Q&A on Anxiety & Panic: The Complete Guide 2025 | CBT and ACT

65 Q&A on Anxiety & Panic, and Coping: The Complete Guide from a CBT, ACT, and NeuroFlex ACT Expert

This comprehensive guide offers honest, accurate, and sensitive answers based on the most advanced psychological approaches : Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), and the unique NeuroFlex ACT model developed by the expert to work directly with the brain and nervous system to create physiological and psychological flexibility.

The goal here is to stop feeling alone and start getting real answers, because avoidance and suppression simply don't work. If you've ever asked yourself anything about anxiety, panic, or treatment methods, chances are the answer is here.

Table of Contents

1. Understanding, Diagnosis, and Feelings (What does it feel like?)
2. Anxiety and Physical Symptoms (Am I in danger?)
3. Anxiety and Panic Attacks (The Big Fear)
4. Connections and Impact on Life (When and How?)
5. Social Anxiety, Relationships, and Intimacy
6. Treatment, Help, and Finding a Solution (Where and How?)
7. Medication, Safety, and Addiction
8. ACT, NeuroFlex ACT, and Psychological Flexibility (Advanced Models)

1. Understanding, Diagnosis, and Feelings (What)

What is anxiety, and what is it truly saying? Anxiety is a natural alarm system that exists to protect us. It's an emotional and physical reaction to a perceived threat, whether the threat is real (like an approaching car, which we'd call fear) or imagined (like a thought about future failure, perhaps waking you up in a fright in the middle of the night). The anxiety itself isn't the problem; the issue lies in how we react to it and the extent of its influence on our lives.

Why do I feel anxious for no reason? Anxiety always appears for a reason ; it's just that the reason isn't always conscious or immediate. Most "reasonless" anxiety stems from a "background noise" of alertness in the nervous system or from automatic thought patterns that detect a threat before you even have a chance to think about it.

Why is this happening to me right now? Anxiety tends to erupt when there is a cumulative imbalance between the demands of life and your coping resources. Often, it's not a single event, but the tip of the iceberg of a long period of stress, fatigue, or avoidance.

Can anxiety appear only in the body without thoughts? Absolutely. This is the classic anxiety scenario where your body reacts faster than your brain. The nervous system enters a state of high alert (Fight or Flight) in response to something in the environment or a sensory memory, and the physical symptoms (heart rate, trembling) appear before you manage to "catch" the threatening thought.

What does anxiety feel like in the body? Many people describe anxiety as a sensation of "molten lava" in the chest, a rapid pulse, or trembling in the limbs. These are physical reactions caused by a surge of stress hormones preparing you for the "fight or flight" response. It's unpleasant, but it is not immediately dangerous.

What does anxiety look like? Anxiety can "wear" many disguises. It might look like a quiet, introverted person avoiding social events, someone over-investing in work or studies, or even someone irritable and impatient. Anxiety is not only fear, but also a pattern of avoidance, procrastination, and people-pleasing.

What is the difference between anxiety, stress, and panic?

Stress is a reaction to a known external factor (like a work deadline). Anxiety is worry about the future that might lack an immediate external cause. A panic attack is the peak of anxiety , a sudden, intense wave of physical symptoms that feels out of control, almost like an emotional earthquake.

Are anxiety and panic attacks the same thing? No, they are not the same, though they are related. A panic attack is a sudden, intense episode typically lasting a few minutes , while anxiety is a more persistent state of worry and tension.

Is anxiety a genetic disorder? Genetic factors definitely play a role. If there is a history of anxiety in the family, the risk is higher. However, the environment you grew up in, trauma, and life events are factors that usually have a more central influence. It is never just genetics.

What is the definition of anxiety? Anxiety is defined as a state of excessive worry, tension, or fear, usually accompanied by physical symptoms. It is considered a disorder when it is intense, long-lasting, and significantly disrupts your daily functioning (work, relationships, social life).

Where does anxiety come from? Anxiety comes from a complex combination of factors : genetics, past experiences (especially traumatic ones or prolonged periods of stress), and also learned thought patterns that cause you to interpret different situations as a threat.

Chapter 1 Summary: Anxiety is a multifaceted, evolutionary response that can manifest as avoidance, procrastination, or people-pleasing. It’s considered a "disorder" when it impairs your daily functioning, and it never appears "for no reason," even if the source is not immediately conscious to you.

2. Anxiety and Physical Symptoms (Can)

Can anxiety cause chest pain? Absolutely. Anxiety causes your chest muscles to contract and your heart rate to increase, which can feel exactly like sharp pain or pressure. It's a frightening feeling, but physically, your heart is healthy. We call this "anxiety masquerading as a heart attack".

