From the outside, it doesn’t look like anxiety.

What does it actually feel like? For some of you it’s the background kind. It’s there when you wake up and still there at midnight, and it doesn’t need a reason. That one has a name, generalized anxiety, and the name doesn’t make it smaller. Give Your Worry an Appointment is something you can start on your own.

For some it’s the attack. Heart going, sure something is badly wrong, in a parking lot or driving home on an ordinary afternoon, with nothing in front of you to explain it. That’s a panic attack. When they keep coming back and you start dreading the next one, it’s called panic disorder. Had one for no reason? There’s a post on that.

Others get a thought that lingers for days, and the private things you do to quiet it down. I call that OCD tendencies.

And for some it arrived after something changed. A move, a divorce, a baby, a diagnosis, a job that ended. It hasn’t left. That one is called adjustment disorder, the clinical name for when a change knocks you harder than anyone expected.

Do you have to fit one of these neatly? No. Nothing here is a test.

Something I say a lot: “Your mood is like the climate and the emotion is the weather.”

Because you’re good at this. You’ve had years of practice looking fine, and the practice worked on everyone but you.

Two things are going on underneath. Worry keeps the body switched on. And the scanning for what could go wrong runs partly below the level you’d notice. So you can sit through a whole meeting looking calm and still be on alert. It’s as if a system built to spot trouble has been running a long time and nobody ever showed it where the off switch is.

Your day might start with the drive down 183 and end with the list still going when you should be asleep. Or your commute is the ten steps to the kitchen table and the day never quite ends. Either way, if that’s your day, there hasn’t been much of a quiet hour in it.

So what do we actually do? Not one method, and not the same thing every week. What we use depends on what you bring in.

Person-centered work, which is being listened to without being managed. CBT, where we catch the thought mid-flight and check whether it’s actually true. DBT skills, things to do in the moment when the feeling is too big to think your way through. And mindfulness. Noticing what’s happening before you react to it, which is not the same thing as an app.

Plenty of the women I see are working on anxiety and trauma together, and for many of them the trauma is part of why they need to keep control of things so much. When that’s true, the work goes there too. I’m trained in EMDR, which works directly on the memories themselves, and trauma and EMDR has its own page.

Does any of this take into account where you come from? It does. I work trauma-informed and culturally sensitive, so I’ll ask where you come from, what home was like, and what you’re up against right now.

Whatever we use, you’re the one who knows your life. The aim isn’t to never feel anxious again. Nobody gets that, and I’d be lying if I offered it. The aim is for the alarm to have less say in how your week goes.