Signs of an Anxiety Disorder and Smart Ways to Cope

The main signs of an anxiety disorder are worry or fear that is hard to control, lasts for weeks or months, shows up in many situations, and gets in the way of work, school, sleep or relationships. Everyday nerves come and go with a stressor; an anxiety disorder tends to stick around and grow, often with physical symptoms like a racing heart, tension or stomach upset.

This guide is for adults who feel anxious more often than they would like, and for family members who are trying to understand what a loved one is going through. It covers how to tell normal anxiety from a disorder, the main types, coping steps that help, what to say to a clinician, and when to get help sooner.

What is the difference between normal anxiety and an anxiety disorder?

Normal anxiety is a temporary reaction to a real stressor, while an anxiety disorder is anxiety that persists, feels out of proportion, and interferes with daily life. The difference is mostly about how long it lasts, how intense it is, and how much it limits you.

MedlinePlus, from the National Library of Medicine, describes anxiety as a feeling of fear, dread and uneasiness that can actually help you cope, for example by keeping you alert before a test. It becomes a disorder when the fear is not temporary and can be overwhelming.

The National Institute of Mental Health (NIMH) explains that anxiety disorders involve anxiety that does not go away, can worsen over time, and can interfere with job performance, schoolwork and relationships.

What are the common emotional and physical signs?

Anxiety shows up in both the mind and the body. Many people notice the physical symptoms first and only later connect them to worry.

Emotional and thinking signs

• Constant worry that is hard to switch off.
• Feeling restless, keyed up or on edge.
• Irritability and a short fuse.
• Trouble concentrating or a mind that goes blank.
• Dread about what might go wrong, even when things are fine.

Physical signs

• Racing or pounding heart.
• Shortness of breath or tight chest.
• Muscle tension, headaches or jaw clenching.
• Stomach upset, nausea or changes in appetite.
• Trouble falling or staying asleep.

NIMH's guide to generalized anxiety disorder says people with GAD may feel irritable or on edge, feel restless, have a hard time concentrating, have trouble sleeping or feel fatigued, and experience headaches, muscle aches or tension. For more on the body side, see our article on physical symptoms of anxiety.

What types of anxiety disorders are there?

Anxiety disorders are a group of related conditions that differ mainly in what triggers the fear. A clinician can help sort out which pattern fits, and some people have more than one.

• Generalized anxiety disorder: ongoing worry about many everyday things, such as health, money or family.
• Panic disorder: repeated, unexpected panic attacks and worry about having more.
• Social anxiety disorder: intense fear of being judged or embarrassed in social or performance situations.
• Specific phobias: strong fear of a particular object or situation, such as heights or flying.
• Separation anxiety: excessive fear about being apart from loved ones.

NIMH describes panic attacks as sudden periods of intense fear that may include a racing heart, sweating, trembling, trouble breathing, dizziness, chest pain and a sense of doom or loss of control. NIMH advises a health care provider exam to rule out other causes. Our article on anxiety versus panic attacks explains the difference.

A quick self-check

Use these questions to decide whether the signs of an anxiety disorder might apply to you. Answering yes to several is a reason to talk with a clinician, not a diagnosis.

• Have I felt worried or on edge on most days for several weeks or longer?
• Do I find it hard to stop worrying once I start?
• Am I avoiding places, people or tasks because of fear?
• Are physical symptoms such as tension, poor sleep or stomach upset showing up often?
• Is anxiety making work, school, parenting or relationships harder?

NIMH notes that anxiety disorders can worsen over time if untreated, so noticing the signs of an anxiety disorder early gives you more options.

How is anxiety different from stress?

Stress is usually a response to a specific outside pressure and fades when that pressure ends, while anxiety can continue even when there is no clear threat. The two often overlap, and long stretches of stress can feed anxiety.

NIMH's fact sheet on stress and anxiety advises seeking help when symptoms interfere with daily life, cause you to avoid things, or seem to be always present. That is a practical test you can apply to yourself.

What can you do to cope, step by step?

Coping with anxiety works best as a short daily practice rather than something you only try in a crisis. These steps are general self-care, not a replacement for treatment when anxiety is significant.

