Signs of Anxiety: When Worry Becomes More Than Just Stress By Dr. Jean Scurria, Ph.D., LCSW | San Ramon
- Jean Scurria
- May 12
- 8 min read
Everyone feels anxious from time to time. A racing heart before a big presentation, a knot in your stomach before a difficult conversation — these are normal, even healthy responses to stress. But when feelings of worry, fear, or dread become persistent, overwhelming, or difficult to control, it may be a sign of something more than ordinary stress.
Anxiety disorders are among the most common mental health conditions in the United States — and they are also among the most treatable. In this article, we'll explore what anxiety disorders actually are, the most common signs to look for (including some that are easy to miss), and when it's time to reach out for professional support.
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What Is an Anxiety Disorder?
According to Harvard Health Publishing, anxiety becomes a clinical concern when feelings of fear or distress are overwhelming, disproportionate to the situation, or begin to interfere with daily life. At that point, what started as a natural stress response may have crossed into an anxiety disorder.
Anxiety is not a single condition — it is a spectrum of related disorders, each with its own characteristics, though many share overlapping symptoms. The most common types include:
Generalized Anxiety Disorder (GAD): Persistent, excessive worry about a wide range of everyday situations
Panic Disorder: Recurrent panic attacks — sudden surges of intense fear accompanied by physical symptoms
Social Anxiety Disorder: Intense fear of social situations and being judged or embarrassed by others
Specific Phobias: Exaggerated fear of a particular object, animal, or situation
Health Anxiety: Persistent worry about having or developing a serious illness, even when medical tests are normal
According to the National Institute of Mental Health (NIMH), an estimated 19.1% of U.S. adults — nearly one in five — experience an anxiety disorder in any given year. Over a lifetime, approximately 31.1% of adults will experience an anxiety disorder at some point. Despite being highly common, anxiety disorders are frequently misunderstood or dismissed, and many people go years without receiving an accurate diagnosis or effective treatment.
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How Is an Anxiety Disorder Different From Everyday Stress?
Stress and anxiety are related but different. Stress is typically a response to a specific external trigger — a deadline, a conflict, a health scare. It tends to ease once the situation resolves. Anxiety, as the Anxiety and Depression Association of America (ADAA) notes, is often a reaction to stress — but in an anxiety disorder, the worry takes on a life of its own, persisting even when there is no identifiable threat.
Three key differences to watch for:
Duration: The worry or fear is present most of the time, not just in specific situations
Proportion: The intensity of the response is out of proportion to the actual risk or situation
Impact: Symptoms interfere with your ability to work, maintain relationships, or enjoy daily life
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Common Signs of an Anxiety Disorder
Harvard Health Publishing identifies several core signs that may indicate an anxiety disorder. While symptoms vary depending on the specific type of anxiety, the following are widely recognized across conditions:
1. Persistent, Uncontrollable Worry
The hallmark of Generalized Anxiety Disorder is frequent or near-constant worry that is difficult to control. According to Harvard Health, the source of the worry may shift from topic to topic — health, finances, relationships, work — but the anxiety itself is almost always present. If you find yourself anticipating every possible problem even when things are objectively fine, this is a meaningful sign.
2. Restlessness or Feeling on Edge
A persistent sense of restlessness, feeling keyed up, or being unable to relax is a common sign of anxiety disorders. You may feel as though something is about to go wrong, even when you can't identify what — sometimes described as a sense of impending doom.
3. Physical Symptoms
Harvard Health notes that anxiety frequently produces physical symptoms that are easy to attribute to other causes. These can include a racing or pounding heart, rapid breathing, chest tightness, headaches, stomach upset, nausea, dizziness, hot or cold flashes, sweating, trembling, and frequent urination. People sometimes seek medical treatment for these physical complaints without ever addressing the underlying anxiety.
4. Fatigue
Chronic anxiety is exhausting. The constant state of alertness that anxiety produces takes a significant toll on the body and mind. Harvard Health identifies persistent fatigue — being tired all the time, not just after exertion — as a frequently overlooked sign of both anxiety and depression.
