Your thoughts are racing. Your heart is practically pounding out of your chest. Your forehead is damp with sweat. Whether you’re about to have a job interview or walk into a party alone, you might chalk up these feelings to run-of-the-mill anxiety. But when does feeling anxious actually qualify as having an anxiety disorder? How much anxiety is a typical part of the human experience? And when does it make sense to seek help for anxiety? Here, mental health experts share what you should know about the difference between feeling anxious and experiencing an anxiety disorder—plus how you can find help if you need it.
What it means to have anxious feelings
Let’s start with the (sort of) good news: Experiencing some amount of anxiety is an indication that you’re human. “Just about all of us have some levels of anxiety and worry,” Richard Zinbarg, Ph.D., professor and psychology department chair at Northwestern University, tells SELF.
Feeling apprehensive about something stressful—even a good thing, like a promotion or wedding—is a sign that your inherent survival mechanism is working as expected. “Some anxiety is helpful and necessary to motivate us to act; for example, if you need to start an assignment that is due tomorrow or if you are in the woods and see a bear,” Holly Valerio, M.D., clinical assistant professor of psychiatry at the Center for the Treatment and Study of Anxiety in the University of Pennsylvania Perelman School of Medicine, tells SELF.
Your amygdala appears to kickstart this survival mechanism, better known as your fight-or-flight response. This tiny region in your brain receives information about the world around you. If it interprets a threat, it sets off a reaction that pings your autonomic nervous system (ANS) and communicates that you may need to engage in combat or flee. Your ANS, which governs automatic processes like your heartbeat and breathing rate, prepares for action. This is why being in an anxiety-provoking situation can give you a racing heartbeat, quicker breathing, sweaty palms, the whole nine.
People with clinical anxiety tend to feel intense worry about everyday issues that most people cope with relatively easily, Zinbarg says. As long as your level of apprehension and the accompanying physical response are in proportion to the thing that is making you anxious, you’re probably dealing with anxious feelings rather than a disorder. If you have some control over those racing thoughts, that’s another indication that your anxiety falls into this camp. Zinbarg explains that people who feel anxious but don’t have an anxiety disorder are generally able to at least partially calm their worries. Maybe you remind yourself that you’ve prepared for this job interview or can handle making small talk when you don’t know anyone at a party. Point is, you can tamp down on the anxiety.
If your worries feel outsized compared to the actual “threat” or gnaw at you no matter how you try to tame them, your levels of anxiety may be clinically significant.
What it means to have an anxiety disorder
Anxiety disorders essentially turn stressful thoughts up to 11, both in intensity and sometimes duration. While people without an anxiety disorder can experience manageable stress for short periods of time, often in relation to a specific situation, those feelings last much longer and may become all-consuming for someone with an anxiety disorder. For people with anxiety disorders, there is “often a disconnect in the estimation of danger … in anxiety-producing situations vs. the actual or realistic threat,” Dr. Valerio explains.
As if this weren’t complicated enough, anxiety disorders can manifest in a number of ways. Here are some of the main ones to know:
- Generalized anxiety disorder (G.A.D.): This describes excessive, persistent worrying that makes it hard to live your life as usual, according to the National Institute on Mental Health (NIMH). Among other issues, GAD can lead to restlessness, an inability to sleep, headaches, tense muscles, and irritability, the NIMH says. For a lot of people, this presents as all-consuming worries about minor matters, Zinbarg says, like being so concerned about making it to a morning appointment on time that they can’t sleep.
- Panic disorder: This involves having repeated panic attacks (bouts of uncontrollable terror) without an obvious trigger. Along with that overwhelming feeling of dread, panic attacks are characterized by physical symptoms such as sweating, trembling, and feeling like you’re choking, the NIMH explains. Worrying about having another panic attack is another key diagnostic criterion.
- Social anxiety: This translates into an incredible fear of situations involving other people or where you have to perform in front of anyone. A lot of this worry centers around a fear of being judged or embarrassed, typically leading people to avoid situations that might have this result, the NIMH says. This is also called social phobia (meaning it’s intense dread centered around a specific circumstance).
In order for a doctor to diagnose you with these or other anxiety disorders, you need to meet specific criteria. For instance, your symptoms can’t be better explained by the use of alcohol or drugs, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). And, as crappy as it is, you’ll need to have sustained experiences of anxiety over time, since anyone can go through really stressful periods but not necessarily meet the criteria for an anxiety disorder. For instance, a diagnosis of GAD requires at least six months of symptoms, the NIMH says, and a diagnosis of panic disorder necessitates repeated panic attacks, not only one.
When to see a professional
If anxiety is making it hard to live the way you’d like, you may want to consider seeing someone.
“The bottom line is how anxiety is affecting your life,” Franklin Schneier, M.D., special lecturer at Columbia University College of Physicians and Surgeons and a principal researcher at the Anxiety Disorders Clinic at New York State Psychiatric Institute, tells SELF. “If you think it may be interfering, it probably is.”
Think about if anxiety is causing you to avoid doing things you would otherwise enjoy, Dr. Valerio explains, like watching the latest Game of Thrones episode with friends, or things you need to do, like finishing an assignment for your boss.
Even if you can’t point to a specific way in which anxiety is holding you back, Zinbarg says that if it’s causing you distress, you may still benefit from seeking treatment. “When somebody is distressed enough that they’re willing to spend time and money on a clinician like me doing an assessment with them, and then coming in for regular therapy sessions, that tells us that the distress is clinically significant,” he says.
Anxiety treatments that can help
The important thing to know here is that anxiety is often treatable. What works for you will depend on your type of anxiety and how your body and mind interact with certain treatment methods. In general, though, medications such as anti-anxiety drugs and antidepressants may help lessen the physiological and psychological reactions at play here, the NIMH says, adding that beta blockers can also tame the physical symptoms of anxiety in some people.
Then there’s therapy to help work through your anxiety under the guidance of a licensed mental health professional. One popular option is cognitive behavioral therapy, which aims to help people reframe thoughts that can provoke or exacerbate anxiety. If you already have a therapist or know of one you’d like to see, great. If not, here’s some help finding affordable therapy in your area, because we know it can be really hard (and therapy can be wildly expensive). You can also ask a doctor you trust, like your primary care physician, if they have a referral.
As with many things related to mental health, anxiety often isn’t as clear-cut as you might wish. Finding a mental health professional you gel with—and landing on the right anxiety treatment for you—can take some trial and error. But if you’re living with an anxiety disorder or not sure if your anxious thoughts have crossed into that territory, know that this doesn’t warrant shame. It’s just your brain doing a (really distressing but utterly human) thing, and a health professional may be able to help.