Anxiety & Nervous System Regulation
When Anxiety Starts Calling the Shots
Anxiety doesn’t always look the way people expect it to.
It can look like racing thoughts and restless nights, but it can also look like overpreparing, procrastinating, second-guessing decisions, having trouble concentrating, or mentally rehearsing conversations that haven’t happened yet.
For some women, anxiety has been around for so long that it barely registers as anxiety anymore. You’re accustomed to thinking ahead. You anticipate what could go wrong. You prepare thoroughly, remember what needs to happen, and make sure important things don’t fall through the cracks.
Some of that may have served you very well.
The difficulty comes when your mind doesn’t seem to know when it’s done. There’s always something else to anticipate, reconsider, prepare for, or solve. Even when things are objectively okay, relaxing can be surprisingly difficult.
Your body can carry that vigilance too. Anxiety may show up as a racing heart, tightness in your chest, headaches, digestive discomfort, muscle tension, disrupted sleep, hot cheeks, cold hands, or a general sense that your system never fully powers down.
After a while, all of that takes energy.
How Anxiety Paints Us Into a Corner
Anxiety is very good at learning what seems to keep us safe.
If something makes you anxious and you avoid it, your nervous system gets immediate relief. The difficult conversation gets postponed. The email waits another day. You don’t make the appointment. You decide against the trip. You check one more time before sending something.
For a little while, you feel better.
Your brain pays attention to that relief. Avoidance, reassurance, checking, overpreparing, or trying to eliminate uncertainty can gradually become strategies for managing anxiety. The problem is that relying on them can also reinforce the sense that whatever you were afraid of really was too risky to handle.
And the original problem usually hasn’t gone anywhere.
Now there may also be an unanswered email, a conversation hanging over you, an opportunity you wish you’d taken, another hour spent checking your work, or frustration with yourself for doing something you genuinely meant not to do again.
Over time, this can make your life smaller in ways that are easy to miss while they’re happening. More decisions get organized around avoiding anxiety. Ordinary things require more preparation. Uncertainty becomes harder to tolerate. You spend increasing amounts of energy trying to prevent yourself from feeling anxious.
At some point, managing anxiety can become nearly as exhausting as anxiety itself.
What We Can Do With Anxiety
I want therapy to help you feel better. I also want you to understand enough about your own anxiety that you know what to do when it shows up again.
My approach draws from Cognitive Behavioral Therapy (CBT), mindfulness, and somatic therapy. The particular combination depends on what your anxiety looks like, what keeps it going, how it shows up in your body, and what is most useful for you.
We may look at the thoughts and assumptions that keep pulling your attention toward possible problems. We may work with avoidance, reassurance seeking, perfectionism, or the need to feel certain before you act. We may practice ways to settle your nervous system when your body is responding as though something is dangerous. And sometimes the work involves learning that an anxious feeling can be present without requiring you to organize your decisions around it.
I also like clients to understand why the things we’re doing can help. A breathing technique is more useful when you understand what it’s doing physiologically. A CBT skill is easier to use when you can recognize the pattern it’s interrupting. Understanding your nervous system can make physical symptoms less mysterious and give you more options for responding to them.
With practice, things that once required a tremendous amount of mental effort can begin to take up less space. You may notice an anxious thought without spending the next hour following it. Make a decision without revisiting it six times. Have the conversation. Send the email. Recognize when your body needs help settling and know what tends to work for you.
There will still be uncertainty. There will still be difficult days, stressful situations, and things worth worrying about.
But anxiety can become something you know how to work with rather than something you have to continually work around.
Get started here
Complete the secure inquiry form below and I’ll personally respond within one business day. We’ll schedule a brief consultation call where you can share a general sense of what brings you to therapy, ask questions about my approach, and decide whether working together feels right for you.
You may also be interested in learning more about:
Worry often begins as an attempt to stay prepared and prevent problems. Learn why it can become so difficult to stop worrying, and how to build greater confidence in your ability to cope with life’s uncertainties.
Panic attacks are intense, overwhelming experiences that leave you feeling frightened and out of control. Learn what is happening in the mind and body during a panic attack, and why panic is more treatable than many people realize.
Mindfulness is the practice of intentionally paying attention. In a world that constantly competes for your focus, learn how mindfulness can help you return to the present moment and the life you’re already living.
Licensed Professional Counselor
Cheryl Zandt
Telehealth Counseling in Washington DC and Virginia
Cheryl Zandt is a Licensed Professional Counselor providing online therapy for women in Virginia and Washington DC. For more than 20 years, she has helped women face anxiety, burnout, panic, relationship challenges, and life transitions with greater understanding, self-trust, and choice.
Thoughtful, collaborative, and grounded in research, curiosity, and genuine human connection, her approach helps clients make sense of experiences that have felt confusing, frustrating, or overwhelming for far too long.
Your questions, answered
What type of therapy do you use for anxiety?
My work is grounded in Cognitive Behavioral Therapy (CBT), mindfulness practice, and somatic therapy. Together, these approaches help you understand the patterns driving anxiety, learn practical tools for responding differently, and build a healthier relationship with your thoughts, emotions, and nervous system. The goal isn’t simply to manage symptoms – it’s to help you regain choices that anxiety may have taken away.
Can therapy help with the physical symptoms of anxiety?
Yes. Anxiety is a whole-body experience, not just a thinking problem. When your nervous system perceives danger, it can affect your breathing, heart rate, digestion, sleep, concentration, and energy levels. Therapy can help you understand why these symptoms occur and teach practical skills that help your nervous system regulate more effectively, often leading to meaningful relief over time.
Should I consider medication for anxiety?
It depends on the severity of your symptoms, how much they’re affecting your daily life, and your personal preferences. For some people, therapy alone is enough to create meaningful relief. For others, medication can be a helpful tool, especially when anxiety is making it difficult to function, sleep, concentrate, or fully engage in therapy.
I don’t prescribe medication, but I’m happy to help you think through your options and, when appropriate, coordinate care with your physician or psychiatrist. My goal is to help you find an approach that works for you, not to push a particular solution.
Why does anxiety make it so hard to do things I know I need to do?
Anxiety often convinces us that avoiding something will make us feel better. In the short term, it usually does. The problem is that the anxiety remains, while the task, conversation, decision, or responsibility is still waiting. Over time, this can create a frustrating cycle of avoidance, relief, and renewed stress. Therapy can help you understand why this happens and develop new ways of responding that reduce anxiety without shrinking your life.
Why does anxiety show up in my body?
Anxiety is a whole body experience. When your brain perceives something as threatening, your nervous system prepares you to respond. That response can affect your breathing, heart rate, digestion, sleep, concentration, and muscle tension. Even when a threat isn’t immediate, your body may still react as though it is. Understanding this process can make anxiety feel much less mysterious and much more manageable.