About anxiety
Anxiety becomes a problem when worry, tension or panic are frequent, hard to control and start to limit daily life. Psychological therapy, especially cognitive-behavioural approaches, has strong evidence for anxiety disorders. A first session usually explores what triggers the anxiety, how it shows up in the body and thoughts, and what goals you want to work on.
Psychoanalysts work with psychoanalytic or psychodynamic therapy, which explores how past experiences and unconscious patterns shape present feelings and relationships. It is usually a longer, in-depth process. Training and titles vary by country: check each professional’s background.
Getting mental health care in Tokelau
Public health system · Tokelau Department of Health
Health care is provided by the Tokelau Department of Health, which is limited by staff and funding. The New Zealand Mental Health Act is applied in Tokelau.
Urgent help in Tokelau
If your life or someone else's is in danger, call the emergency number now. These services can help at any time:
- 23114 · Fanuafala Hospital (Fakaofo)
Information reviewed in November 2026 · Sources: who.int
Signs to look out for
Some anxiety is normal before an exam or a difficult conversation. It becomes worth looking at when worry feels constant and hard to switch off, when you avoid places or situations because of it, or when you notice frequent physical symptoms such as a racing heart, tight chest, dizziness, stomach upset or poor sleep. Sudden waves of intense fear, called panic attacks, are another common sign.
What helps: treatments and professionals
Cognitive-behavioural therapy (CBT) has the strongest evidence for most anxiety problems, often including gradual exposure to feared situations. Acceptance and commitment therapy (ACT) and mindfulness-based approaches can also help. Psychologists, clinical psychologists and psychotherapists usually lead treatment. A psychiatrist or family doctor may assess whether medication could be useful alongside therapy, especially when anxiety is severe or long-lasting.
When to seek urgent help
Seek medical help promptly if you have chest pain, shortness of breath or symptoms you have never had before, as these should be checked to rule out a physical cause. If anxiety comes with thoughts of ending your life or harming yourself, contact your local emergency services or go to the nearest emergency department straight away. You do not have to wait for an appointment.
What you can do in the meantime
While you look for support, try to keep regular sleep and meal times, move your body most days, and cut down on caffeine and alcohol, which can worsen anxiety. Slow breathing can help during peaks. Avoiding feared situations brings relief now but tends to make anxiety grow, so small, gradual steps are better. Talk to someone you trust and rely on trustworthy health sources.
What does a psychoanalyst do?
A psychoanalyst works with people who want to explore how early experiences, desires, conflicts and unconscious patterns influence how they feel, relate and choose today. Day to day they listen closely, help connect present difficulties with personal history, and pay attention to dreams, repetitions and the relationship with the analyst. Sessions are usually frequent and the process tends to be long-term.
When to see a psychoanalyst
Psychoanalysis or psychodynamic therapy may suit you if you notice repeating patterns in relationships, a persistent sense of emptiness or dissatisfaction, or want to understand yourself in depth and are open to a longer process. If you need quick relief for a specific symptom, such as panic attacks or a phobia, a structured approach like CBT may be more appropriate first.
How to choose
When choosing, check the licence and training, the approach they use and whether they have experience with what you need. Consider practical aspects too: language, price, location or online sessions and availability. The relationship with the professional matters a great deal; if after a few sessions it does not feel right, it is fine to change.
Frequently asked questions
Does the public health system in Tokelau cover psychological care?
Health care is provided by the Tokelau Department of Health, which is limited by staff and funding. The New Zealand Mental Health Act is applied in Tokelau.