How do I know if it's anxiety or something physical? The only way to know for sure is a medical examination by a family doctor or cardiologist if the symptoms are new and frightening. However, if your symptoms appear and disappear relatively quickly, peak, and then fade, and are related to times of stress, the chances are high that it’s anxiety originating from your nervous system.

Can anxiety cause nausea? Yes. When the sympathetic nervous system (the stress system) kicks in, it "shuts down" the digestive system to divert energy to the muscles. This can cause feelings of nausea, an "nervous stomach," or "butterflies" in your stomach.

Can anxiety cause dizziness? Dizziness is a very common symptom. It usually results from slight, unnoticed hyperventilation (over-breathing), which causes an imbalance of oxygen and carbon dioxide in the brain.

Can anxiety cause headaches? Yes. Chronic muscle tension, which occurs when the body is in a constant state of alertness, often leads to tension headaches or migraines.

Can anxiety cause high blood pressure? Anxiety causes a temporary rise in blood pressure and heart rate. This is a normal reaction to stress. Chronic anxiety doesn't necessarily cause chronic hypertension , but the constant alertness can certainly contribute to it.

Can anxiety cause shortness of breath? This often happens when breathing becomes shallow and rapid. The brain receives a message that there isn't enough air, which increases the anxiety and creates a vicious cycle.

Can anxiety cause diarrhea? Yes. Anxiety and stress directly affect the digestive system. This is part of the Brain-Gut Axis connection.

Can anxiety cause stomach problems? Absolutely. Anxiety can cause every type of stomach problem: pain, nausea, a feeling of fullness, and constipation or diarrhea.

Can anxiety make you sick? Anxiety itself doesn't cause the flu. But chronic stress weakens the immune system , which makes you more susceptible to illness. Anxiety wears down the body's "line of defense".

Can anxiety cause night sweats? Yes. Night sweats are a common symptom. The body secretes stress hormones that raise body temperature and metabolism, even when you're asleep. This is a sign that the brain is in a state of high alert even during rest.

Can anxiety cause fainting or lightheadedness? A feeling of dizziness or lightheadedness is very common. It usually results from slight, unnoticed hyperventilation (over-breathing), which temporarily reduces blood flow to the brain.

Can anxiety cause chronic stomach problems? Anxiety may lead to mild chronic inflammation in the digestive system and also affects the balance of gut bacteria. This can contribute to Irritable Bowel Syndrome (IBS) and other persistent stomach issues.

Chapter 2 Summary: Most physical symptoms of anxiety (chest pain, dizziness, shortness of breath) are not dangerous, even if they frighten you greatly. The right treatment teaches your body how to relax and exit the sympathetic cycle.

3. Anxiety and Panic Attacks (The Big Fear)

What should I do during an anxiety attack? The first thing is to remember that it is not dangerous and it will pass. Use a grounding technique: count 5 things you see, 4 things you hear, 3 things you feel, 2 things you smell, and 1 thing you taste. This redirects your attention from the anxious brain to the present moment.

How long does an anxiety attack last? A panic attack usually reaches its peak within 10 minutes and then subsides. For example, an attack might start right as you stand in line at the grocery store and suddenly feel dizzy and have a fast pulse , but the highest intensity is relatively short.

What happens in the body during an anxiety attack? The nervous system floods the body with adrenaline and cortisol. Heart rate increases, breathing accelerates, and muscles contract. This is a strong and unrestrained "fight or flight" reaction that has no real external threat.

Is an anxiety attack dangerous? No, it is not dangerous. It feels awful, but purely physically, a panic attack cannot kill you and is not harmful to your heart. The fear of the attack is often worse than the attack itself.

How do I calm a panic attack? Using slow and controlled breathing (for example, 4 seconds inhale, 6 seconds exhale) is the best tool. This sends a message to the nervous system that it's safe to relax, gradually shifting from a stress state (sympathetic) to a rest state (parasympathetic).

Chapter 3 Summary: Panic attacks are not dangerous and subside quickly. The most effective tools are slow, controlled breathing and grounding techniques, which return control to you and attention to the present moment.

4. Connections and Impact on Life (When / How)

How does anxiety affect relationships? Anxiety makes us more sensitive to criticism , suspicious, and can cause us to withdraw from partners or friends. It activates our need for control, which makes the other person feel distant.

How are anxiety and depression related? They are related like two sides of the same coin. Anxiety is a fear of the future, while depression is often sinking into the past. When you try to control anxiety without success, you may be drawn into depression (a feeling of helplessness).

When is anxiety too much? Anxiety is "too much" when it causes you to avoid things you want or need to do: work, studies, leaving the house, or social connections. When it paralyzes your actions, that's the time to seek professional help.

