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Anxiety Therapy

Whether anxiety has been with you your whole life, crept up on you recently, or you're not sure what to call what you're feeling, you're not imagining it and you're not alone.

The short version

Anxiety in adults often hides behind high functioning. You may look capable on the outside while internally living with constant worry, overthinking, tension, self-doubt, or a nervous system that rarely fully settles. Many adults spend years functioning this way before realizing how much energy it takes to hold everything together. Other times it's been there so long it simply feels like your personality.


Therapy focuses on understanding not just the symptoms but the deeper patterns underneath them. If you've been managing anxiety for years, there's usually something worth looking at underneath it. The goal is not just getting better at carrying it, but actually carrying less.

Common Patterns

Overthinking

Mental loops, second-guessing, catastrophizing, and difficulty tolerating uncertainty can create an overall hum of internal noise. Anxiety often creates avoidance too, where decisions, conversations, or situations feel hard to face.

Hypervigilance

Many people with anxiety feel constantly on alert, scanning for problems, rejection, conflict, mistakes, or worst-case scenarios. The nervous system stays in a low-level preparation mode, trying to anticipate what might go wrong before it does.

Emotional Exhaustion

It shows up as perfectionism, people-pleasing, burnout, irritability, sleep issues, and difficulty fully relaxing. For men especially, anxiety can look like irritability, overworking, or a low-grade restlessness that never settles.

How I Work with Anxiety

Anxiety is often the symptom. The deeper question is what it's protecting.

Working on anxiety in therapy means getting the relief you need while understanding the deeper patterns that keep it coming back. In early sessions, we'll map out your particular version of anxiety. What it feels like in your body, when it shows up, what makes it louder, and what you've been doing to manage it. Some of those strategies have helped you get through difficult things. Others may now be keeping the anxiety going more than relieving it.
 
From there, we'll work on interrupting the cycles. We'll look at avoidance, reassurance-seeking, and the way worry can feel productive even when it isn't. We'll also go deeper. That means understanding where your anxiety started to grow in the first place. This isn't about analyzing your childhood endlessly but it is about understanding it.

Anxiety also frequently overlaps with ADHD, relationship patterns, and substance use. Sometimes what looks like anxiety on the surface is connected to something else underneath, and part of the work is understanding what's actually driving it. I draw on psychodynamic, experiential, and somatic approaches depending on what the work calls for.

What Therapy Can Help With

Emotional Regulation

Anxiety often shows up in the body before it reaches your thoughts. Racing heart, tight chest, a wave of dread that seems to come from nowhere. We'll work on building your capacity to move through those states rather than getting stuck in them.

Relationship Patterns

Understand how anxiety affects boundaries, reassurance-seeking, people-pleasing, trust, social anxiety, hypervigilance around how you're perceived, and emotional connection.

Self Trust

Reduce overthinking, perfectionism, and chronic self-doubt while building more confidence in yourself and your decisions. Part of that work is learning to tell the difference between a fear that needs attending to and noise that needs quieting.

Different Types of Anxiety

Anxiety does not always look like obvious fear or panic. It can show up through irritability, overworking, perfectionism, relationship difficulties, chronic overthinking, or a nervous system that never fully settles. I work with generalized anxiety, social anxiety, panic, health anxiety, phobias, obsessive-compulsive patterns, perfectionism, and high-functioning anxiety.

​DC LICSW # LC200004425

MD LCSW-C # 32747
VA LCSW # 0904019292

IL LCSW # 149031601

MA LICSW # LICSW1144075

Megan Goldberg, LICSW, LCSW-C, LCSW

megan@megangoldbergtherapy.com

1350 Connecticut Ave NW, Washington, DC 20036

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