Anxiety and panic
Anxiety that keeps running in the background
Sometimes it is a constant hum of worry, sometimes a sudden wave of panic that comes out of nowhere. In therapy we can look at what the anxiety is about and how it shapes your days.
Anxiety is a normal response to threat or uncertainty. It becomes a problem when it is intense, hard to control and lasts long enough to limit work, sleep, relationships or the places you are willing to go. A panic attack is a sudden surge of intense fear with strong physical symptoms, such as a racing heart, breathlessness or dizziness.
Anxiety, together with depression, is one of the main themes of my practice. Some people first notice it after a panic attack, shaken by how physical it felt. Others live with steady worry for so long that they stop noticing it, until someone asks how they sleep.
How anxiety shows up
Anxiety tends to show up in three areas: the body, your thoughts and your behaviour. Most people notice one of them first.
In the body. A racing heart, tight chest, shallow breathing, a knot in the stomach, sweating, trembling, restless legs, tense shoulders, trouble falling asleep or waking early with your mind already running. The WHO's fact sheet on anxiety disorders lists many of these.
In your thoughts. "What if" chains that do not stop, imagining the worst, replaying conversations, difficulty concentrating, a sense that something bad is about to happen.
In what you do. You might avoid the meeting, the phone call, the crowded tram or the doctor's appointment, check things twice, prepare far more than the task needs, or say yes to keep things calm. Avoidance brings relief in the moment, and over time the list of things you avoid can quietly grow.
When anxiety becomes a problem
Feeling anxious before an exam, a hard conversation or a flight is ordinary. Anxiety usually starts to need attention when it is out of proportion to the situation, hard to control, and lasts long enough that it begins to decide things for you.
| Everyday anxiety | Anxiety that may need help | |
|---|---|---|
| Trigger | A clear situation: a deadline, an interview | Often unclear, or out of proportion to what is happening |
| Duration | Passes when the situation is over | Stays for weeks, or keeps coming back |
| Control | You can set it aside | Hard to stop, even when you know it is excessive |
| Effect on life | Uncomfortable but manageable | You start avoiding places, people or tasks |
| Body | Short burst of tension | Ongoing tension, poor sleep, or panic attacks |
About panic attacks and the heart. Chest pain, a pounding heart and breathlessness can come with panic, and they can also signal a heart or lung problem. The first time it happens, or if anything about it is different from before, please see a doctor first. If you have chest pain right now, call emergency services rather than reading on. The NHS page on panic disorder describes the typical symptoms.
Living in a second language
If you have moved to Prague, some of your days probably run in a language and culture that are not your own. Small things, a phone call to an office or a misunderstanding at school pick-up, can take more effort than they would at home. That extra effort can add pressure, especially when the people you would usually lean on are far away. It is not a diagnosis, only something worth naming, and in therapy you can talk about it in the language you think in.
How I work with this
We meet one to one for 50 minutes, in Prague 1 or online, and you can choose English, Czech or Slovak. I am a psychologist, psychotherapist in training (Gestalt, Institut Dialog), working under supervision.
In Gestalt therapy, working with anxiety often means paying attention to what happens in the session itself: where in the body you feel the anxiety, what it seems to protect you from, and what you do when it rises. We may look at the situations you avoid and at what avoiding them has cost you. I cannot promise how therapy will go. What I can offer is a safe, trusting relationship without judgement, and a pace that suits you.
If the body is the loudest part, see psychosomatics. If the anxiety sits under a capable life that feels empty inside, high-functioning depression may fit better, and if it peaks at work around a fear of being found out, read about imposter syndrome. If your worry is a teenager who has started avoiding school, I offer consultations for parents of teenagers.
When this is not the right place
- Acute crisis. If you feel you cannot keep yourself safe, please do not use the contact form. Use the crisis lines on this page.
- Chest pain or a possible heart problem. See a doctor or call emergency services first.
- Medication. I do not advise on starting, changing or stopping medication. Please talk to your GP or a psychiatrist.
- Children and teenagers. I work only with adults (18+).
Prices are on the pricing page. If you are unsure what kind of help you need, when to seek help walks through the options, and you can contact me by form, phone or email.
Last updated 1 October 2026
Questions and answers
How do I know if my anxiety needs treatment?
A useful question is how much it limits you. If worry or fear has lasted for weeks, is hard to control and starts deciding what you do or avoid, it is worth talking to a professional. A GP is a good first stop, and therapy can be part of the plan.
How is anxiety treated without medication?
The WHO lists psychological treatment among the effective options for anxiety disorders. Whether medication would help is a question for a doctor or psychiatrist, not for me. Therapy and medical care can run side by side, and I am glad to work alongside your doctor.
What does a panic attack feel like?
Common signs are a pounding heart, shortness of breath, chest tightness, sweating, trembling, dizziness and a sense that something terrible is about to happen. Because several of these overlap with heart and lung problems, the first time it happens, or if anything about it is different, please get checked by a doctor.
Is it normal to feel more anxious since moving to Prague?
A move to a new country brings a lot of change at once, and feeling more on edge for a while is understandable. If the anxiety stays, grows or starts limiting your life, it is worth taking seriously. You can talk about it with me in English.
How long does therapy for anxiety take?
There is no fixed number of sessions. Some people come for a few meetings to understand what is going on, others stay longer. We can talk about it openly as we go.
Related pages
Would you like to start with one conversation?
Write a few lines about what you are noticing, without detailed health information. I will reply and suggest a time.