Determining the root cause of someone’s anxiety can take time. It requires careful examination of the client’s history and assessment of the weight of contributing factors. These can include diet, exercise, sleep patterns, and especially relationships. In my anxiety therapy practice in Delray Beach, Florida, I often see a variety of intensity in reported experiences of anxiety. Some students, for example, are simply fatigued, nervous, and socially awkward with little in the way of coping skills to manage a normal condition of worry. But in some cases, anxiety can be completely debilitating. To the point of requiring medication and perhaps a higher, more restrictive level of care like psychiatric treatment on an inpatient basis.

I’ll share a vignette of someone I worked with through anxiety therapy to illustrate such a case. Of course, the names and identifying details of this case have been changed to protect privacy. Also, some of the cases mentioned in articles like this contain composites of those I’ve worked with in the past. Any resemblance to actual persons, living or dead, or situations, past or present, is purely coincidental.

Can Personality, Lifestyle, and Family History Cause Anxiety?

JP was referred to me by his mother. She phoned me days before we met to explain her family’s concern about her 29-year-old son and his seeming decline. He wasn’t eating or sleeping normally, she reported. He’d had outbursts of rage at inexplicable moments with members of his family. Including a brother and sister with whom he’d been close his entire life. In tears, she explained that she and her husband were lost and didn’t know what to do to help him. He adamantly refused their invitations to drop by, perhaps have lunch or dinner, and talk. I instructed her to give him my phone number and have him text or call me to introduce himself and ask for a consultation.

I was a bit surprised to get a text that same afternoon from JP. “When can we meet?” was his short note. Without hesitation, I scheduled him for the following morning. His eagerness to engage was a positive note and could be a reason for optimism. It would be from JP that I would learn the frightening extent to which several extreme personality factors would combine with lifestyle choices and family history to produce profoundly disturbing anxiety and even psychosis.

Personality Factors: Signs of Obsession, Paranoia, and Psychosis

JP was early for our 8 AM appointment. He was clean-shaven and well-dressed, with a formal bearing, sitting stiffly upright as if he were interviewing for a job. Clearly anxious with trembling hands, he was polite to a fault. He called me “doc”, even though I’m not an MD. His demeanor was warm and engaging, and he had a sincerity about him that appealed to me right away.

Finally, in the first and subsequent sessions, JP seemed relieved to finally be telling his story. “I want to get this monkey off my back,” he said. “I’ve had it with my parents, their company, and my ex-girlfriend. They are all out to get me”.

JP related that he’d recently been let go from his father’s grocery business. He was told to “stay away for a while” for his health. He’d become obsessed with carefully watching the managers and drivers, convinced they were stealing. He told me these details in a kind of manic, pressured speaking style as if he couldn’t wait to tell me his entire life story. He’d also broken up with his girlfriend after an alcohol-fueled altercation in front of his family at a holiday gathering. “I know she’s been cheating on me,” he said. “It all makes sense, and it’s been going on for a long time”. His obsession with her felt much like his descriptions of his paranoid delusions at work.

Lifestyle Choices: Substance Abuse As a Cause for Anxiety

Within months, he’d lost his job and his girlfriend and the goodwill of his family. Halfway through our session, JP paused mid-sentence and cried out in desperation. “How do I make all this stop!” he pleaded through tears. I wanted more context for JP’s story. I was surprised when he gave me permission to speak with his mom and dad, as well as his girlfriend. Confidentiality is the backbone of anxiety therapy. The client must trust beyond all doubt that their privacy will be protected. I was careful to be specific about what I would want to know, the details of their history, and a finite time frame in which to explore. In a series of brief calls, I connected with his family and friends, and JP’s stories began making more sense.

I learned that JP had been abusing Adderall for years. He’d been diagnosed with ADHD in high school and was prescribed the drug by a family doctor. Dangerously, JP began doubling and tripling the doses in the last couple of years when problems began to appear at his father’s grocery firm. He began buying Adderall on a “gray market” when shopping between prescribing doctors no longer worked. JP also drank heavily occasionally and used cannabis late at night to calm the jittery effects of Adderall. Staying nights at work and rarely sleeping, he’d developed a deep sense of paranoia. As a result, he was frequently deluded in his thinking that people were out to get him. This extended from the grocery business where he was a manager, to his family and his girlfriend as well. He seriously believed they were all out to get him.

Decompensation: How Psychosis Can Cause Anxiety and Pain

Talking briefly with his ex-girlfriend helped me to see his distortions clearly, as she carefully explained the timeline of his “decompensation”. His ex-girlfriend’s stories were corroborated by his family. I was sure JP’s narratives were infused with psychotic breaks that would cause him anxiety and pain. When we finally were able to discuss the Adderall addiction, he began to change. It was as if he were dropping a burden he’d carried for years.

He wept openly, several times, relating his feelings of inferiority as a short guy on his basketball team and a long history of idealizing his brother, a superior athlete and scholar. As his anxiety therapist, I was relieved to see him turn these corners. I’d been researching his possible placement into a psychiatric care facility with a number of professional colleagues and was glad to stand down while JP did the work himself in my outpatient anxiety therapy practice. He’d suspected the dangers of Adderall for a while. Initially begun as a “study drug”, he’d relied on it to perform in the classroom and on the basketball court in college.

