Understanding anxiety

It's one topic at a time. You can read it or click Listen: the phrase that sounds is color-coded.

What anxiety is

Anxiety is a normal reaction to what we experience as a threat. It's the body's alarm: it prepares you for action. Feeling it now and then is normal and sometimes helpful. We talk about an anxiety disorder when the fear or worry is intense, excessive and doesn't go away. And when they interfere with your life: work, school, family or relationships. Anxiety disorders are the most common mental health problems in the world. They affect some 359 million people, just over 4% of the population. They are more common in women and usually begin in childhood or adolescence.

Sources: 1, 2 (see Sources tab)

How it shows in the body

Your heart beats fast or hard. Breathing becomes faster or it seems like you're short of air. The muscles are tense. There may be tremors and sweating. Stomach discomfort, dizziness or tingling appear. It's hard to sleep and fatigue builds up. They're very upsetting sensations. They're the alarm of the moving body. If they are new, very intense or you are unsure, see your doctor to rule out other causes.

Sources: 2 (see Sources tab)

How it shows in your mind and in what you do

Worry is hard to control and jumps from one topic to another. The mind expects the worst. It's hard to concentrate or the mind goes blank. There's irritability and a feeling of being on the edge. You start to avoid situations, places, or people. You check things many times or ask others to reassure you.

Sources: 1, 2 (see Sources tab)

Types of anxiety

Generalized anxiety: Excessive worry about many everyday things for months. Panic disorder: repeated panic attacks and fear of them coming back. Social anxiety: intense fear of being observed and judged by others. Specific phobias: a very strong fear of something specific, such as flying, heights, needles or some animals. Agoraphobia: fear of places from which it would be difficult to get out or receive help. You can have more than one at the same time.

Sources: 1, 2 (see Sources tab)

What a panic attack is

It's a sudden surge of very intense fear. It brings palpitations, sweating, tremors, tightness in the chest, tingling and a sense of impending catastrophe. It can look like a heart attack or you're gonna lose control. It goes up fast, reaches a maximum and comes down alone. It can happen several times a day or just a few times a year. Having a panic attack doesn't mean you have panic disorder. If you have new or unusual chest pain, seek medical attention.

Sources: 2 (see Sources tab)

Why it persists

Anxiety persists when we value danger as more than it is. Avoiding what scares you relieves you right away. But that relief tells the brain that the situation was dangerous. Next time the fear is greater and you avoid more things. The same goes for checking, asking for reassurance, or always carrying something just in case. What relieves today keeps the problem tomorrow.

Sources: 3 (see Sources tab)

Why it appears

There is no single cause. Social, psychological and biological factors are combined. Having experienced severe loss, abuse, or other difficult experiences increases the likelihood. Physical health also plays a role, and anxiety plays a role. It isn't weakness or a lack of character.

Sources: 1 (see Sources tab)

When to ask for help

Only 1 in 4 people with an anxiety disorder gets treatment. Ask for help if your anxiety lasts for weeks and doesn't subside. If it prevents you from working, studying or socializing. If you avoid more and more things. If you use alcohol, pills or other substances to calm yourself. If your mood is also very low. The diagnosis is made by a healthcare professional. This app is not for diagnosis.

Sources: 1 (see Sources tab)

Which treatments work

Very effective treatments exist. Psychological therapy is the essential treatment, especially cognitive-behavioral. In the trials, this therapy clearly outperformed placebo. It teaches you to question the threat and to gradually approach the feared. Some antidepressants can help adults. They are indicated and followed by a doctor. Tranquilizers such as benzodiazepines are generally not recommended: they can be addictive and help little in the long run. Do not leave or change any medication on your own. Talk to your doctor. Physical exercise reduces symptoms of anxiety, with a small to moderate effect. In a trial with 276 adults, an 8-week mindfulness programme was as effective as a commonly used antidepressant.

Fonts: 1, 3, 4, 5, 6 (see the Fonts tab)

Common myths

Anxiety is for weak people. False. It's the most common mental health problem. If I avoid what scares me, it will happen. False. Avoiding it makes it grow. A panic attack is never over. False. It goes up, it reaches a maximum and it goes down. You have to eliminate anxiety completely. False. The point is, I don't run your life. This has no solution. False. There are very effective treatments.

