It seems everyone is talking about anxiety these days, and that’s not a bad thing. Shining a light on mental health helps reduce the stigma that keeps many people from seeking support.
At the same time, it can be hard to know if the worries and racing heart you experience at the thought of, say, meeting new people, is run-of-the-mill stress, or if you’re actually experiencing some level of anxiety and could benefit from seeing a professional.
“I can’t tell you how many people I see who say, ‘I don’t know if I should be coming in here,’” clinical psychologist Robert Duff, Ph.D., author of Hardcore Self Help: F**k Anxiety., tells SELF. “On a broad scale, [talking about anxiety] is positive, but I don’t blame anyone for the confusion.”
Figuring out how serious your anxiety is can be tough because anxiety is a normal and essential part of being a human.
“Anxiety is a reaction to a situation we perceive as stressful or dangerous,” Monique Reynolds, Ph.D., licensed clinical psychologist at the Center for Anxiety & Behavioral Change in Rockville, Maryland, tells SELF. This produces a stress response in your body—specifically, your brain’s hypothalamus triggers your sympathetic nervous system to release norepinephrine (aka adrenaline) and cortisol (a stress hormone) to get you out of harm’s way.
This is actually a good thing when there is a real threat of danger present. “A major part of our brain’s job is to keep us alive, and fear and anxiety are a big part of that,” Reynolds says. For example, the anxiety you would feel at seeing a truck hurtling towards you would make you move from its way more quickly.
But if you have anxiety, that stress response can kick in when it shouldn’t. “You feel very much the way you do when in a dangerous situation…[but] there’s no real danger there,” Duff says. Instead of being helpful, this misfiring of your fight or flight reaction can hinder you.
While a little anxiety can also help you to perform at an optimal level under stress, giving you a burst of adrenaline and hyper-focus to finish a business proposal before deadline or nail that dance number at a performance, living in a constant heightened state of anxiety can be distracting at best and debilitating at worst. When anxious thoughts are interfering with your life and causing you significant distress, that isn’t something you should just chalk up to nerves and push through. That’s something you can get help with.
Anxiety is the most prevalent mental illness in the United States, and it comes in various forms.
Anxiety affects about 40 million American adults each year, according to the Anxiety and Depression Association of America (ADAA). But it’s not as cut-and-dry as saying that anxiety is simply when you feel nervous all the time. This mental health condition comes in many forms.
Generalized anxiety disorder (GAD) is characterized by having excessive worries and fears for months, according to the National Institute of Mental Health (NIMH). Per the ADAA, GAD affects 6.8 million U.S. adults each year. Panic disorder involves spontaneous bouts of debilitating fear known as panic attacks, along with intense worry about when the next attack will come, according to the NIMH. Per the ADAA, it affects 6 million American adults each year. Social anxiety disorder (also known as social phobia) happens when you have a marked fear of social situations in which you might be judged or rejected, as well as avoiding these situations or experiencing symptoms like nausea, trembling, or sweating as a result.
Then there are other issues that are closely related to anxiety, like obsessive-compulsive disorder, which involves intrusive thoughts and urges, and posttraumatic stress disorder, which happens when people have a prolonged stress response to harrowing situations.
These are just some of the various anxiety and anxiety-adjacent disorders out there. That these issues can present in myriad ways can make it even harder to know if what you’re experiencing is anxiety that could benefit from outside help.
“Some people feel they can control their anxiety, some feel it’s something they ‘should’ be able to manage, some feel shame, some fear they might be ‘crazy,’ and others downplay how much their anxiety is impacting them,” Reynolds says.
If anxiety interferes with your daily life—whatever that might look like to you—that’s reason enough to see a mental health professional.
“When your world starts to become limited because of anxiety, that is a good signal that it’s time to seek treatment,” Reynolds says. “What is it doing to your life, your relationships, your sleep, health, work, and ability to learn and pursue things that are important to you?”