1. Name it. Say to yourself, "This is anxiety." Labeling the feeling can make it less overwhelming.
2. Slow your breathing. Breathe in gently through your nose and out slowly for a few minutes.
3. Ground yourself. Notice five things you can see, four you can hear and three you can touch.
4. Move your body. A short walk can take the edge off physical tension.
5. Cut back on caffeine and alcohol. Both can worsen anxiety and sleep for many people.
6. Keep regular sleep. Aim for consistent bed and wake times.
7. Face, do not flee. Small, planned steps toward situations you avoid often shrink fear over time.

The National Center for Complementary and Integrative Health (NCCIH) notes that relaxation techniques are generally considered safe for healthy people, though a few people report increased anxiety, and it advises seeing a provider for severe or long-lasting symptoms. Our guide to grounding techniques has more ideas.

How is an anxiety disorder treated?

Anxiety disorders are commonly treated with psychotherapy, medication, or both. Many people improve meaningfully with the right plan.

NIMH describes cognitive behavioral therapy (CBT) as a research-supported psychotherapy commonly used to treat GAD, and acceptance and commitment therapy (ACT) as another option that encourages nonjudgmental acceptance of thoughts and behaviors. NIMH's stress and anxiety fact sheet names therapy and medication as the main treatments for anxiety disorders.

If medication is part of the discussion, a prescriber will review benefits, side effects and your health history. Do not start, stop or change any medication without talking to your prescriber.

What should you tell a clinician about your anxiety?

Tell a clinician what the anxiety feels like, how long it has been going on, and what it is stopping you from doing. Concrete examples are more helpful than trying to diagnose yourself.

Use this checklist before your visit:

• When the anxiety started and whether it comes in waves or is constant.
• Situations you now avoid because of fear.
• Physical symptoms, including any panic attacks.
• Sleep, caffeine, alcohol and substance use.
• Medicines and supplements you take.
• Any low mood, hopelessness or thoughts of self-harm.

Example only: "I have been waking at 4 a.m. with my heart racing most nights for two months, and I have started skipping meetings." A statement like that gives a clinician a clear starting point.

When should you get help sooner?

Get help promptly if anxiety is stopping you from working, leaving the house, sleeping or caring for others, or if you have thoughts of harming yourself. Waiting for anxiety to pass on its own is not the right choice in these situations.

• Chest pain, fainting or trouble breathing that you have not had checked; call 911 if symptoms are severe or new.
• Panic attacks happening often, or fear of them shaping your day.
• Using alcohol or other substances to calm down.
• Hopelessness or thoughts that life is not worth living.

NIMH's panic disorder guide recommends seeing a health care provider to rule out other medical causes of physical symptoms. That check is reassuring and worthwhile.

What should Texans know about getting anxiety care?

Texans can get anxiety care through primary care, outpatient therapy and psychiatry practices, telehealth, and local mental health authorities. Coverage and availability depend on your plan and provider, so it helps to confirm details first.

Texas Health and Human Services lists 24/7 crisis lines for local mental health authorities in every county, which can help when anxiety becomes a crisis.

Lyte Psychiatry offers telehealth visits to patients who are physically located in Texas at the time of the visit. All Lyte Psychiatry services are available in Spanish.

Getting support in Texas

Lyte Psychiatry offers therapy, psychiatric evaluation and medication management in Texas. In-person visits are available at Lyte Psychiatry's clinic in Pantego, in the Dallas–Fort Worth area. You can read more about anxiety care and therapy.

Most new patients are seen within 1–2 business days. Weekend appointments are limited. Availability, insurance and clinician fit require confirmation. Lyte Psychiatry is an outpatient practice. It does not provide inpatient care, crisis or after-hours coverage, medically supervised detox, or intensive outpatient or partial hospitalization programs.

If you recognize the signs of an anxiety disorder in yourself, you do not need to wait until it gets worse. For a longer look at one common type, see living with generalized anxiety disorder.

If you are in a mental-health crisis in the United States, call or text 988. Call 911 for immediate danger.

Educational information, not a diagnosis or individual treatment plan.