Anxiety Treatment at Cardinal Clinic

Anxiety stops being ordinary worry when it starts making decisions for you. When you turn down work, avoid the motorway, cancel plans, lie awake rehearsing conversations, or check things repeatedly before you can settle, the anxiety is no longer information about a risk. It has become the problem itself.

Anxiety disorders are among the most treatable conditions in mental health. Most people improve substantially with psychological therapy, and many need nothing more than that. Cardinal Clinic provides private, consultant psychiatrist-led assessment and treatment for anxiety in Windsor, Berkshire, for people across Berkshire, Surrey and West London.

You do not need a referral from your GP to ask for an assessment. See self-referral for how to begin, and fees and finance for what private treatment involves.

At a glance

• Who it is for: adults whose anxiety, worry or panic is persistent, distressing, or changing how they live, work or relate to people.
• What is treated: generalised anxiety disorder, panic disorder and panic attacks, social anxiety, health anxiety, and anxiety occurring alongside depression, trauma, obsessive compulsive disorder or alcohol use.
• Main treatments: cognitive behavioural therapy (CBT), other evidence-based psychological therapies, psychiatric assessment, and medication review where appropriate.
• Levels of care: most anxiety is treated as an outpatient. Day-patient and inpatient care are available where anxiety is severe, where someone cannot function day to day, or where another condition needs treating at the same time.
• Approach: consultant psychiatrist-led, with the plan built around the whole picture rather than the symptom.
• Location and catchment: Windsor, Berkshire, serving Surrey and West London.

What anxiety actually is

Anxiety is the body's threat response doing its job at the wrong moment. The physical symptoms are real and often frightening in themselves: a racing heart, tight chest, breathlessness, nausea, dizziness, sweating, trembling, a sense that something terrible is about to happen. Many people first present convinced there is something wrong with their heart.

What separates an anxiety disorder from normal worry is not the intensity of any single episode. It is persistence, and the cost. Anxiety becomes a clinical problem when it lasts beyond the situation that triggered it, when the worry moves from one subject to another without ever resolving, or when avoiding the anxiety starts to shrink your life.

Anxiety takes several recognised forms, and they respond to different emphases in treatment:

• Generalised anxiety disorder is persistent, wide-ranging worry that moves between topics. People describe it as being unable to switch off, often with muscle tension, poor sleep and constant tiredness.
• Panic disorder involves sudden surges of intense fear with strong physical symptoms, often followed by fear of the next attack. That second fear is frequently what maintains the condition.
• Social anxiety is an intense fear of being judged, which leads to avoiding situations or enduring them with dread. It is often mistaken for shyness and often goes untreated for years.
• Health anxiety involves persistent fear of serious illness, usually with repeated checking or reassurance seeking that relieves the fear briefly and strengthens it over time.

Anxiety also rarely arrives alone. It commonly sits alongside depression, obsessive compulsive disorder, trauma, or alcohol use that began as a way of managing the symptoms. A good assessment looks for that, because treating the anxiety while missing what sits underneath it tends not to hold.

How anxiety is treated

The evidence base for anxiety treatment is strong, and NICE guidance is clear that psychological therapy comes first for most people.

Cognitive behavioural therapy is the best-established treatment. It works by identifying the loops that keep anxiety going, then testing them. Someone with panic learns that the physical sensations they fear are not dangerous. Someone with social anxiety tests what actually happens when they stop using safety behaviours. Someone with health anxiety learns what checking and reassurance are doing to the fear rather than for it. The work is practical, structured, and usually time-limited.

Graded exposure is a core part of this where avoidance has taken hold. You approach what you have been avoiding in planned, manageable steps, staying long enough for the anxiety to fall on its own. It is not about forcing yourself through panic. Done properly it is gradual, collaborative, and paced by you.

Psychiatric assessment matters when the picture is less clear. Anxiety can be driven or worsened by depression, trauma, ADHD, thyroid problems, medication, caffeine, or alcohol. It can also be the presenting face of something else. A consultant psychiatrist can distinguish these and treat what is actually there.

Medication has a place, particularly in moderate to severe anxiety, and often alongside therapy rather than instead of it. Decisions about medication belong in a conversation with a psychiatrist who knows your history, including what you have tried before and how you responded. Some medications commonly used for short-term relief carry dependence risks and need careful review, which is a reason to have that conversation properly rather than manage it piecemeal.

