Anxiety symptoms and treatment

Anxiety is your body's alarm system: a feeling of worry, tension or fear about what might happen. Everyone feels it sometimes. It becomes an anxiety disorder when the worry is hard to control, shows up most days, and gets in the way of work, sleep or relationships. Anxiety disorders are the most common mental health conditions in the US, and they are very treatable.

What does anxiety feel like?

Anxiety shows up in your mind and your body at the same time. Common signs include:

• Worrying a lot, about many things, and finding it hard to stop
• Feeling restless, keyed up or on edge
• Getting tired easily
• Trouble concentrating, or your mind going blank
• Irritability
• Tight, tense muscles, headaches or stomach problems
• Trouble falling or staying asleep

Many people also notice a racing heart, sweating or shortness of breath, and start avoiding places or situations that set off the worry.

When is anxiety a disorder, not just stress?

Stress usually has a clear cause and fades when the situation passes. An anxiety disorder sticks around. Clinicians look at three things: how long it has lasted, how hard it is to control, and how much it gets in the way of daily life.

For generalized anxiety disorder (GAD), the most common type, the worry has been present on more days than not for at least six months, along with physical symptoms like the ones above.

If you're not sure where you fall, the free anxiety self-check uses the GAD-7, the same seven questions many clinicians use. It takes about two minutes and shows how much anxiety has been affecting you over the past two weeks.

What are the types of anxiety disorders?

• Generalized anxiety disorder (GAD): ongoing worry about everyday things like work, health, money or family.
• Panic disorder: sudden, intense waves of fear (panic attacks) and worry about having more. See the panic attack self-check.
• Social anxiety disorder: strong fear of being judged or embarrassed in social situations.
• Specific phobias: intense fear of one thing, like flying, heights or needles.
• Agoraphobia: fear of places where escape or help might be hard to get, like crowds or public transit.

Anxiety often comes with other conditions. Depression is the most common partner, and trauma can also leave people anxious long after the event (see the PTSD self-check).

What is generalized anxiety disorder (GAD)?

Generalized anxiety disorder is the most common type of anxiety disorder. People with GAD worry a lot, about many everyday things, on more days than not for at least six months, and find the worry hard to control. The worry comes with at least three of these: restlessness, getting tired easily, trouble concentrating, irritability, muscle tension and trouble sleeping.

About 2.7% of US adults have GAD in a given year, according to NIMH. It's very treatable: cognitive behavioral therapy and antidepressants such as SSRIs and SNRIs are the usual first choices, and buspirone is another option. The anxiety self-check uses the GAD-7, a questionnaire built to screen for it.

How common is anxiety?

Very common. About 19% of US adults have an anxiety disorder in a given year, and about 31% will have one at some point in their lives, according to the National Institute of Mental Health (NIMH). Women are diagnosed more often than men.

What causes anxiety?

There is rarely a single cause. Anxiety tends to come from a mix of:

• Genes and family history: anxiety often runs in families.
• Life events: stress, loss, trauma or big changes.
• Health: thyroid problems, heart conditions, and some medications can cause anxiety-like symptoms.
• Substances: caffeine, alcohol, nicotine and some drugs can trigger or worsen anxiety, and so can withdrawal from them.

This is one reason a doctor may want to rule out a physical cause before calling it an anxiety disorder.

How is anxiety diagnosed?

A clinician diagnoses anxiety by talking with you about your symptoms: what you feel, how long it has lasted, and how much it affects your life. There's no blood test or scan for anxiety. Your primary care doctor may order tests to rule out physical causes like a thyroid problem.

Questionnaires like the GAD-7 help measure how severe things are and track progress over time, but they don't diagnose on their own.

How is anxiety treated?

Most people get real relief with treatment, and many use a combination of approaches.

Therapy. Cognitive behavioral therapy (CBT) is one of the best-studied treatments for anxiety. It teaches you to notice anxious thoughts, test them, and gradually face what you've been avoiding. Many people notice a difference within a few months of weekly sessions.

Medication. SSRIs and SNRIs, two families of antidepressants, are common first choices for ongoing anxiety. They usually take a few weeks to start working. Buspirone is another option for GAD. Benzodiazepines can calm anxiety quickly but can be habit-forming, so they're generally meant for short-term use.

Everyday habits. Regular exercise, steady sleep, and cutting back on caffeine and alcohol won't cure an anxiety disorder, but they make treatment work better.

Who should I see for anxiety?

For many people, a therapist is a good first step, since talk therapy works well for anxiety. If anxiety is affecting your sleep, work or ability to get through the day, or therapy alone isn't enough, a psychiatrist or psychiatric nurse practitioner can talk with you about medication. Your primary care doctor can also prescribe common anxiety medications and rule out physical causes.

Not sure which to choose? Our guide to psychiatrist vs therapist explains the difference, and how to find a therapist who fits walks you through the search.

Does insurance cover anxiety treatment?

Usually, yes. Most health plans cover therapy and medication visits for anxiety, and federal parity rules mean most plans can't make mental health care harder to use than comparable medical care. What you pay depends on your plan and whether the provider is in-network. See how much does therapy cost for typical prices and the questions to ask your plan.