5. Difficulty Concentrating
Anxiety can make it genuinely difficult to focus. You may find your mind going blank, jumping from thought to thought, or being unable to complete tasks that should feel routine. Harvard Health notes that people experiencing anxiety often struggle to concentrate or pay attention to others, because their mental energy is consumed by worry.
6. Sleep Disturbances
Difficulty falling asleep, staying asleep, or waking up with your mind already racing are common symptoms of anxiety disorders. The brain's heightened state of alertness can make it hard to settle, even when you're exhausted.
7. Irritability
Anxiety doesn't always look like fear or worry. In many people — particularly men — anxiety presents as irritability, impatience, or being easily frustrated. Harvard Health identifies mood swings and heightened irritability as signs that anxiety or depression may be a factor.
8. Avoidance Behavior
One of the most telling behavioral signs of an anxiety disorder is avoidance — structuring your life around situations that trigger anxiety in order to avoid experiencing it. Harvard Health notes that this can include shying away from activities, places, or people. Over time, avoidance tends to make anxiety worse, not better, because it reinforces the belief that the avoided situation is truly dangerous.
9. Muscle Tension
Physical tension — particularly in the neck, shoulders, and jaw — is a common and often overlooked sign of chronic anxiety. The body's stress response produces muscle tension as part of its "fight or flight" preparation, and in people with anxiety disorders, this tension can become a persistent baseline state.
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Signs of Anxiety That Often Go Unrecognized
Beyond the more widely known symptoms, there are several less obvious signs of anxiety that are frequently missed or attributed to other causes:
Avoiding decisions or procrastinating. According to Harvard Health, people with anxiety often struggle to make decisions because they worry that whatever choice they make will be the wrong one. This can look like indecisiveness or procrastination rather than anxiety.
Excessive reassurance-seeking. Frequently asking others for reassurance — that you're okay, that a decision was right, that something isn't as bad as it seems — can be a sign of underlying anxiety, particularly health anxiety or GAD.
Digestive problems. The gut and the brain are closely connected. Chronic anxiety can manifest as stomach upset, irritable bowel symptoms, or nausea that doesn't have an obvious physical cause.
Overthinking past events. Anxiety isn't only future-focused. Replaying past conversations, second-guessing decisions you already made, or dwelling on things you said or did are also common anxiety symptoms.
"High-functioning" anxiety. Many people with anxiety disorders appear outwardly capable and accomplished — using productivity, perfectionism, and over-preparation as ways of managing their internal anxiety. This can make the condition easy to overlook, even for the person experiencing it.
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Anxiety and Depression: A Common Combination
It's important to know that anxiety and depression frequently occur together. Harvard Health reports that many people with depression also have anxiety, and Harvard's research on Generalized Anxiety Disorder notes that between 50% and 90% of people with GAD also have at least one other condition — most commonly depression. According to the ADAA, GAD also frequently co-occurs with major depression specifically.
If you recognize signs of both conditions in yourself or someone you care about, this is not unusual — and treatment approaches exist that address both simultaneously.
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Who Is Most at Risk?
According to the NIMH, anxiety disorders affect women at higher rates than men — with a past-year prevalence of 23.4% in women compared to 14.3% in men. That said, anxiety disorders affect people across all ages, backgrounds, and circumstances. The ADAA notes that Generalized Anxiety Disorder affects approximately 6.8 million American adults, yet fewer than half are receiving treatment.
Anxiety disorders tend to run in families, and Harvard Health notes that they likely stem from how certain brain structures communicate with each other as the individual tries to manage the fear response. Life experiences, significant relationships, and environmental stressors all influence how anxiety develops and expresses itself in any given person.
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When Should You Seek Help?
If you've been experiencing several of the symptoms above — and they've been persistent, difficult to control, or getting in the way of your daily life — it's worth speaking with a mental health professional. You don't need to be in crisis to seek support. In fact, the earlier anxiety is addressed, the more straightforward treatment tends to be.
Harvard Health and the NIMH both note that anxiety disorders respond well to treatment. According to Harvard Health's reporting on Generalized Anxiety Disorder, with appropriate treatment, 70% or more of people experience significant improvement. Treatment doesn't have to mean medication — psychotherapy, particularly Cognitive Behavioral Therapy (CBT), is one of the most well-researched and effective approaches available.
