Reviewed and Updated September 2026 by Iris Hogan, MSW, LICSW
Sometimes the hardest part of anxiety isn’t what you’re worried about. It’s what happens when you notice anxiety starting.
Your heart speeds up while you’re sitting in traffic. You feel a little dizzy in the grocery store. There’s a surge of adrenaline when the phone rings in the middle of the day and, before you’ve even looked at the screen, your stomach drops.
For mothers, that phone call can have its own particular flavor. Is that the school? Daycare? Did something happen?
Your body has reacted before you’ve even answered.
Or maybe it happens at 2 a.m. You wake up, notice that you’re awake, and immediately think, Oh no. I’m not going to be able to get back to sleep.
Now you’re not only awake. You’re anxious about being awake.
Something similar can happen with anxiety itself. At some point, you may find that you’re no longer only worried about what might happen.
You’re worried about what will happen if you become anxious.
When Anxiety Becomes the Thing You’re Afraid Of
Psychologists use the term anxiety sensitivity to describe a tendency to fear the sensations associated with anxiety.
It isn’t a diagnosis, and it isn’t simply another term for being anxious.
Anxiety sensitivity isn’t the same thing as panic disorder, health anxiety, or generalized anxiety, although they can certainly overlap. It’s more specific than that. You become afraid of the anxiety sensations themselves—and of what those sensations might mean.
A racing heart is no longer just a racing heart. It might mean, I’m going to panic. I’m going to faint. Something is wrong.
And that meaning is what can start the whole cycle.
One mom described it to me this way:
“After my first anxiety attack, I started looking for signs that it might happen again. I monitored my body for anything that felt unusual, and when I noticed something different, I was sure it was bad. I could hardly think about anything except how I was feeling. It made it hard to be part of conversations or even have fun.”
She wasn’t imagining the sensations. She really was noticing things in her body. What had changed was what those sensations meant to her.
Before the anxiety attack, a strange sensation might have been just that—a strange sensation. Afterward, it could feel like a warning.
Is this how it started last time? Is it happening again?
If anxiety tends to hide behind planning, competence, and staying one step ahead, you may also recognize yourself in High-Functioning Anxiety in Women: Calm Outside, Chaos Inside.
Doomsdale Detective Mode
After a frightening anxiety attack, you can move into what I think of as Doomsdale Detective Mode.
Suddenly you’re investigating yourself.
You notice what you’re doing, what you’re thinking, how you’re breathing, whether your heart feels different, whether you’re slightly dizzy or unusually tired. Things you probably wouldn’t have given much thought to before are now potential clues.
And the detective already has a theory: another anxiety attack may be coming.
So you start collecting evidence. Why did my heart just do that? Am I breathing differently? Why do I feel a little strange? Is this how it started last time?
And the more you don’t want the anxiety to come back, the more evidence you seem to find that it might.
Of course you do. Bodies are noisy. Hearts speed up and slow down. We get warm, tired, hungry, lightheaded, tense, excited, and occasionally just feel a little strange.
Before the anxiety attack, you probably wouldn’t have paid much attention to most of this. Now you’re looking for it, and every unusual sensation has the potential to become a clue.
The problem isn’t that you’re making the sensations up. You’re noticing real things. It’s the conclusion the detective keeps reaching: This might mean another anxiety attack is coming.
And all that detective work takes attention. You can be having dinner with friends while part of your mind is still conducting the investigation: How am I feeling now? Is that sensation still there? Is it getting worse?
No wonder the mom I described found it hard to join conversations or have fun. She was physically there, but a significant part of her attention was busy watching for danger.
This is one of the less obvious costs of anxiety sensitivity. It doesn’t only make anxiety more frightening. It can make it harder to be present for the life that’s happening while you’re watching for the anxiety that might happen next.
When You Start Trying to Prevent the Next Anxiety Attack
Once Doomsdale Detective Mode has found enough evidence that another anxiety attack might be coming, the next question is pretty predictable:
How do I keep it from happening?
Maybe you carry water because it helped last time. You check your heart rate, sit near the door, drive where you can easily pull over, or make sure someone comes with you. You might Google a symptom or ask someone you trust, Do you think I’m okay?
“It makes me feel safer.”
I’ve heard many women describe these behaviors that way. And they’re right—at least partially.
In anxiety treatment, we call these safety behaviors: things we do to feel safer or reduce anxiety in the moment that can sometimes keep anxiety going in the long run.
I remember learning to downhill ski as a kid. When I got scared, I wanted to lean into the hill. It felt safer. If I fell, at least I wouldn’t have as far to go.
It took me a while to learn that skiing required something that felt completely counterintuitive: I had to shift my weight away from the hill and over my skis. What felt safer wasn’t necessarily what helped me ski more safely.
Safety behaviors can work a little like that.
You check your heart rate and feel relieved when the number looks okay. You bring someone with you and make it through the store. You carry the water and don’t panic.
Of course you’re going to think, Good thing I did that.
But you don’t get to discover what might have happened without it. Maybe your heart would have settled on its own. Maybe you could have felt anxious and still finished your shopping.