Why does anxiety increase in the morning? In the morning, cortisol (the stress hormone) levels naturally rise to wake us up. If you're already stressed, this surge can boost anxiety to the maximum, even before your day has started.

Why does anxiety happen at night? At night, when there are no distractions, the worried and anxious thoughts surface undisturbed. The body is quiet, but the mind starts to race.

Can anxiety turn into anger? Yes. Anger is often "fear of loss of control". Anxiety causes a feeling of helplessness, and anger gives us a false sense of control and power. This is a common defense mechanism against the feeling of anxiety itself.

How does anxiety affect daily life? It affects every area : decreased concentration, chronic fatigue, difficulty making decisions, a tendency to postpone tasks, and an increased need for control. It shrinks our world.

When does anxiety take over? It takes over when we start living life according to its rules: avoidance. When we stop going to places, meeting people, or doing things just because we're afraid "it will happen again".

What does it mean when anxiety feels like you are not real (Derealization)? This is a common and frightening phenomenon called derealization. It is a defense mechanism where the brain disconnects you from the moment to cope with emotional overload. It is not dangerous, but it's important to learn grounding techniques to return to the here and now.

How does anxiety make me tired? Yes. The physical and mental preparation for a constant emergency state is horribly exhausting. The brain and body work overtime even when you're resting.

Chapter 4 Summary: Anxiety impacts your world by causing you to avoid important actions, and it can disguise itself as anger or chronic fatigue. If anxiety is managing your actions, it's a sign to seek help.

5. Social Anxiety, Relationships, and Intimacy

How does social anxiety ruin relationships? Social anxiety causes you to avoid relationships or to act within them out of an intense need for validation. This can lead to a pattern of self-cancellation, excessive people-pleasing, or conversely, an outburst of anger when expectations aren't met. The avoidance shrinks the circle of people and the damage is double.

What do I do when I feel anxiety in a relationship? The first thing to do is to acknowledge the emotion and communicate it. In the ACT approach, we don't try to "eliminate" the anxiety, but rather identify what is important to us in the relationship (our values) and commit to actions that promote them, even when anxiety is present.

How to stop overthinking in relationships? Overthinking is like trying to solve a problem in a rocking chair: lots of motion, no forward progress. To stop it, we need to learn to direct our attention back to the present moment, to what can be controlled, and to pay attention to what the body is feeling right now (a NeuroFlex ACT tool).

How is social anxiety treated? The most effective treatment is CBT , which focuses on gradual exposure to threatening situations, combined with ACT , which focuses on accepting the anxiety and committing to action. It's like convincing the anxious brain that it exaggerated its predictions.

Is social anxiety genetic? Like most anxiety disorders, genetic factors definitely play a role. However, the main role is played by environmental learning patterns where a person learned to "scan" the environment for signs of rejection.

Social anxiety – how do I start a new relationship? Start with "small doses" of interaction while accepting the fear. ACT teaches us that the fear will appear , but we can choose to move toward the relationship despite it. The work is about accepting anxiety as a temporary companion, not an obstacle to be eliminated.

Chapter 5 Summary: Social anxiety can be effectively treated through gradual exposure, where the key step is the separation between your self-worth and the need for external validation.

6. Treatment, Help, and Finding a Solution (Will / Where)

Does anxiety go away on its own? Mild anxiety can pass once the source of stress disappears. Chronic and significant anxiety usually does not go away on its own. It requires actively learning new tools and changing patterns (as in CBT/ACT).

Does talk therapy really work for anxiety? Yes. Focused therapies like CBT and ACT have been proven by research to be highly effective. They don't just alleviate symptoms; they teach you practical, long-term tools for managing anxiety.

How long does anxiety treatment usually last? Focused CBT/ACT treatment is usually relatively short-term. In most cases, significant improvement is achieved within 8 to 20 sessions , depending on the severity of the situation and the patient's commitment.

What treatments are available for anxiety? The most evidence-based treatments are CBT (focused on thoughts) , ACT (focused on values and acceptance) , and medication. Newer approaches integrate somatic (body-based) tools with ACT, such as Process-Based Therapy (PBT).

Where can I get help for anxiety? You can reach out to your family doctor, a psychiatrist, or a private cognitive-behavioral therapist (CBT/ACT) or through your health service provider. Private therapists can be found through a focused search for the required expertise (e.g., "ACT therapist in [City Name]").

Can anxiety kill me? No, it cannot kill you. The physical symptoms are a normal reaction to stress. Even though the symptoms are sometimes very frightening, they do not directly cause health damage.

Can anxiety be a good thing? That's an interesting question. In the right dosage, anxiety is fuel. It can motivate us to study, prepare for a test, or avoid risk. The problem begins when it takes over and turns from "fuel" into a "barrier".

