What are the most common signs of anxiety?
The most common signs of anxiety are worry that is hard to switch off, a sense of being on edge, and physical tension: tight muscles, a fast heartbeat, a churning stomach, poor sleep. Many people also notice that they have started avoiding things, or checking and seeking reassurance more than they used to.
Anxiety in itself is not a problem. The National Institute of Mental Health (NIMH) says feeling anxious is a normal part of life, and many people worry about health, money, work or family. What NIMH describes as different about anxiety disorders is that the anxiety does not go away, shows up in many situations, and can get worse over time.
Signs in your thoughts and feelings
NIMH's guide to generalized anxiety disorder describes worry that is excessive about everyday things and hard to control, and feeling irritable or on edge. Other signs people describe include:
- Jumping to the worst case and finding it hard to come back from there.
- Trouble concentrating, or the mind going blank.
- A sense of dread without a clear reason.
- Needing certainty before you can relax, and rarely getting it.
- Worry that moves from one subject to the next once the first is settled.
When the worry will not stop
Going over and over the same thoughts is common in both anxiety and depression. Overthinking and worry looks at why that loop is so sticky and what research suggests can loosen it.
Signs in your body
Anxiety is physical as much as mental. NIMH lists restlessness, trouble falling or staying asleep, fatigue, headaches, muscle aches, stomachaches, trembling, sweating, lightheadedness, feeling short of breath and frequent trips to the bathroom among the signs of generalized anxiety.
Panic attacks are the most intense version. NIMH describes them as a sudden wave of fear or discomfort, or a sense of losing control, even when there is no clear danger, often with a pounding heart, trembling or tingling that can feel like a heart attack. The Tryon guide's page on panic attacks covers them in more depth, and anxiety in the body explains why the body stays on alert.
Because these symptoms overlap with medical problems, new or worrying physical symptoms belong with a doctor first. Chest pain, trouble breathing or fainting are reasons to call 911, not to assume it is anxiety.
Signs in what you do
The behavioral signs are often the easiest to miss, because they feel like sensible choices. They include avoiding situations, people or tasks that bring on anxiety; putting off decisions; checking things repeatedly; asking others for reassurance; overpreparing; and using alcohol or other substances to calm down.
Each of these brings relief in the moment, which is why they stick. The practice's article when anxiety becomes the default explains how that relief can keep anxiety going over time.
Social anxiety has its own pattern. NIMH describes fear of being judged or embarrassed in situations such as meeting new people, speaking up at work or eating in front of others, often leading people to avoid those situations altogether.
Partners and friends sometimes notice these changes first: plans quietly dropped, more irritability, more questions that start with what if. If someone close to you has mentioned it, that is worth taking seriously rather than explaining away, and it can be a useful starting point for a conversation with a doctor or therapist.
Everyday worry or an anxiety disorder?
Everyone feels anxious before a medical test or a hard conversation. NIMH distinguishes stress, a response to an outside cause, from anxiety, which it describes as the body's reaction to stress that can continue even when there is no current threat. For a closer look at that difference, see is it anxiety or stress.
There are several kinds of anxiety disorder, including generalized anxiety disorder, panic disorder, social anxiety disorder and phobias. NIMH estimates that about a third of U.S. adolescents and adults will experience one at some point in their lives. Only a clinician can say whether what you are experiencing meets the criteria for any of them, and you do not need a diagnosis to deserve help.
Anxiety also often travels with low mood. If you recognize signs of both, when depression and anxiety come together explains why that is so common.
When to get help, and where counseling fits
It is worth talking to someone when anxiety is getting in the way of work, relationships or sleep, when you are arranging your life around avoiding things, or when what used to help has stopped helping. NIMH notes that anxiety disorder symptoms can interfere with job performance and relationships. A doctor can rule out physical causes, and talking therapies such as cognitive behavioral therapy have a strong evidence base for anxiety.
Laura Bass works with adults in Charlotte, North Carolina, and depression and anxiety are among the concerns she works with in individual counseling. Laura does not prescribe medication; questions about medication belong with a physician or psychiatric prescriber. Contact Laura to ask how she works with anxiety.
If anxiety ever comes with thoughts of harming yourself, call or text 988 at any hour, and in an emergency call 911.
Common questions
Can anxiety cause physical symptoms?
Yes. NIMH lists headaches, muscle aches, stomachaches, trembling, sweating, lightheadedness, shortness of breath, fatigue and sleep problems among the signs of generalized anxiety. Because many of these can also have medical causes, it is wise to see a doctor about new or worrying symptoms, and to call 911 for chest pain, fainting or severe trouble breathing.
How do I know if my anxiety is normal?
Anxiety that comes with a specific situation and settles when it passes is part of ordinary life. NIMH describes anxiety disorders as anxiety that does not go away, is felt in many situations and can get worse over time. If worry is hard to control, is wearing you out, or is leading you to avoid things, it is worth talking to someone.
What is the difference between a panic attack and anxiety?
Anxiety tends to build and linger, often around worries about what might happen. A panic attack, as NIMH describes it, is a sudden wave of intense fear or discomfort, often with a racing heart, trembling or a sense of losing control, that can come on even without a clear trigger. Some people with ongoing anxiety have panic attacks; many do not.
Can counseling help with anxiety without medication?
For many people, yes. NIMH says treatment typically involves psychotherapy, medication or both, and calls cognitive behavioral therapy the well-studied gold standard psychotherapy for generalized anxiety. Some people use therapy alone while others combine it with medication. That decision depends on severity and personal preference and is one to make with a physician. Laura Bass offers counseling and does not prescribe.