Anxiety.

A body braced for something that is not in the room. Anxiety is not a personality trait or a failure of nerve. It is a threat system doing its job with the sensitivity turned too high, and it is among the most treatable things we see. In person in Prahran, Melbourne, and online anywhere in Australia.

tl;dr

At a glance.

Who it is for: Adults living with worry, panic, social fear, health anxiety, or a body that will not come down off alert
What we offer: Therapy that treats the mechanism rather than reassuring the content, which is why it holds after therapy ends
Approaches: CBT with graded exposure, ACT, Schema Therapy, and trauma-informed work where the anxiety sits on top of something older
Referral: You can contact us to start the process. You need a GP referral before your first appointment, like every client. A Mental Health Treatment Plan is a separate thing again, and it is what brings the Medicare rebate
Evidence: Anxiety disorders respond to psychological treatment as well as anything in mental health. Most people improve substantially
If it is urgent: We are not a crisis service and we do not answer after hours. Our crisis support page lists the lines that answer around the clock
Telehealth: Everything on this page can be done by video

What it looks like

What anxiety can look like in adults.

Most people who come to us for anxiety have been managing it for years, competently, at considerable cost. They are often the reliable one, the prepared one, the one who has already thought of what could go wrong. Anxiety is frequently invisible from the outside precisely because it is so effective at producing over-preparation.

The engine underneath is simple and stubborn. Something feels dangerous. You do something to make the danger feel manageable: you avoid it, you check, you rehearse, you seek reassurance, you over-prepare. The relief is immediate and real. And because the relief arrives, your brain files the conclusion that the thing you did is what kept you safe. The fear never gets the chance to be disproven. The territory shrinks by a little. Then a little more.

This is why reassurance does not work for long, and why advice to stop worrying is useless. The problem is not the content of the worry. It is the loop that keeps the worry credible.

Anxiety also shows up in the body long before it shows up in language. Many people arrive after years of tests for chest pain, dizziness, gut symptoms or a racing heart. Then they are told it is anxiety, which can be frustrating. That annoyance is fair. Being told it is anxiety is usually delivered as a dismissal. It should not be. The symptoms are physically real; the driver is a nervous system, not an organ.

Does any of this sound like you?

The everyday version.

These are the things people describe to us, in their words rather than the manual's. You do not need all of them, and coping well does not disqualify you.

The worry itself

It does not switch off

One thing resolves and the attention moves straight to the next. There is always a next.

Worst case, automatically

Your mind arrives at the catastrophic version first, in detail, before you have decided to think about it.

Worry that feels productive

It has the texture of problem-solving and none of the output. Nothing is decided and nothing is finished.

The body

Braced all the time

Jaw, shoulders, stomach. You only notice the tension when it briefly goes.

Heart, chest, breath

Racing, tight, unable to get a full breath. Often investigated thoroughly and found to be structurally fine.

Gut

Nausea, urgency, appetite gone. The gut is wired into the threat system and reports first.

Wired and exhausted

Too tired to function and too activated to rest. Lying down and being more awake than you were standing up.

Panic

Out of nowhere

A surge that peaks in minutes: heart hammering, dizzy, tingling, unreal. Terrifying, and not dangerous.

Fear of the fear

Then you start avoiding places where it happened, or where getting out would be hard.

Sure it is your heart

Almost everyone with panic has considered a cardiac event. Getting checked once is sensible. Getting checked repeatedly becomes part of the loop.

Other people

Replaying conversations

Hours afterwards, auditing what you said and how it landed.

Certain you are being judged

And certain that the judgement is accurate, which is the part that stings.

Agreeing to things you do not want

Because the discomfort of declining is sharper than the cost of going.

Health and checking

Symptom searching

A sensation, then a search, then a worse possibility, then a worse one.

Body scanning

Monitoring yourself for the thing you are afraid of, which reliably finds something, because bodies always have something.

Reassurance that lasts an hour

From a doctor, a partner, a forum. Real relief, very short, and it strengthens the loop each time.

What it costs

The world gets smaller

Trips not taken, roles not applied for, plans declined. Each avoidance is small; the accumulation is a narrowed life.

Preparing for everything

Arriving early, over-researching, scripting conversations. It works, and it is exhausting, and it never ends.

Relief that never arrives

You get through the thing you dreaded and there is no reprieve, because the attention has already moved on.

The criteria

What the diagnosis actually requires, in plain language.

Anxiety is not one diagnosis. The DSM-5-TR describes several. Each responds to a different focus in treatment, so it is worth telling them apart rather than treating anxiety as one thing.

Generalised anxiety disorder

Excessive worry about a number of things, more days than not, for at least six months, that you find hard to control. Plus at least three of: restlessness or feeling on edge, tiring easily, trouble concentrating, irritability, muscle tension, disturbed sleep. The worry moves between topics; resolving one does not end it.

Panic disorder

Recurrent unexpected panic attacks, an abrupt surge peaking within minutes, with symptoms like pounding heart, sweating, trembling, breathlessness, chest pain, nausea, dizziness, numbness, chills or heat, feelings of unreality, fear of losing control or dying. Then at least a month of worrying about more attacks, or changing your behaviour to avoid them. The attacks themselves are not dangerous, however convincingly they present otherwise.