Sources: 1, 2, 3 (see Sources tab)

Tips for each difficulty

Choose the area that weighs the most on you today. Mark the pattern you're going to practice and it'll be kept in My plan.

Constant worry

The mind tries to solve the future by thinking over and over again. It isn't about stopping thinking. It's about giving it a set time and limits.

Worry time. Set aside 15 minutes a day, always at the same time. When a concern comes up outside that time, write it down and leave it there.Problem or assumption? If you have a solution, decide the first step and when you're going to do it. If it's a "what if?" there's nothing to figure out. Let it go.Put it on paper. Writing your worry down in concrete words makes it smaller than it is in a whirlwind.Practise not knowing. Pick something small and don't check it: don't check the message, don't look at the door again. See that nothing happens.Less reassurance-seeking. Reduce the number of times you ask others or search the Internet for symptoms. Calm down for a while and feed the doubt.Come back to the present. Use the Tools 5-4-3-2-1 anchor when the head goes off.

Guidelines are common techniques in cognitive behavioral therapy.

Panic attack

A panic attack is the body alarm triggered without any real danger. It goes up fast, reaches a maximum and comes down alone.

Name it. Tell yourself: "It's a panic attack. I know it. It will pass."Stay where you are. If you can, don't run away. Leaving shows your brain that the place was dangerous.Breathe slowly. Breathe in for 4 seconds and out for 6. Use the circle in Tools.Relax your body. Lower your shoulders, loosen your jaw and feel your feet on the ground.Don't fight the sensations. Observe them like a wave: up, up and down. Fighting with them makes them longer.Carry on with what you were doing. When I come down, you can get on with your day. It's what reduces fear the most to the next.Get anything new checked. A new or different chest pain needs medical evaluation.

Sources: 2. Guidelines are common techniques of cognitive behavioral therapy.

Avoidance

The more you avoid, the more fear grows. Approaching it slowly and repeatedly is what reduces it the most.

Make your list. Write down the situations you avoid and score the fear of each one on a scale of 0 to 10.It starts with a 3 or a 4. Something that costs money, but you can do. Don't start with the hard part.Stay until it goes down. Remain in the situation until you notice that the anxiety has eased or that you can sustain it.Repeat many times. Once is not enough. Repeat the same step several days before climbing to the next one.Drop the "just in case" habits. Take it slowly, without the companion, without the water bottle or without looking out.If it's too intense, do it with someone. With very strong fears, this work is best guided by a psychologist.

Sources: 3. Guidelines are common techniques in cognitive behavioral therapy.

Physical symptoms

The body is in alarm mode: fast heart rate, tension, knot in the stomach. You can lower the activation with daily practice.

Slow breathing every day. Five minutes, once or twice a day, even if you're fine. That's how it works when you need it.Tense and release. Tense a muscle group for 5 seconds and let go. Work through your hands, shoulders, face and legs.Get moving. Exercise, especially aerobics, reduces symptoms of anxiety. Walking fast already counts.Change how you read it. When you feel the heart, say: It's the adrenaline, it's my alarm. The feeling is less scary.A medical check-up, once. If you're worried about a symptom, see him. With the normal result, avoid repeat tests to calm you down.

Sources: 4, 5. Guidelines are common techniques in cognitive behavioral therapy.

Catastrophic thoughts

Anxiety exaggerates two things: how likely the danger is and how bad it will be. A thought is not a fact.

Catch the thought. Write down the exact phrase that scares you: I'm going to fail, I'm going to get something.Look for evidence. What data do I have for and against? How many times have I thought about it and it didn't happen?The most likely outcome. Write down the worst, the best and the most likely. Keep the third.What if it happened? Think about what you would do and who would help you. There's almost always a plan.Step back. Say, "I'm having a thought that"... It's a thought, not a news story.Talk to yourself kindly. Tell me what you'd say to someone you love in your own situation.

Sources: 3. Guidelines are common techniques in cognitive behavioral therapy.

Social anxiety

The fear is of being watched and judged. The attention goes inward: how I look, if I'm noticed.