At my clinic in San Ramon, I work with individuals experiencing clinical depression using evidence-based approaches including Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), Eye Movement Desensitization and Reprocessing (EMDR), Hypnotherapy, Psychodynamic Therapy, and Trauma-Focused Psychotherapy to name a few. I understand that reaching out can feel like a big step — and I am here to make it as straightforward as possible..
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Frequently Asked Questions About Anxiety Disorders
Q: Is anxiety a mental illness or just a personality trait?
Anxiety is a normal human emotion, but anxiety disorders are genuine mental health conditions. When anxiety is persistent, difficult to control, and interfering with daily functioning, it meets clinical criteria for a disorder — not a personality type or character flaw.
Q: Can anxiety go away on its own without treatment?
Mild anxiety may improve with lifestyle changes, stress reduction, and social support. However, anxiety disorders tend to persist or worsen without professional treatment. Avoidance — a common coping mechanism — often makes anxiety worse over time by reinforcing fear responses.
Q: How is an anxiety disorder diagnosed?
An anxiety disorder is diagnosed by a licensed mental health or medical professional through a clinical interview and symptom assessment using criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). There is no lab test for anxiety, though a physical exam may be recommended to rule out medical causes for physical symptoms.
Q: What is the most effective treatment for anxiety?
The most well-researched treatment for anxiety disorders is Cognitive Behavioral Therapy (CBT), which helps people identify and reframe negative thought patterns and change avoidance behaviors. Medication, including certain antidepressants and anti-anxiety medications, can also be effective — particularly in combination with therapy.
Q: What's the difference between an anxiety disorder and a panic attack?
A panic attack is an episode of sudden, intense fear accompanied by physical symptoms such as a racing heart, shortness of breath, and dizziness. Panic attacks can occur in several types of anxiety disorders, or as isolated events. Panic disorder is a specific anxiety disorder characterized by recurrent, unexpected panic attacks and ongoing worry about future attacks.
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Ready to Take the Next Step?
Anxiety is one of the most common — and most treatable — mental health conditions there is. If what you've read here resonates with you, please don't wait to reach out. You don't have to white-knuckle your way through persistent worry or fear.
Contact Information
📞 925-365-7300
📍 2610 Crow Canyon Road Suite 320, San Ramon CA, 94583
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If you or someone you know is in crisis, please contact the 988 Suicide and Crisis Lifeline by calling or texting 988. Help is available 24/7.
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Sources
Harvard Health Publishing. Anxiety. Harvard Medical School. (June 2024). https://www.health.harvard.edu/topics/anxiety
Harvard Health Publishing. Anxiety Disorders. Harvard Medical School. https://www.health.harvard.edu/mind-and-mood/anxiety-disorders
Harvard Health Publishing. Recognizing and Easing the Physical Symptoms of Anxiety. Harvard Medical School. (July 2024). https://www.health.harvard.edu/mind-and-mood/recognizing-and-easing-the-physical-symptoms-of-anxiety
Harvard Health Publishing. Generalized Anxiety Disorder. Harvard Medical School. (July 2025). https://www.health.harvard.edu/mind-and-mood/generalized-anxiety-disorder-a-to-z
Harvard Health Publishing. Are You Missing These Signs of Anxiety or Depression? Harvard Medical School. (September 2024). https://www.health.harvard.edu/mind-and-mood/are-you-missing-these-signs-of-anxiety-or-depression
National Institute of Mental Health (NIMH). Any Anxiety Disorder. https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder
National Institute of Mental Health (NIMH). Generalized Anxiety Disorder. https://www.nimh.nih.gov/health/statistics/generalized-anxiety-disorder
Anxiety and Depression Association of America (ADAA). Facts and Statistics. https://adaa.org/understanding-anxiety/facts-statistics
National Alliance on Mental Illness (NAMI). Mental Health By the Numbers. (Reviewed 2025). https://www.nami.org/about-mental-illness/mental-health-by-the-numbers/
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).
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Dr. Jean Scurria is a psychologist with 40+ years of experience specializing in treating various mental and social health challenges including anxiety in San Ramon. To learn more or schedule an appointment, visit DrJeanScurria.com.