There is a normal kind of worry — the kind that helps you prepare for an exam, finish a deadline or remember to call a parent. And there is a clinical kind of anxiety, in which the same machinery is running constantly, in the absence of any specific threat, and is starting to cost you sleep, focus, appetite or relationships. The second kind is what we treat.

Five signs that anxiety has crossed the line

First, the worry is present most days for two weeks or more. Second, you find it hard to switch off even when you're tired. Third, your body is in it — chest tightness, throat constriction, racing heart, restless legs, shallow breath. Fourth, you're starting to avoid situations 'in case' something goes wrong. Fifth, the people closest to you have noticed.

If three or more of these are true for you right now, please take the GAD-7. It is the same instrument I use in clinic and takes about two minutes.

What helps

The single most useful first step is regulating the body, not the thought. Slow exhales (longer than the inhale), softening the jaw, widening the visual field. Then — only then — examine the prediction the brain just made. If the loop keeps coming back week after week, that is precisely what Cognitive Regulation therapy is for.