That’s the frustrating part of anxiety: what feels safer in the moment can sometimes make you less confident that you can handle anxiety the next time it shows up.
When Your World Starts Getting Smaller
Most people don’t decide to start avoiding things because of anxiety. It happens a little at a time.
You had an anxiety attack in a crowded store, so next time you go when it’s quieter. That feels better. Then you start going only to the store close to home. You avoid the freeway because it’s harder to pull over. You don’t go somewhere when you’re tired because tired can feel a little too much like anxious.
Each decision makes sense on its own.
But after a while, you may notice that you’re making more and more decisions around one question:
What if I get anxious?
Sometimes the changes are subtle. You still go to the party, but you drive yourself so you can leave whenever you want. You go out to dinner, but want the seat at the end of the table. You take the trip, but spend the first two days monitoring how you’re feeling.
You’re still doing things, but anxiety has acquired a surprising amount of influence over how you do them.
Your life doesn’t have to become obviously restricted for anxiety to be taking up a lot of space.
Instead of asking only How can I make sure I don’t get anxious? Another question becomes worth asking:
How much of my life do I want to organize around the possibility that I might?
Learning Something New
If safety behaviors keep you from discovering what you’re actually capable of handling, part of getting better can involve giving yourself opportunities to learn something different.
Not by throwing yourself into the most frightening situation you can imagine or telling yourself there is nothing to be afraid of. You start small.
Maybe you wait a little longer before checking your heart rate. You go into the store without first checking how you’re feeling. You let the anxious sensation be there for a moment before deciding you need to leave.
The important part isn’t whether you feel calm. It’s what you get a chance to discover when you don’t immediately try to make the anxiety go away. Your heart may race and then slow down. You may feel dizzy and realize you didn’t faint. You can be anxious during a conversation and still have the conversation.
Little by little, you get different evidence: an uncomfortable feeling can show up, and you can handle what happens next.
That’s very different from walking away thinking, I got through it because I made sure I was safe.
For some people, therapy may also include gradually and intentionally experiencing physical sensations they’ve become afraid of. This is sometimes called interoceptive exposure. It is a structured therapeutic approach designed to help someone learn something different about feared sensations rather than continuing to interpret the sensations themselves as evidence of danger.
When You Can’t Problem-Solve Your Way Out of Anxiety
So many of the smart, capable women I work with are paid to solve problems. They analyze complicated situations, anticipate what might go wrong, make decisions, and find solutions. They’re good at it.
Then anxiety shows up, and naturally they turn the same skills on themselves.
Why am I feeling this way? What caused it? What am I missing? How do I fix it?
And it is incredibly frustrating when all that thinking doesn’t work.
The problem isn’t that you’re suddenly bad at problem-solving. Anxiety often isn’t giving you a problem that can be solved. It’s giving you uncertainty that it wants you to eliminate.
If I forgot to refill a prescription, I can call the pharmacy. There is a problem, an action, and eventually an endpoint.
But what if I have an anxiety attack while I’m away from home? It doesn’t have the same kind of solution. You can make plans, think through possibilities, research, rehearse, and prepare, but eventually anxiety comes back with another question.
Okay, but what if…
For someone who is used to being able to think her way toward an answer, that can be maddening. You keep applying more of a skill that serves you extremely well in the rest of your life and can’t understand why you’re getting more exhausted instead of more certain.
That same drive to anticipate and prevent problems can also spill into how much responsibility you carry. I write more about that in Why It’s So Hard to Stop Overfunctioning — Even When You’re Exhausted.
Sometimes the task isn’t to solve the uncertainty.
It’s learning that you can live with some of it unresolved.
When the Answer Isn’t More Thinking
This is where anxiety asks us to do something that can feel completely backwards.
Instead of finding the right thought that will finally make you certain, you begin practicing having some uncertainty without immediately trying to solve it.
That doesn’t mean ignoring real problems or giving up good judgment. If something needs your attention, take care of it. But when you’ve done what reasonably can be done and your mind is still asking for another guarantee, you can begin to recognize what is happening.
There I go, trying to solve this again.
You don’t have to prove that you won’t panic at dinner in order to go to dinner. You don’t have to know that you’ll sleep well tonight to stop trying to solve sleep at 2 a.m. And you don’t have to feel completely calm before joining the conversation that’s happening around you.
This brings me back to the mom I mentioned earlier. She described being with people she cared about but hardly being able to participate because so much of her attention was turned inward, checking how she felt.
For her, progress wasn’t simply feeling less anxious. It was getting some of her attention back.
She could notice an odd sensation without immediately investigating it. Sometimes she became interested in a conversation and simply forgot to check how her heart was beating. She could have fun and realize afterward that she hadn’t been monitoring herself for a while.
We tend to measure progress by asking, How anxious was I?
But sometimes a more useful question is:
How much of my life did anxiety get today?
When Calm Starts Feeling Suspicious
There is another strange thing that can happen after you’ve spent a long time watching for danger: calm can feel a little suspicious.
