How CBT Helps With Anxiety

Anxiety has a way of creeping in and quietly taking over the mind. What starts as worry about one thing—a work presentation, school, a relationship issue, can gradually grow until it feels like everything is a source of stress. If you find yourself anxious about everything from minor decisions to major life events, you’re not alone. Anxiety disorders are the most common mental health conditions worldwide, affecting millions of people. If you’re someone who’s anxiety affects every aspect of your life and you need help so that it doesn’t become more insidious, there is a well-researched, extremely effective treatment to help with this disorder, and it’s Cognitive Behavioral Therapy (CBT). With CBT treatment, anxiety doesn’t need to control your life anymore.

What Causes Constant Anxiety?

Constant anxiety can be due to a combination of factors such as biological, psychological, and environmental. Here are some of the common reasons anxiety may feel constant.

Brain Chemistry & Genetics

Imbalances in neurotransmitters such as serotonin, dopamine, norepinephrine, and GABA can increase the brain’s susceptibility to anxiety. Also, if you there’s a family history of anxiety or other mental health conditions, this could make a person more prone to having an anxiety disorder.

Personality Traits

People who are naturally more sensitive, perfectionistic, or prone to overthinking may be especially susceptible to chronic anxiety. This heightened sense of awareness and tendency to dwell on potential problems can create a constant state of worry, even in situations that can happen everyday.

Life Experiences & Stressors

Traumatic experiences, (e.g. abuse, loss of a loved one, or divorce) can be major triggers for having chronic anxiety. A traumatic event can overwhelm the mind and body, creating a heightened sense of tension well beyond the experience itself. When stress becomes chronic, it can keep the body locked in a constant “fight-or-flight” state, which becomes a hamster wheel of worry that makes it difficult to relax, stay calm, or even feel safe.

Medical Conditions

Medical conditions can cause or contribute to anxiety because of changes or imbalances in your body. Some medical conditions that can cause anxiety include, but aren’t limited to: thyroid disorders, Parkinson’s disease, multiple sclerosis, diabetes, or heart arrhythmias.

Perimenopause & Menopause

Perimenopause and menopause can trigger anxiety or make existing symptoms more noticeable, often coming on suddenly that can feel very overwhelming. Even women with no history of anxiety may develop symptoms during perimenopause or menopause because hormonal shifts disrupt mood-regulating brain chemicals, heighten stress responses, interfere with sleep, and reduce the calming effects of progesterone which make the nervous system more reactive and prone to anxiety.

Teens With ADHD

Anxiety can show up differently in teens with ADHD, and it’s often misunderstood or mistaken as a symptom of ADHD. Because ADHD and anxiety often occur together, anxiety can be overlooked or may intensify existing ADHD symptoms. Anxiety in teens with ADHD often shows up as irritability, emotional outbursts, avoidance, and increased restlessness rather than verbalized worry. It can disrupt sleep, cause reassurance-seeking, and intensify self-doubt or fear of failure, compounding ADHD symptoms that are actually fueled by anxiety. If you’d like to have your teen tested for anxiety, contact us to learn more about testing.

Mental Patterns That Fuel Anxiety

Persistent worry, rumination, or catastrophizing can make someone feel constantly anxious so it feels like having anxiety is inescapable. Avoiding situations that trigger anxiety can help give short-term relief, but often only makes anxiety worse. When we consistently steer clear of challenges or discomfort, the brain starts to associate these situations with danger, making them feel increasingly threatening even when no threat is present.

What Is CBT?

CBT is a structured, evidence-based form of psychotherapy that focuses on the relationship between thoughts, feelings, and behaviors. Rather than dwelling on the past, CBT focuses on the present and emphasizes practical, action-oriented strategies. CBT’s core principle is that our thoughts shape our emotions and behaviors, and by identifying and adjusting unhelpful thinking patterns, we can transform how we feel and respond. CBT has been extensively researched for anxiety disorders, and has consistently shown to be helpful in reducing and alleviating anxiety symptoms by applying strategies and tools learned in therapy that can be used in daily life.

How Does CBT Help With Anxiety?

Anxiety often traps people in a constant loop where a negative thought triggers fear, which leads to avoidance behavior, which reinforces the negative thought. CBT works to break this cycle by:

Identifies Thought Patterns

The first step in CBT is about recognizing your automatic thoughts. These are quick, often unconscious mental reactions that arise in response to everyday situations. When you’re anxious about everything, these thoughts manifest in a few common patterns such as:

Catastrophizing. Example of this: “If I make one mistake at work, I’ll get fired and never find another job.”
All-or-nothing thinking. Example of this: “If I’m not perfect, I’m a complete failure.”
Overgeneralization. Example of this: “I struggled with this once, so I’ll always struggle with it”
Mind reading: Example of this: “If I give my opinion, they’ll I don’t know what I’m talking about.”

Challenges Unhelpful Thoughts

Once anxious thought patterns are identified, CBT helps you step back and evaluate them more thoughtfully and realistically. This isn’t about pretending everything is great or that problems don’t exist, but about looking at how accurate and helpful these thoughts are. These exercises will help you develop more balanced, realistic perspectives on thoughts to reduce anxiety.

Behavioral Experiments

CBT isn’t just about changing thought patterns, but also focuses on changing behaviors that reinforce anxiety. The anxiety cycle revolves around avoidance, which may bring temporary relief, however, it strengthens and amplifies the original fear through a process called negative reinforcement. For example, if going to social events makes you anxious, you could start with small gatherings that make interactions manageable, and gradually work up to more challenging social situations. Every successful experience builds confidence and helps to reduce anxiety over time.

Builds Coping Skills

CBT gives you a toolkit of strategies that help you take control of anxiety and navigate stressful situations confidently. This could include:

Relaxation techniques like deep breathing or progressive muscle relaxation.
Mindfulness practices to help you stay grounded in the present moment.
Problem-solving skills to address real-world concerns without spinning concerns in your head.
Engaging in positive activities to counteract the lethargy and withdrawal that often happen after a period of heightened anxiety.

What Should You Expect During CBT Sessions?

During CBT sessions, you’ll work closely with one of our CBT therapists to explore the thoughts, feelings, and behaviors that contribute to your anxiety. The first few sessions usually focus on understanding your patterns and identifying triggers, then working towards learning and practicing strategies that challenge unhelpful thoughts and build confidence to tackle fearful situations. After each session, your homework will be applying what you learned into your daily life and track your progress week over week.

CBT Therapy In DC, MD & VA & Telehealth In 43 States

Being anxious about everything doesn’t have to be your permanent reality. It’s important to know that ADHD and anxiety are closely linked and often occur together. The everyday challenges of managing ADHD symptoms can be highly stressful, which can then trigger or cause chronic anxiety. If you would like an assessment for ADHD, we offer in-person adult ADHD assessments and CBT therapy in Georgetown (DC), Bethesda (MD), McLean (VA), and Alexandria (VA), and virtual therapy in 43 states.

If you’d like to schedule a therapy session or an ADHD assessment, contact Sarah Smathers, our Director of Client Services at sarah@georgetownpsychology.com or (301) 652-5550.