This “functional impairment,” as Reynolds calls it, can show up in different ways in different people. Is anxiety making you avoid doing things with loved ones because you’re too nervous to go outside? Do you skip school or work out of fear of what people may think of you? Can you not get enough sleep because you’re up all night worrying about the next day? Is your anxiety over certain tasks, like paying bills, leading to procrastination so extreme it comes with consequences, like getting your lights turned off?
Keep tabs on whether you’re blowing up at people, too. Anger and irritability can sometimes be a sign of anxiety. “We often forget that fight or flight includes ‘fight,’” Reynolds says. “If you have a shorter fuse or are always on edge for triggers, it could be related to anxiety.”
So, too, could physical issues. “We think of ourselves as these disembodied heads floating around,” Reynolds says. “We forget that there is a big feedback loop between the nervous system and the body.” Every part of you, from your head to your stomach to your feet, has nerves to regulate important processes, which is why your sympathetic nervous system’s stress response can be so far-reaching. You even have an entire nervous system reserved for gastrointestinal function, known as your enteric nervous system, which may help explain why there’s such a strong link between issues like irritable bowel syndrome and anxiety.
Constant fatigue can also kick in if your anxiety is in overdrive. “The physical reaction to anxiety, by nature, is supposed to be short-term. The body is supposed to come back down to baseline,” Duff says. “But a prolonged period of anxiety depletes your resources and exhausts you.”
“If your anxiety is bothering you and you are suffering, you deserve to get help,” Duff says. That’s true whether or not you think your anxiety is serious, whether or not you think you meet diagnostic criteria you read online, and whether or not your friends and family treat your anxiety with the weight it deserves. And if your anxiety is getting to the point where you’re worried for your safety, call 9-1-1 or the National Suicide Prevention Lifeline (it’s available 24 hours a day, seven days a week at 1-800-273-8255), or go to the emergency room, Reynolds says.
Seeing a therapist can be anxiety-inducing on its own, but it’s worth it. Here are a few ways to make it easier.
Knowing what to expect at your first therapy session may make the experience less scary. Although every professional is different, you’re likely to get a lot of questions at the first visit. Ultimately, your psychologist or therapist’s goal is to learn what troubles you’re having so that they can create a plan to help you build the skills you need to address your anxiety.
They’ll also want to figure out which kind of therapy best matches your needs. Different forms, like cognitive behavioral therapy, which aims to help people change negative thought patterns, work for different people.
Since the cost of therapy can be prohibitive, know that there are resources to help you find affordable treatment, like the National Alliance on Mental Health’s HelpLine at 1-800-950-6264. The HelpLine is available Monday through Friday, from 10 A.M. to 6 P.M., and you can explain your specific situation to the staffer or volunteer who answers. They may be able to refer you to local organizations that offer more affordable treatment. You can also try the Substance Abuse and Mental Health Services Administration (SAMHSA) treatment locator tool, which can help you find mental health providers who take various forms of insurance, offer payment assistance, or use a sliding scale. Resources like GoodTherapy also allow you to limit search results to therapists who use sliding scales.
And don’t stress about meeting some arbitrary threshold of anxiety for your appointment to be worth the effort. “Somebody with anxiety [may] think there is a risk to seeing someone. ‘If I go and don’t have an anxiety disorder, there’s something bad about that,’” Duff says. “That’s not true. If you are suffering and seeing some of these signs, that’s enough.”
It may be that all you need is a few sessions, or you may meet weekly for months or years based on your goals. Your psychologist or therapist might decide medication would help you live your healthiest, happiest life, or just having someone to talk to might work for you. Also, if you decide you’re not really into the person you’re seeing but you still want help, there’s absolutely nothing wrong with trying someone else, Duff says.
Ask yourself what kind of life you want to live and what’s holding you back from achieving it, Reynolds says, adding, “If there’s anything related to fear and anxiety, it’s a great sign that maybe you need support around those things.”