varies by person and presentation, but many structured, evidence-based approaches to anxiety are designed to be time-limited rather than open-ended, with progress reviewed regularly throughout.
This page is general information only and is not a substitute for personalised psychological advice, diagnosis or treatment. A psychologist can assess your history, current symptoms, goals and support needs before recommending a treatment plan.
Insight Psychology is not a crisis service. If you are in immediate danger, call 000. If you need urgent mental health support in Australia, contact Lifeline on 13 11 14 or Beyond Blue on 1300 22 4636.