Understanding Anxiety: Causes, Symptoms, and Strategies for Management

Anxiety is one of the most common reasons people start psychotherapy. Although anxiety is a normal and even adaptive response to stressful circumstances, persistent or overwhelming anxiety can be debilitating and interfere with work, relationships, parenting, and the overall quality of life. Fortunately, anxiety therapy in NYC is an extremely effective treatment for helping people learn the root causes of their anxiety and develop the skills to move through it, rather than get stuck in it. In today’s post, we are going to unpack the nature of anxiety, its causes, and how therapy can help to manage it.

What Is Anxiety?

Anxiety is a natural emotional response to perceived threats or challenges. It is characterized by feelings of worry, nervousness, or fear. Unlike fear, which is a response to an immediate danger, anxiety is often related to the anticipation of future events or uncertainty about outcomes. Physiologically, anxiety triggers the body's "fight-or-flight" response, releasing the stress hormone, cortisol, as well as adrenaline. This response can increase heart rate, heighten alertness, and prepare the body to respond to perceived threats.

Depictions of anxiety in popular culture can make it seem as though anxiety has to be acute and overwhelming, but not all anxiety has that stop-you-dead-in-your-tracks feeling to it. Sometimes people do hit a wall of anxiety – this is typically called a “panic attack” – that feels physically preventative of doing anything other than crumpling over and taking big gulps of air. But sometimes anxiety is persistent, hanging around for days or weeks or months. This type of anxiety generally doesn’t have that acute feeling; it is more of an ambient feeling that sits just in the background of all of your experiences. It is hard to shake off and seems to infect every moment you’re in. 

While anxiety serves a protective function, helping individuals respond to challenges or dangers, it becomes problematic when it is disproportionate, persistent, or disruptive. Experts on anxiety sometimes make an analogy to smoke detectors. Consider when you are cooking fajitas, and your smoke alarm goes off: Did it malfunction? Although it seems like it should know when you are cooking and when there is a real fire, smoke detectors are overly sensitive by design. That is, because the false-positive (i.e., a smoke detector going off when there is no fire) is merely irritating and the false-negative (i.e., a smoke detector not going off when there is a fire) is deadly, properly functioning smoke detectors tend to go off more often than they need to. 

Similarly, anxiety evolved to detect real threats, but it is overly sensitive by design. Nevertheless, just like a smoke detector, if your anxiety response is going off all the time, or is too intense when it is triggered, something is wrong. The easiest way to know if therapy can help is by checking your symptoms.

How Anxiety Affects Daily Life

When left unmanaged, anxiety can impact nearly every aspect of life.

• Work and School: Difficulty concentrating, decision-making challenges, reduced productivity

• Relationships: Increased conflict or conflict avoidance, withdrawal, reassurance-seeking 

• Physical Health: Elevated risk of cardiovascular problems, weakened immune function, chronic pain

• Emotional Well-Being: Reduced self-confidence, irritability, and emotional exhaustion

Common Symptoms of Anxiety

Anxiety is highly individual and may be experienced differently depending on developmental stages (i.e., middle school, high school, college, mid-career, etc.) and factors of living (e.g., age, relationships, career, etc.), and we will touch on these differences below. In general, however, symptoms of anxiety tend to cluster in three domains: emotional/cognitive symptoms, physical symptoms, and behavioral symptoms.

Physical Symptoms of Anxiety

• Rapid heart rate or palpitations – particularly with anxiety attacks or panic attacks, people often notice their heart rate climb, sometimes feeling it in their chest. 

• Shortness of breath or chest tightness – this is the first symptom people tend to notice, and so can be a helpful signal that an acute episode is coming on.  

• Muscle tension or chronic pain – anxiety activates the sympathetic nervous system, preparing the body for fight-or-flight. This involves activating your muscles to respond quickly to danger. With sustained muscle tension, particularly in the jaw and brow areas, anxiety can cause chronic headaches and pain in the shoulders and neck.

• Sweating, shaking, or trembling – acute anxiety attacks that cause rapid breathing and increased heart rate, can pump blood laced with cortisol and adrenaline throughout your system, causing you to sweat or have a tremor – in some cases, it can cause visible shaking. 

• Gastrointestinal discomfort – Anxiety can either accelerate or decelerate digestion, causing bloating, nausea, cramps, and even diarrhea

• Sleep disturbances - including insomnia, anxiety keeps the nervous system in a state of heightened arousal, making it difficult to shift into the relaxed state required for sleep. 

Emotional and Cognitive Symptoms of Anxiety

• Racing or intrusive thoughts - anxiety increases mental arousal and reduces inhibitory control in the brain, making it harder to filter or stop thoughts once they begin. As a result, thoughts feel rapid, repetitive, and intrusive

• Difficulty concentrating – anxiety redirects cognitive resources toward monitoring threats and cycling through intrusive thoughts, interfering with working memory and focus 

• Irritability or restlessness – being in a chronic state of nervous system excitation lowers your ability to endure minor irritations. Friends, family, and partners can sometimes notice heightened frustration and irritability. 