When to get help for anxiety

There is no threshold you have to cross before you are entitled to ask. If you are wondering whether your anxiety is bad enough to justify an appointment, that question is usually itself worth an hour of someone's time.

That said, these are the patterns that most reliably indicate treatment would help:

Is this anxiety that warrants treatment?

• It has lasted for months rather than days, and it has not shifted with the situation that started it.
• You are avoiding things you used to do, and the list of avoided things is growing.
• You are having panic attacks, or you are organising your life around not having one.
• Sleep has gone, or you are waking early with dread.
• You are drinking, using cannabis or taking something else to take the edge off.
• Work, study or relationships are being affected.
• People close to you have noticed and said something.
• You have tried self-help, apps or breathing techniques and they have not been enough.

The last point deserves emphasis. Self-help works for a good number of people, and it failing does not mean you have failed or that your anxiety is untreatable. It usually means the anxiety needs a structured approach with someone trained to deliver it.

When anxiety comes with low mood or thoughts of self-harm

Anxiety and depression occur together often enough that treating one while ignoring the other rarely works. If alongside the anxiety you are experiencing persistent low mood, loss of interest, hopelessness, or a sense that things would be easier if you were not here, say so at assessment. It changes what is offered, and it is a common thing to disclose rather than an unusual one.

If you are having thoughts of harming yourself and feel unsafe now, do not wait for an appointment. Contact your GP urgently, call NHS 111 and choose the mental health option, or go to your nearest emergency department. If life is at immediate risk, call 999. Samaritans can be reached free on 116 123, at any hour.

For anxiety that is severe but not an emergency, an urgent private assessment is often possible within days. That is worth asking about rather than assuming a long wait.

How Cardinal Clinic treats anxiety

Assessment comes first, with a consultant psychiatrist, and it is a conversation rather than a test. It covers what the anxiety looks like in practice, how long it has been going on, what you have already tried, your physical health and medication, sleep, alcohol and substance use, and what else is going on in your life. The purpose is to arrive at a plan that fits the whole picture.

Most people are treated as outpatients, attending for therapy and review while continuing to work and live at home. Where anxiety is severe, where someone cannot function day to day, or where another condition needs treating at the same time, day-patient and inpatient care are available on the same site with the same consultant-led team, so a change in the level of care does not mean starting again with new clinicians.

Because anxiety overlaps so often with other conditions, treatment frequently draws on the same team that treats phobias, obsessive compulsive disorder and depression. You can see who would be involved on the clinical team page.

Frequently asked questions

How long does anxiety treatment take?

A course of CBT for anxiety is typically somewhere between seven and fifteen sessions, depending on the type of anxiety and how long it has been established. Many people notice change well before the end. Your clinician should be able to give you a realistic estimate after assessment rather than at the first phone call.

Will I have to take medication?

No. Psychological therapy is the first-line treatment for most anxiety disorders and many people are treated without medication at all. If medication is worth considering, it is discussed with you, with the reasoning and the alternatives set out, and the decision is yours.

Can I be treated without my employer finding out?

Yes. Treatment is confidential. We would only share information with an employer, GP or anyone else with your consent, other than in the rare circumstances where there is a serious risk to someone's safety, which would be discussed with you wherever possible.

Is it still anxiety if the symptoms are mostly physical?

Often, yes. Chest tightness, breathlessness, palpitations, stomach problems and dizziness are common in anxiety disorders, and it is very common to seek help for the physical symptoms first. Physical causes should be excluded, which is part of a proper assessment, but a physical presentation does not make the anxiety any less real or any less treatable.

Do I need a GP referral?

No. You can refer yourself directly. See self-referral for how it works. With your permission we will usually keep your GP informed, which helps if medication is involved.

What if I have had therapy before and it did not work?

That is common and it is useful information rather than a bad sign. It often means the type of therapy did not fit the type of anxiety, the course was too short, or something else in the picture was driving it. Assessment should include what you tried, what happened, and what to do differently.

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If anxiety is shaping your decisions, an assessment is a reasonable next step rather than a drastic one. You can contact us to ask a question first, or refer yourself when you are ready.