Social anxiety disorder

Marked fear of social situations where you might be scrutinised, driven by fear of being judged, humiliated or rejected. The situations are avoided or endured with intense distress, typically for six months or more. It is far more than shyness and it is one of the most common anxiety disorders there is.

Agoraphobia

Fear of two or more of: public transport, open spaces, enclosed spaces, queues or crowds, being outside the home alone, because escape might be hard or help unavailable if something went wrong.

Specific phobia

Marked fear of a particular object or situation, out of proportion to the actual danger, avoided or endured with intense distress. Among the most treatable conditions in the manual.

Illness anxiety and somatic symptom disorder

Preoccupation with having or developing a serious illness, with checking or avoidance, persisting despite appropriate medical reassurance.

What all of them share

For all of them, the anxiety has to be out of proportion to the real risk, last over time, and cost you something. It also must not be better explained by a substance, a medical condition, or another mental health condition. That last part matters. An overactive thyroid, some medications and caffeine can all look a lot like anxiety. That is one reason the GP visit first is not a formality.

A threshold, not a verdict

Subclinical anxiety is still expensive to live with. You do not need to meet a definition to get something out of treatment.

Co-occurring

What often travels with anxiety.

Anxiety is frequently a symptom of something else rather than the whole story. Every new client here is screened for trauma and for neurodivergency as standard, because anxiety is the most common way both of those present.

Depression

The most common pairing there is. Many people have both, and the combination responds better when treated as a combination.

Depression →

Trauma and PTSD

Hypervigilance is an anxiety symptom and a trauma symptom. Where there is a trauma history, treating the anxiety alone tends to plateau.

Trauma & PTSD →

ADHD

Chronic vigilance is a rational response to years of missing things. This anxiety is a consequence, and it often eases when the ADHD is addressed.

ADHD →

Autism

Anxiety rates are very high among autistic adults, often driven by sensory load, unpredictability and the cost of masking. The treatment needs to account for that rather than targeting the anxiety in isolation.

Autism →

OCD

Related but distinct. Compulsions are more structured than general anxious checking, and OCD responds best to a specific approach.

OCD →

Eating and body concerns

Anxiety about eating, and eating to manage anxiety, both occur. Where both are present we address them together.

Eating & body →

Alcohol and other drugs

Alcohol is an extremely effective short-term anxiolytic with a well-documented rebound. Many people are managing anxiety without naming it that way.

Sleep

Anxiety wrecks sleep and poor sleep amplifies anxiety. Treating the insomnia directly is often the fastest available win.

Chronic pain and fatigue

Persistent physical symptoms and anxiety feed each other. We work alongside your GP, never instead of them.

Thyroid, caffeine and medication effects

All can produce a convincing imitation of an anxiety disorder. Worth excluding properly before assuming the cause.

Perfectionism

Not a diagnosis. A common engine, and one that is often praised by employers while quietly costing the person a great deal.

Words you will hear

A short glossary.

Terms that come up in appointments, in self-help material and online. Some are clinical, some are shorthand.

ACT and defusion

Changing your relationship to thoughts rather than arguing with their content, so they carry less weight.

Anticipatory anxiety

The dread before the event, which is very often worse than the event.

Avoidance

The central mechanism. Every avoidance works brilliantly in the short term and makes the next encounter harder.

Benzodiazepine

A fast-acting anxiety medication. Effective short term, prescribed cautiously because of dependence and because it can undercut exposure work.

Graded exposure

Deliberately approaching what you avoid, in a planned order you set, staying long enough for the anxiety to fall on its own. The most effective ingredient we have.

Habituation

The natural decline in fear when you stay in a situation without escaping. It happens by itself if you let it.

Hyperventilation

Over-breathing, usually unnoticed. Produces the dizziness, tingling and unreality that make a panic attack feel catastrophic.

Inhibitory learning

The updated understanding of why exposure works: not erasing the fear, but building a stronger competing memory of safety.

Interoception

The sense of your own internal state. Anxious people are often unusually accurate at detecting it, which is part of the problem.

Intolerance of uncertainty

The engine of generalised anxiety: not fear of a specific outcome, but difficulty sitting with not knowing.

Metacognition

Your beliefs about your own thinking, such as worrying being useful or being uncontrollable. Often the useful target.

MHTP

Mental Health Treatment Plan. The GP referral that brings a Medicare rebate on eligible therapy sessions.

Panic attack

An abrupt surge of intense fear peaking within minutes. Extremely unpleasant, not dangerous, and it always ends.

Reassurance seeking

Asking, checking or searching to reduce doubt. Works for minutes and strengthens the loop each time.

Rumination and worry

Worry runs forward into what might happen; rumination runs backward over what did. Different directions, same loop.

Safety behaviour

Anything you do to make a feared situation feel survivable: sitting near the exit, over-preparing, having water to hand. It provides relief and prevents the fear being disproven.