• Feeling overwhelmed or on edge - anxiety heightens sensitivity and lowers your tolerance for irritations, making everyday demands feel intense or unmanageable. 

Behavioral Symptoms

• Avoidance of certain situations or activities – because anxiety causes you to feel under threat, avoiding certain situations can temporarily reduce those feelings. However, continued avoidance tends to worsen existing anxieties, create new anxieties, and reduce social supports. 

• Procrastination or indecisiveness – anxiety’s effect on one’s cognitive resources can sometimes distort how bad certain consequences will be or over exaggerate the likelihood of these consequences. This can make decisions feel risky or overwhelming, causing people to delay acting, even when that increases anxieties later on.  

• Reassurance-seeking behaviors – for obvious reasons, people with anxiety can repeatedly seek confirmation from others that everything is “all right.” While reassurance provides brief relief, it prevents the development of internal confidence and tolerance of uncertainty.

• Compulsive habits or rituals – compulsive behaviors can temporarily reduce anxiety by creating an artificially controlled set of circumstances. Because this relief is short-lived, it can encourage people to return to that behavior whenever anxiety occurs, reinforcing the repetitive cycle of ritualized behaviors. 

How Anxiety Manifests Across Different Populations

As we alluded to above, anxiety is deeply heterogeneous, expressing itself in a variety of ways depending on developmental stage and life circumstances. For some, anxiety comes on strong and fades quickly, others feel a low-grade but constant hum of anxiety throughout the day; for some it appears isolated and disconnected, coming out of nowhere, while for others it feels immediately and obviously connected to previous traumas or depressive feelings; for some it is attached to dreaded features of one's life or day, for others it is bewilderingly connected to their most cherished people and events.

Understanding the variations in how people experience anxiety is critical for tailoring treatments that address the specific cognitive, emotional, and behavioral patterns present in different populations.

Parents

Among parents, anxiety frequently centers on concerns regarding child safety, well-being, and developmental outcomes. Heightened vigilance, anticipatory worry, and perfectionistic tendencies can lead to chronic stress, emotional fatigue, and challenges in maintaining a balance between parental responsibilities and personal self-care.

Professionals

In professional contexts, anxiety often manifests as performance-related stress, fear of evaluation, and heightened self-criticism. These patterns may contribute to difficulties with concentration, decision-making, interpersonal interactions, and productivity, and can increase susceptibility to occupational burnout.

Adolescents

For adolescents, anxiety frequently intersects with identity formation, peer dynamics, and academic pressures. Behavioral manifestations can include social withdrawal, irritability, avoidance of responsibilities, and disruptions in sleep, all of which can impact psychosocial development and academic functioning.

Couples

Within intimate partnerships, anxiety can influence communication patterns, conflict resolution, and emotional intimacy. Excessive worry, reassurance-seeking, or avoidance behaviors can create cyclical patterns of tension and emotional distance, impacting relationship satisfaction and cohesion.

Older Adults

In older adults, anxiety often presents in relation to health concerns, functional decline, and anticipatory fears regarding loss and dependency. Symptoms may include persistent worry, sleep disturbances, irritability, and social withdrawal, which can compound age-related vulnerabilities and diminish quality of life.

When Anxiety Therapy Can Help: Recognizing the Tipping Point

Anxiety, like most things, exists on a continuum. At one end is normal, adaptive anxiety – the kind that arises in response to stress, uncertainty, or change and gradually settles as circumstances stabilize. At the other end is anxiety that becomes persistent, intrusive, and limiting. People can sometimes spend months or years feeling bouts of intense and uncontrollable anxiety, or a persistent ambient kind of anxiety, while they try to figure out exactly where the line between adaptive and maladaptive anxiety is and whether they have crossed it. 

The reality is that your anxiety doesn’t need to be disordered to be maladaptive and treatable. If anxiety affects your work or relationships, causes you to dread certain situations, lasts for weeks or months, interferes with sleep, or causes any of the physical symptoms above, anxiety therapy can help. Psychotherapy provides a structured space to understand how the patterns of thought, emotion, and behavior that generate anxiety develop, what they are responding to, and how they are maintained, rather than simply managing symptoms.

By increasing emotional awareness, improving tolerance for uncertainty, and helping recalibrate a nervous system that may be habitually overactivated, therapy can reduce unnecessary strain while preserving motivation and functioning. In this way, therapy serves not only as treatment, but as a preventative and restorative process—supporting psychological flexibility, emotional balance, and a more sustainable way of engaging with everyday life.