Focus outwards. Notice what the other person says, in their face, in the place.No rehearsing or replaying. Do not prepare every sentence before or review the conversation afterward.One small exposure a day. Say hello, ask a question in a store, give a brief opinion.Drop the safety behaviours. Look them in the eye, talk without your cell phone in your hand, don't hide in the background.Behavioural goals. The goal is to say something in the meeting, not to get nervous.People look at you less than you think. Each person is concerned above all about himself.

Guidelines are common techniques in cognitive behavioral therapy.

Sleep and night-time anxiety

At night it's quiet and the head is filled with worries. Sleeping poorly increases anxiety the next day.

Same time to get up. Every day, even on the weekends.Notebook on the bedside table. Write down what's going on around you and save it for your worrying time tomorrow.If you can't sleep, get up. If you've been up a long time, get out of bed and do something quiet until you're sleepy.Don't look at the clock. Calculate the number of hours the alarm remains active.Screens away. Leave your cell phone outside the bedroom and turn off the lights an hour before.No alcohol to help you sleep. It helps you sleep, but the sleep is worse and the anxiety gets stronger.

Guidelines are common techniques in cognitive behavioral therapy.

Caffeine, alcohol and habits

Some habits raise the body's alarm without you even noticing. Changing them doesn't cure anxiety, but it lowers the starting point.

Cut down on caffeine. In high doses, anxiety increases. In people with panic disorder, doses of about five coffees caused attacks in half of the studies.Be careful with energy drinks. That's a lot of caffeine in a short time. It also counts tea, cola and some medicines.Less alcohol. Reducing or avoiding it helps. Alcohol and other drugs can make anxiety worse.Regular exercise. Better little and frequent than a lot a day. Pick something you like.A few minutes of mindfulness. Practice mindfulness every day, even for five minutes.Don't isolate yourself. Keep in touch with people you trust and let them know how you're doing.

Sources: 1, 7, and 8. Guidelines are common techniques in cognitive behavioral therapy.

Overwhelm at work or in your studies

When everything seems urgent, anxiety blocks. Sorting and reducing brings back the sense of control.

Empty your head. Write down everything that's outstanding on one list.Choose three. Mark the three tasks for today, the rest will wait.One thing at a time. He works in blocks with short breaks. Multitasking increases stress.Ask and delegate. Saying "not on time" is better than not delivering.Put an end to the day. Set a time to close and do something that marks the change: walk, shower, cook.

Guidelines are common techniques in cognitive behavioral therapy.

Sources

The information comes from these guides and studies. The numbers of each subject refer to this list.

World Health Organization (2025). Anxiety disorders: fact sheet. Open
The National Institute of Mental Health (NIMH) of the U.S. Anxiety disorders. Open
Carpenter et al. (2018). Cognitive behavioural therapy for anxiety: meta-analysis of 41 placebo-controlled trials. Depression and Anxiety. Open
Stubbs et al. (2017). Anxiolytic effect of exercise in people with anxiety disorders: meta-analysis. Psychiatry Research. Open
Munro et al. (2026). Effect of exercise on symptoms of depression and anxiety: umbrella review. British Journal of Sports Medicine. Open
Hoge et al. (2023). Mindfulness-based stress reduction vs escitalopram in adults with anxiety disorders: clinical trial. JAMA Psychiatry. Open
Klevebrant and Frick (2022). Effects of caffeine on anxiety and panic attacks: meta-analysis. General Hospital Psychiatry. Open
Liu et al. (2024). Caffeine intake and anxiety: meta-analysis. Frontiers in Psychology. Open

This app provides information and general tips. It doesn't diagnose or replace your doctor or psychologist. If you are in crisis or thinking about harming yourself, call 112 or 024.

Would you rather talk it over with a professional? Order your first appointment at the Vivaldi Clinic., in person in Valencia or online.

This guide is produced by Clínica Vivaldi, a psychological health centre in Valencia.: María Teresa Fernández Vicente, Health psychologist and neuropsychologist (CV17304). November 9, 2026. This is the first time I've seen you. The scientific sources are in the Fonts tab. If you need professional help: An anxiety psychologist at the Vivaldi Clinic.