Over the years of working with clients struggling with anxiety, I’ve noticed a general pattern—three broad types of anxiety that tend to show up. Of course, this is a huge oversimplification, and there’s often overlap, but these categories help me understand how anxiety manifests differently in people.
1. The Overachieving Anxiety
This person doesn’t know the meaning of the word rest. They are always on the go, chasing success, staying disciplined with healthy habits, and doing all the “right” things. On the surface, they seem put together, but underneath, they experience overwhelming anxiety, often in the form of panic attacks or sleep disturbances.
Working with this client can be tricky—they want quick solutions and often resist exploring the deeper emotional wounds driving their behavior. Typically, their anxiety stems from a deep-seated fear of not being enough, a sense of low self-worth, or a fear of abandonment. Achievements become their way of proving their value.
The work here involves healing that core wound, recognizing their worth beyond accomplishments, and reconnecting with the parts of themselves that are creative, spontaneous, and capable of rest.
2. The Shy Anxiety
This person is more withdrawn. They isolate, dissociate, and often struggle with social anxiety. They are people-pleasers to the core, even in therapy, making sure I feel like I’m doing a good job. They’re pleasant to work with, but it takes time for them to truly open up and be vulnerable.
At the heart of their struggle is an exile part—one that holds deep shame and fear of rejection. Their anxiety often arises from a lifelong pattern of trying to be agreeable, avoiding conflict, and suppressing their true feelings.
Healing involves gently nurturing this exiled part, helping them build self-worth from the inside out. They also benefit from a nudge to engage more socially, push past the inertia, and build confidence in relationships.
3. The Chaotic Anxiety
If the Overachiever is too controlled and the Shy one is too withdrawn, this type of anxiety is all over the place. Relationships are turbulent, career paths are uncertain, and emotions swing wildly. This client’s therapy sessions can feel like managing one crisis after another.
Unlike the Overachiever, they don’t suppress their emotions—in fact, they express them freely, sometimes explosively. But that doesn’t mean they’re processing them in a way that leads to healing. There’s often a history of significant trauma, and their anxiety thrives in the instability they experience daily.
With this client, therapy focuses on slowing down. Setting boundaries, building self-regulation skills, and redirecting their attention inward are key. The work is often deep, requiring patience and a trauma-informed approach.
Anxiety Isn’t One-Size-Fits-All
While these categories aren’t rigid, they help illustrate the different ways anxiety can show up in people’s lives. Some clients see themselves in one, others in a mix of two or all three. But at the core of anxiety—no matter how it manifests—is usually some variation of fear, unhealed wounds, and the need for self-compassion.
If you see yourself in one of these descriptions, know that healing is possible. I offer a free consultation to learn more about your story and explore how we can work together. You can also visit my website for more details on my therapeutic approach.
For fellow therapists, I’d love to hear your thoughts! Do you notice similar patterns in your clients? What strategies have been most effective in your practice?
