When anxiety needs professional help

Almost everyone feels anxious sometimes: before an interview, during a move, while waiting for medical news. That is not a disorder; it is the body preparing for something it reads as important.

The reasonable doubt appears when that feeling no longer fits what is happening around you, lasts longer than it should, or starts making decisions for you. Here is what to look at to tell one from the other, and what you can try even before booking an appointment.

Ordinary anxiety has three features

First, it has an identifiable cause: you know what sets it off. Second, it is proportionate: it roughly matches the size of what is going on. And third, it passes: once the situation resolves, it settles on its own within hours or days.

The kind of anxiety worth looking at more closely breaks one of those three. It appears with no clear cause, it is out of proportion to what triggers it, or it stays even after the problem is over.

Signs worth paying attention to

You are avoiding things. You stop going places, put off phone calls, turn down plans, or change your route to avoid somewhere. Avoidance brings relief in the short term, but it is what feeds anxiety most in the long run: every time you avoid, you confirm there was danger.

Your body has been signalling for weeks. Tension that never lets go, digestive discomfort, headaches, a knot in the chest, sleeping badly for a sustained period. It is worth ruling out medical causes with your GP first: if there are none, anxiety is a common explanation.

You cannot switch off. The worry is still there during downtime, at weekends or on holiday, and shows up just as you go to bed.

It is affecting your life. You perform worse, argue more, struggle to concentrate, or have started drinking, smoking or eating differently to calm down.

It has gone on for months. A spike of anxiety during a hard week is expected; keeping it up for months is not.

This is not a test and it is not for self-diagnosis: it is a rough guide to decide whether it is worth talking to someone.

What you can try on your own

Looking after your sleep, moving regularly and cutting down on coffee and alcohol are not empty advice: they have a real effect on how activated the body is. Reducing screens and news before bed usually shows too.

And one thing helps to make sense of what is happening: for a week or two, note down when the anxiety appears, in which situations, and what you do afterwards. If you do end up in therapy, that information is worth a great deal.

If you try this for a few weeks and nothing shifts, that is an answer in itself: it is not a matter of willpower or of trying harder.

When not to wait

There are situations where giving it more time makes no sense: repeated panic episodes, anxiety that stops you working or leaving the house, or anxiety alongside a sustained low mood.

And one that is an emergency, not an appointment: if thoughts of harming yourself appear, do not wait. In Spain, call 112, or 024, the free suicide-prevention line, available 24 hours a day.

What therapy does with anxiety

The work is not about eliminating anxiety, because it is a useful response we all need. It is about understanding what sets it off in your particular case, seeing what you do to manage it —sometimes, without realising, the very thing that sustains it— and building a different way of responding.

You can see how it is approached on the anxiety page. And if you are wondering whether your situation is "enough" to see a psychologist, I cover that in how to know if you need therapy.

In person or online?

For anxiety, both formats work. For some people, starting from their own surroundings also makes the first step easier, especially when leaving the house is part of what is hard.

If that interests you, it is explained on the online therapy page, available across Spain.

If you recognise several of these signs, you do not need to be completely sure before asking. You can write to me and we can look at it together, with no obligation.