How Psychotherapy Helps Anxiety

Psychotherapy treats anxiety by addressing the cognitive, emotional, behavioral, relational, and physiological processes that sustain it. Rather than focusing only on symptom reduction, effective anxiety therapy helps restore nervous system regulation, emotional flexibility, and a more adaptive relationship to anxiety.

Cognitive Behavioral Therapy (CBT) for Anxiety

Cognitive approaches help identify and modify thought patterns that create and intensify anxiety. These patterns often operate automatically and reinforce fear-based responses.

By learning to identify cognitive distortions such as catastrophic thinking, intolerance of uncertainty, and overestimation of threat, patients can gain control of their anxiety responses, leading to reduced emotional reactivity and improved decision-making. As cognitive rigidity decreases, anxiety becomes less dominant and more manageable.

Psychodynamic Therapy for Anxiety

Evidence indicates that modern psychodynamic approaches are equally as effective as cognitive behavioral therapy in treating anxiety. Psychodynamic psychotherapy understands anxiety as meaningful, rather than random. Anxiety almost always reflects subtle, not always acknowledged, beliefs or feelings, attachment patterns, or early experiences that continue to influence present-day behavior.  

Through insight-oriented work, individuals gain an understanding of why anxiety emerges in specific situations. This deeper awareness supports lasting change rather than temporary symptom relief.

Internal Family Systems (IFS) Therapy for Anxiety

Internal Family Systems (IFS) therapy understands anxiety as a protective response rather than a disorder to be eliminated. From an IFS perspective, anxiety arises when certain internal “parts” take on the role of keeping the individual safe in the face of perceived threat, vulnerability, or emotional pain. IFS helps clients access the Self, a calm and compassionate state, to relate to anxious parts with understanding rather than judgment, reducing anxiety as internal harmony and self-trust increase.

Somatic Therapy and Nervous System Regulation

Anxiety is a physiological state as much as a psychological one. Somatic and body-based approaches address breathing patterns, muscle tension, posture, and physical sensations associated with chronic stress.

By calming autonomic nervous system activation and increasing tolerance for bodily sensations, these approaches reduce physical anxiety symptoms and support a return to a regulated state.

Emotional Processing in Anxiety Treatment

Anxiety often serves as a defense against emotions that feel overwhelming or unsafe, such as grief, anger, shame, or fear. When these emotions are avoided or suppressed, anxiety persists.

Psychotherapy provides a safe space to identify and process underlying emotions. As emotional awareness and tolerance increase, anxiety frequently decreases because constant vigilance is no longer required.

The Importance of Individualized Treatment for Anxiety

No two experiences of anxiety are exactly alike. Each person brings a unique combination of life experiences, biology, and environmental influences that shape how anxiety develops and manifests. At Lexington Park Psychotherapy, effective treatment begins with a comprehensive understanding of these individual factors to ensure therapy is tailored to your particular needs.

The anxiety therapists at Lexington Park Psychotherapy provide an individualized approach that addresses both the immediate symptoms and the underlying systems that maintain them. By carefully understanding both the acute elements of anxiety actively interfering with your quality of life as well as the way that the feeling of anxiety interacts with other patterns of thinking, feeling, and behaving, our therapists provide a tailored approach to your specific needs. Good anxiety therapy is not one-size-fits-all - it should be tailored to your history, your needs, and your goals.

Get Started with Anxiety Therapy in NYC

If anxiety is affecting your work, relationships, or quality of life, you don't have to manage it alone. Anxiety therapy in NYC offers evidence-based approaches that address not just your symptoms, but the underlying patterns that sustain anxiety. At Lexington Park Psychotherapy, our therapists provide individualized treatment to help you develop lasting skills, restore emotional balance, and regain confidence and clarity. Follow these three simple steps to get started:

1. Schedule a Free Consultation to discuss whether anxiety therapy is right for you

2. Meet with an experienced anxiety therapist who will work with you to understand your specific concerns

3. Start building the skills to better understand and manage your anxiety with expert guidance

Schedule a Free Consultation

Additional Services Offered at Lexington Park Psychotherapy

At Lexington Park Psychotherapy, we understand that you may be struggling with more than just anxiety. In addition to anxiety therapy in NYC, we also offer specialized treatment for depression, trauma, couples therapy, adolescent and teenager support, and maternity-related mental health concerns.

Our approach is collaborative and tailored to your unique needs, drawing from evidence-based modalities including Cognitive Behavioral Therapy (CBT), Psychodynamic Therapy, Internal Family Systems (IFS), and somatic approaches to support lasting change. Whether you're seeking support for depression, trauma recovery, couples therapy, adolescent care, or maternity-related mental health concerns, our therapists provide the compassionate, individualized treatment you deserve. Visit our blog for more helpful resources and insights on mental health and therapy.