What we do

Treating the loop, not the content.

If we spent our sessions examining whether each worry was realistic, you would leave reassured and be back where you started by Thursday. The content is not the problem. The loop is.

Understanding the mechanism

We start by mapping your particular version: what sets it off, what you do about it, what relief that buys, and what it costs. Most people have never seen it laid out, and seeing it changes something immediately.

Graded exposure, on your terms

The active ingredient in anxiety treatment is approaching what you avoid, deliberately, in an order you set, staying long enough to learn something new. Not flooding. Not being pushed. A planned ladder you build with us and climb at a rate you choose. This is also where the safety behaviours get dismantled, because they are what has been preventing the learning.

The thinking work

CBT for the overestimation of danger and the underestimation of your own capacity to cope. Also for the beliefs about worry itself, which are often the thing holding it in place.

Where fighting it is the problem

ACT for when the struggle against anxiety has become larger than the anxiety. The move is toward a life you want rather than away from a feeling.

The older layer

Schema Therapy where the anxiety sits on beliefs formed a long time ago about danger, defectiveness or needing to be perfect to be safe.

When it is not really anxiety

Sometimes what presents as anxiety is trauma, undiagnosed ADHD or autism, or a sensory environment that is genuinely unmanageable. Treating it as generic anxiety will not work. That is why we screen properly at the start rather than taking the presenting label at face value.

Medication

We do not prescribe. Medication can be a useful support, particularly at the severe end. It works best alongside therapy rather than instead of it, and we will talk plainly about how it interacts with exposure work if you are taking something.

Getting started

How we begin.

Nothing here involves being pushed into anything. You set the pace and the order, every time.

01 Before we meet
You see your GP for the referral we need before your first appointment. If you want the Medicare rebate, ask about a Mental Health Treatment Plan while you are there. It is a separate document from the referral. Your GP can also rule out the physical things that imitate anxiety.
02 Mapping it
What sets it off, what you do to manage it, and what that costs. We ask about trauma and about neurodivergency with everyone.
03 Building the ladder
Your avoided situations, ordered by difficulty, by you. We start well below the hard end, and nothing goes on the list without your agreement.
04 Climbing it
Steadily, with the safety behaviours coming out as you go. This is the part that produces lasting change rather than temporary relief.
05 Making it stick
Anxiety tends to return under stress. You finish with your own plan for what to do when it does, so a flare-up does not become a relapse.

Questions

Questions people ask about anxiety.

Is my anxiety bad enough to bother with?

If it is costing you things you would otherwise do, it is worth treating. There is no severity threshold for being allowed to ask.

Will you make me do things I am terrified of?

No. Exposure is planned with you, ordered by you, and started well below the hard end. Being pushed does not work; it teaches your system that the fear was justified.

Can you just tell me nothing bad will happen?

We could, and it would help until about Thursday. Reassurance is one of the things maintaining the loop, so we will do something more useful instead.

Are panic attacks dangerous?

No. They are among the most unpleasant experiences there are and they are not harmful. Understanding what is physically happening usually reduces their intensity on its own.

Do I need medication?

Not necessarily. Psychological treatment alone works well for most anxiety disorders. At the severe end, or where anxiety is preventing you engaging with therapy at all, medication can help. That is a GP or psychiatrist decision and we will support either way.

How long does it take?

Anxiety responds faster than most things we treat. Specific phobias can shift in a handful of sessions. Generalised or long-standing social anxiety takes longer. We review progress rather than assuming it.

What if my anxiety is about something real?

Plenty is. Health, money, discrimination and safety are real risks for real people. The work then is not about whether the risk exists, but about whether the worry is doing anything useful about it, which it usually is not.

I am autistic or ADHD. Is this different?

Yes, meaningfully. Anxiety driven by sensory overload, unpredictability or the cost of masking needs the environment addressing too, not just the thinking. Standard anxiety protocols applied without that adjustment tend to fail, and then get blamed on the person.

Does it work over video?

Yes. Some exposure work is actually easier to do from home, because we can practise in the environment where it happens.

Do you have a psychologist for anxiety in Melbourne?

Yes. We work with anxiety in adults, in person at our Prahran clinic in Melbourne and online anywhere in Australia. You can contact us to start the process, and you need a GP referral before your first appointment.

Nearby in the manual

Related conditions in the DSM-5-TR.

Anxiety is not one diagnosis but a family of them, and most people meet criteria for more than one at some point. We list them because the label matters less than the mechanism, and because people often recognise themselves in a neighbour.

Generalised Anxiety Disorder
Panic Disorder
Social Anxiety Disorder
Agoraphobia
Specific Phobia
Separation Anxiety Disorder
Selective Mutism
Illness Anxiety Disorder
Somatic Symptom Disorder
Substance or Medication-Induced Anxiety Disorder

Naming them is not diagnosing them. Which one fits is a conversation for your first session, and the treatment overlaps considerably either way.

Beyond us

Further information and support.

These organisations publish plain-language information, run helplines and offer peer support, independently of us. We list them properly, with links, on our resources page.