Chapter 6 Summary: Significant anxiety does not resolve on its own, and it does not pose a physical danger to your body. Focused treatment (like CBT and ACT) is the most effective way to learn practical tools for anxiety management, usually in a relatively short timeframe.

7. Medication, Safety, and Addiction

Should I take anti-anxiety medication? This is a personal decision dependent on the severity of the situation. Medication can be an excellent lifeline in the short term and in severe cases. In such cases, in CBT/ACT treatment, we usually recommend combining them with talk therapy , because the medication primarily treats the symptoms, but not the root of the problem.

Are anti-anxiety medications addictive? There are types (like benzodiazepines) that can be addictive and are intended for short-term use only. Most common medications (like SSRIs) are not addictive , but they do have side effects and require slow withdrawal.

Which anxiety medications are the safest? Medications in the SSRI family (like Prozac, Cipralex) are generally considered the safest. They don't work immediately, but they work on long-term chemical balance.

Which anxiety medication causes weight gain? This is a common question. Certain medications (like some SSRIs and TCAs) can cause weight gain. It is important to discuss this possibility with the psychiatrist to find the right dose and type for you.

Do anxiety medications help with overthinking? They can help. Medication reduces overall tension and alertness, which lowers the "volume" of thoughts. But cognitive therapy (CBT/ACT) is what teaches you how to relate to the thoughts so they don't take over.

Which anxiety medication works the fastest? Benzodiazepines (like Clonazepam) work very quickly, usually within minutes. However, they are intended for emergency situations and not for daily treatment. SSRI/SNRI medications, which are intended for long-term treatment, require 3–6 weeks to start working effectively.

Are anxiety medications safe to use? Many anxiety medications are considered safe with proper use and medical supervision. They undergo rigorous research. Safety depends on the type of medication, the dosage, and the patient's general medical condition.

Chapter 7 Summary: Anxiety medications (like SSRIs) are considered safe with proper use and can help reduce symptoms , but they usually do not treat the root of the problem alone. Therefore, combining them with talk therapy is recommended.

8. ACT, NeuroFlex ACT, and Psychological Flexibility (Advanced Models)

What is the difference between CBT and ACT?

CBT primarily focuses on changing or challenging the content of thoughts. ACT (Acceptance and Commitment Therapy) focuses on changing the relationship with thoughts and learning psychological flexibility. ACT asks: "Does this work?", while CBT asks: "Is this the truth?".

What is NeuroFlex ACT and why is it better for anxiety? NeuroFlex ACT is a working model within ACT that combines the psychological flexibility of ACT with up-to-date knowledge on neuroplasticity and the autonomic nervous system. We don't just work with thoughts; we teach the brain and body to create new neural patterns of calm.

How is the nervous system in the body related to anxiety? Anxiety is activated by the nervous system (the sympathetic one), which puts the body into a "survival" state. In NeuroFlex ACT, we use neuroplastic principles to teach the nervous system a new response , thereby reducing overall sensitivity.

What is TF-ACT?

TF-ACT (Trauma-Focused ACT) is an evidence-based model within the ACT approach , specially adapted for focused and effective work with trauma and post-trauma. The therapy combines the principles of acceptance and commitment with focused somatic (body) work , in a gentle and gradual way to prevent emotional flooding.

How does ACT help with OCD? ACT is very effective for OCD because instead of trying to suppress obsessive thoughts, it teaches us to separate ourselves from them (Defusion). Instead of fighting the compulsions, we choose to see the thoughts as a "story currently running in the mind" and act according to our values, despite the pressure to perform the ritual.

Can NeuroFlex ACT help with avoidance? Absolutely. Avoidance is a learned neural pattern. NeuroFlex ACT works on two fronts : reducing physical alertness in the body (making it easier to approach the threat) and increasing psychological flexibility to choose action despite the anxiety.

Chapter 8 Summary: Advanced approaches like ACT and NeuroFlex ACT (developed by the expert) focus on changing your relationship with thoughts and your body's physical reaction to stress to create real and lasting flexibility.

Final Word: Your Next Step

Did you know? The mere act of reading this information, which validates and provides answers to your feelings, is already a first step toward change. We believe that knowledge is power, and the path to freedom from anxiety passes through a deep understanding of how the brain and body work together.

If you feel that anxiety is affecting your life and you're ready for the next step , you can receive advanced CBT/ACT treatment at the expert's clinic in Tel Aviv or online. The expert works with a Process-Based Therapy (PBT) approach and integrates somatic tools and NeuroFlex ACT.

Do you have further questions about NeuroFlex ACT or CBT/ACT treatment?

Ronen invites you for a brief phone consultation so you can check together how this unique model can help you become more flexible, break free from patterns of avoidance, and return to acting according to the values that truly matter to you.