You finally have an evening when nothing is wrong. Nobody needs anything. There isn’t a problem to solve.
And instead of relaxing, you find yourself thinking, What am I forgetting?
I’ve heard women describe almost not trusting the quiet. Their minds start searching for the thing they haven’t remembered yet.
Sometimes, of course, you really did forget something. That’s life.
But sometimes the quiet is just quiet.
Learning to let it stay that way for a while—without sending Doomsdale Detective out to investigate—is part of getting your life back too.
What Getting Better Can Look Like
I don’t think recovery from anxiety sensitivity necessarily announces itself dramatically.
You may still notice your heart racing. The difference is that you don’t immediately need to know why. You might feel anxious in the grocery store and continue shopping for a while, notice the urge to ask for reassurance and decide to wait, or feel strange before a meeting without spending the next twenty minutes figuring out what the feeling means.
Progress can be easy to miss because sometimes it’s simply realizing at the end of the day that you didn’t check yourself nearly as much.
You were busy doing something else.
That counts too.
Your Body Still Deserves Appropriate Attention
None of this means you should assume that every physical sensation is anxiety.
Bodies do things for all kinds of reasons. New, severe, unexplained, or concerning symptoms deserve appropriate medical attention. Learning about anxiety sensitivity isn’t about ignoring your body or talking yourself out of getting medical care when you need it.
The distinction becomes more useful when a familiar sensation has already been appropriately evaluated, but you find yourself repeatedly monitoring it, seeking reassurance about it, or changing your life to make sure you don’t experience it again.
The goal isn’t to stop paying attention to your body. It’s to stop having to investigate every sensation as a possible emergency.
When Therapy Can Help
You don’t have to wait until anxiety has taken over your life to get help.
Sometimes the first sign that things have shifted is simply realizing how much work you’re doing to prevent anxiety: checking, planning, avoiding, seeking reassurance, monitoring your body, or making sure you always have a way out.
Therapy can help you look at that pattern without taking away every coping strategy at once. You can begin figuring out what you’re afraid will happen, which things genuinely help, and which things mostly provide relief for a few minutes while keeping you afraid of the next anxious feeling.
For some people, part of that work is gradually becoming more comfortable with the physical sensations they’ve learned to fear. It may also mean doing things again without all the precautions anxiety has gradually added along the way.
The goal isn’t to become fearless. You’re learning that anxiety can show up without automatically becoming an emergency.
And perhaps that’s the larger shift.
You stop spending quite so much of today preparing for how you might feel tomorrow. You have the conversation, finish the shopping, or get interested in what someone else is saying and forget, for a while, to monitor how you’re feeling.
You get some of your attention back. And with it, some of your life.
If anxiety, panic, or fear of your own anxiety symptoms is beginning to limit your life, you can learn more about Anxiety Therapy for Women or schedule a free 15-minute consultation.
Until We Meet Again
Until we meet again — breathe gently, walk slowly, and treat yourself with kindness.
— Iris
Research & Sources
Goodson, J. T., Patel, T. A., Zech, J. M., Sala, M. C., & Cougle, J. R. (2026). The standalone effect of safety behavior manipulations: A systematic review and meta-analysis. Clinical Psychology Review, 124, 102703.
PubMed research check
This systematic review included 26 studies, with 19 eligible for meta-analysis. Reducing safety behaviors was associated with reductions in safety behaviors and clinical symptoms. The authors also found evidence of publication bias, which is one reason I use cautious language such as “can sometimes keep anxiety going.”
Clemente, R., Murphy, A., & Murphy, J. (2024). The relationship between self-reported interoception and anxiety: A systematic review and meta-analysis. Neuroscience & Biobehavioral Reviews, 167, 105923.
PubMed research check
Across 71 studies, anxiety was associated with greater negative attention to, evaluation of, and sensitivity toward bodily signals. This supports the discussion of monitoring and interpreting bodily sensations without claiming that anxious people are necessarily more accurate at detecting bodily changes.
Fitzgerald, H. E., Hoyt, D. L., Kredlow, M. A., Smits, J. A. J., Schmidt, N. B., Edmondson, D., & Otto, M. W. (2021). Anxiety Sensitivity as a Malleable Mechanistic Target for Prevention Interventions: A Meta-Analysis of the Efficacy of Brief Treatment Interventions. Clinical Psychology: Science and Practice, 28(4), 323–337.
PubMed research check
This meta-analysis included 28 studies and 1,998 participants. Interventions targeting anxiety sensitivity produced a moderate reduction in anxiety sensitivity immediately after treatment, supporting anxiety sensitivity as a modifiable treatment target.
Kausche, F. M., Carsten, H. P., Sobania, K. M., & Riesel, A. (2025). Fear and safety learning in anxiety- and stress-related disorders: An updated meta-analysis. Neuroscience & Biobehavioral Reviews, 169, 105983.
PubMed research check
This meta-analysis included 77 studies and more than 5,000 participants and found differences in fear acquisition, extinction, and extinction recall between clinical and healthy comparison groups. A corrigendum was subsequently published; the PubMed corrigendum is available here.