But Adderall has serious side effects that include disturbing mood shifts and a tendency for bouts of depression and anxiety that would affect his relationships. Adderall boosts the brain chemicals dopamine and norepinephrine by making your brain release more of them, keeping them from being taken back up, and helping them stick around longer. At normal prescribed doses, this improves focus and impulse control. When abused, it can cause serious loss of sleep, appetite, and motivation. Significantly, it affects the pathway that handles reward, motivation, and salience (“this matters”).

Family Relationships: From Cause and Effect to Anxiety Recovery

JP began working out each morning with a personal trainer who guided his diet and schedule. JP dropped the Adderall and met with a psychiatrist for supplemental help with an antidepressant. Coming off a powerful drug like Adderall can cause complications, especially mood swings. He and I met regularly, sometimes twice a week, for a period of several months. During this time, JP’s mental health improved greatly. He attended Narcotics Anonymous meetings during our time together. He spoke more easily in our sessions and often laughed out loud when recounting stories of his college days. As his physical health improved, his thinking cleared. He was able to understand the paranoid delusions caused by stress, drugs, and alcohol.

JP learned that his obsession with work and an awful relationship and breakup with his ex-girlfriend had been catalysts for his increased drug and alcohol abuse, which in turn led to uncontrollable bouts of anxiety and depression, and even psychosis. He began the difficult process of finally grieving the real loss of his ex-girlfriend and began letting go of his paranoid delusions. Family therapy was rewarding, and I was optimistic for JP when he took the lead in these sessions, explaining his difficult journey of recovery. Along the way, he forgave himself and allowed his family to forgive him. After six months, JP returned to work with his father at a less stressful position.

JP saved his own life. I was privileged to be a part of his difficult journey.

Final Encouragement From an Experienced Anxiety Therapist in Delray Beach

If you or someone you love is struggling with anxiety that is affecting relationships, it can be empowering to ask for help. Especially if drugs or alcohol are involved. Also, becoming aware of early childhood influences, especially learning difficulties like ADHD, can create a path to new adult health and bring fresh success to difficult relationships. Therapy can be a wise investment and may take time, but the payoff can be priceless.

I would love to help. Call or text me at 561-213-8030 or email me at jdlmhc@gmail.com for a consultation.

Find Relief and Understanding Through Anxiety Therapy in Delray Beach, FL

If anxiety has you feeling stuck in a cycle of worry, tension, or emotional overload, you’re not alone. And you don’t have to figure it out by yourself. Anxiety therapy offers a focused, supportive space to explore what’s driving your symptoms, understand how cause and effect work in your nervous system, and learn practical tools to regain a sense of calm and control. At my Delray Beach counseling practice, I help clients move beyond symptom management toward real insight, balance, and emotional resilience.

Here’s how you can take the next step toward lasting relief:

• 1. Explore the underlying cause of your anxiety in a safe, nonjudgmental setting by scheduling an initial consultation.
• 2. Learn evidence-based strategies to manage anxious thoughts, physical symptoms, and emotional triggers with guidance from an experienced Delray therapist.
• 3. Build healthier coping skills that support clarity, confidence, and a more grounded daily life.

Other Services With John Davis Counseling in Delray Beach, Florida

Anxiety often feels overwhelming because its root cause isn’t always clear. Through therapy, you can begin to uncover what’s driving your anxiety and learn how those factors affect your mind and body. Anxiety therapy offers a structured, supportive space to identify these underlying causes, understand your personal anxiety cycle, and develop practical tools to interrupt it, helping you move toward lasting relief rather than temporary coping.

Because anxiety often overlaps with other challenges, my Delray Beach counseling practice offers a broad range of therapeutic services to support your overall mental health. Along with anxiety therapy, I provide counseling for relationships and couples, trauma, addiction, grief and loss, and concerns related to narcissistic personality disorder (NPD). I also work with individuals navigating ADHD/ADD, impulse control difficulties, and spiritual or existential questions.

Each client receives an individualized treatment plan using an integrative, evidence-based approach. Depending on your needs, sessions may include CBT, EMDR, Gestalt therapy, mindfulness techniques, psychodrama, or clinical hypnosis. My goal is to help you build lasting emotional resilience, strengthen coping skills, and create a greater sense of calm and stability. I invite you to explore my blog for more insight and schedule an appointment when you’re ready to begin.

About the Author

John Davis, LMHC, is a highly regarded therapist in Delray Beach with extensive experience helping individuals understand and manage anxiety rooted in trauma, emotional stress, and long-standing relational patterns. Using a trauma-informed approach that integrates EMDR, CBT, psychodrama, and mindfulness, John supports clients in identifying the underlying cause of anxiety and developing healthier ways to regulate emotions, set boundaries, and regain a sense of control. With a strong foundation in child and family therapy, he recognizes how early experiences and learned behaviors can fuel anxiety later in life. As Executive Director of the Mental Health Counselors’ Association of Palm Beach, a recipient of the Outstanding Community Service Award, and a featured expert on StayMarriedFlorida.com, John is a trusted leader in the mental health field. His work empowers clients to reduce anxiety, restore emotional safety, and build greater clarity and resilience in their lives.