Anxiety Disorders
Anxiety disorders involve persistent fear, worry, or avoidance that interferes with daily life. Treatment can include therapy, medication, or both, with care available in person or online.
Ready for Help?
What Is an Anxiety Disorder?
An anxiety disorder involves fear or worry that persists, becomes hard to manage, and interferes with daily life. It can affect your thoughts, body, sleep, relationships, and the activities you feel able to do. Anxiety disorders are treatable, and support can include talk therapy (also called psychotherapy), medication, or both.[1][2][3]
Feeling anxious before an exam, an important conversation, or a difficult decision is common. An anxiety disorder goes beyond an occasional stressful moment. You may feel afraid even when there is no immediate threat, spend much of your time anticipating problems, or organize your life around avoiding situations that feel unsafe.[2]
You do not need to identify the exact disorder before asking for help. A primary care provider or mental health professional can assess your symptoms and help you choose the next step.[4]
- Anxiety can cause physical symptoms as well as worry and fear.[2]
- Generalized anxiety, panic disorder, social anxiety, and phobias have different patterns and may need different treatment approaches.[1][2]
- A panic attack does not automatically mean you have panic disorder.[5]
- Therapies supported by research can be delivered in person or online, depending on your needs and the provider.[6]
Anxiety Symptoms and Their Effects on Daily Life
Anxiety symptoms can be emotional, physical, and behavioral. People do not all experience the same combination, and the symptoms can vary with the situation or disorder.[2]
- Thoughts and emotions: Persistent worry, dread, irritability, difficulty concentrating, or feeling unable to control anxious thoughts.[6]
- Body and sleep: Muscle tension, aches, restlessness, fatigue, stomach discomfort, or trouble falling or staying asleep.[6]
- During intense fear or panic: A racing heart, sweating, trembling, dizziness, tingling, nausea, or difficulty breathing.[5]
- Behavior and daily activities: Avoiding feared situations, struggling to participate at work or school, or withdrawing from interactions you would otherwise want to have.[2][7]
For example, someone with social anxiety may want to meet friends but avoid the gathering because of fear of being judged. Someone with generalized anxiety may lie awake worrying about several everyday responsibilities. Someone with panic disorder may stop traveling because they fear another attack.[7][6][5]
These patterns are useful to describe at an appointment. A symptom checklist cannot establish a diagnosis. A clinician considers the pattern, how long it has lasted, its effect on your life, and other possible explanations.[2]
When Symptoms Need Urgent Medical Attention
Do not assume new chest pain is anxiety. Call 911 for sudden crushing, squeezing, tightening, or pressure in your chest, pain spreading to your jaw, arm, or back, or chest pain with shortness of breath, sweating, nausea, or dizziness. Panic can produce overlapping sensations, but a heart attack is not an anxiety symptom.[8][5]
If you are in emotional distress or thinking about suicide, call or text 988 in the United States. Call 911 in a life-threatening emergency.[4]
Types of Anxiety Disorders
Anxiety disorders differ in what triggers fear and how the symptoms develop. Learning the distinctions can help you explain what you are experiencing and find more specific information.[1]
Generalized Anxiety Disorder
Generalized anxiety disorder (GAD) involves persistent, difficult-to-control worry about everyday concerns, such as health, money, family, or work. It can come with tension, poor sleep, fatigue, and trouble concentrating. Clinicians consider a pattern of excessive worry on most days for at least six months when evaluating GAD. You can seek help before that point if symptoms are affecting you.[6]
Panic Disorder
Panic disorder involves repeated, unexpected panic attacks followed by ongoing worry about another attack or changes in behavior to avoid one. A panic attack is a sudden episode of intense fear or discomfort that may include a pounding heart, shaking, or a feeling of losing control. An isolated panic attack is not the same as panic disorder.[5]
Social Anxiety Disorder
Social anxiety disorder involves intense fear of being watched, judged, embarrassed, or rejected in social or performance situations. It can affect conversations, classes, work meetings, dating, or eating in front of other people. It is more than a preference for privacy or occasional shyness.[7]
Specific Phobias and Agoraphobia
A specific phobia involves intense fear of a particular object or situation, such as flying or certain animals, beyond the danger it presents. Agoraphobia involves fear of situations where escape or getting help might feel difficult if panic-like symptoms occur. It can occur alongside panic disorder, but it is different from fearing other people’s judgment.[2][5]
How OCD and PTSD Are Related
Obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD) can involve substantial anxiety, but current diagnostic classifications place them in separate groups from anxiety disorders.[9]
OCD involves recurring, uncontrollable thoughts, repetitive behaviors, or both. PTSD can develop after a traumatic event. Symptoms may include recurring memories or dreams of the event, staying away from reminders, changes in mood or thinking, and feeling constantly on guard. These differences matter because treatment should address the specific condition.[10][11]
What Causes Anxiety Disorders?
Anxiety disorders do not have one established cause. Researchers study how inherited traits, the way the brain and body work, stressful experiences, and a person’s environment interact. A family history or traumatic experience may increase risk, but neither means that someone will inevitably develop a disorder.[2][6]
Symptoms can also be influenced by physical health conditions, medications, caffeine, or other substances. For example, a thyroid problem or an abnormal heart rhythm may produce symptoms that resemble anxiety. A medical assessment helps distinguish these possibilities from an anxiety disorder or identify when they occur together.[2]
The explanation is more complex than a simple “chemical imbalance.” Treatment decisions should follow an assessment of your symptoms, health, circumstances, and preferences.[6]
How Common Are Anxiety Disorders?
Anxiety disorders are common, but estimates depend on when and how people were surveyed. The National Institute of Mental Health (NIMH) reports that 19.1% of U.S. adults had an anxiety disorder in the past year in the National Comorbidity Survey Replication, conducted in 2001–2003.[9]
That historical estimate used an older diagnostic grouping that included OCD and PTSD. It is not a current-year estimate under today’s classifications.[9]
How Anxiety Disorders Are Diagnosed
An evaluation usually begins with a conversation about your symptoms and health history. A provider may also perform a physical examination or order tests to check for another medical explanation. A mental health assessment considers how the fear or worry affects everyday activities, such as sleeping, working, or spending time with other people.[2][6]
What to Bring to Your Anxiety Appointment
Use these prompts to make a few notes before the visit:
- When symptoms started, how often they happen, and what tends to trigger them.
- What you have stopped doing or find harder because of anxiety.
- Changes in sleep, concentration, work, school, or relationships.
- Your medications, supplements, caffeine, alcohol, and other substance use.
- What you have tried and whether it helped.
These notes support an assessment. They are not a self-diagnosis. Be open about substance use and medication changes so the clinician can consider those factors alongside your symptoms.[6][2][12]
Anxiety and Addiction
Anxiety and a substance use disorder can occur together, and both deserve care. Some people use alcohol or other drugs to cope with distress. Substance use can also contribute to mental health symptoms, and shared factors such as stress or trauma can increase the likelihood of both conditions. Having both does not prove that one caused the other.[13]
A provider can consider anxiety symptoms and substance use together to understand how each affects you. Tell your providers about all substances and prescriptions so they can plan care together. Co-occurring conditions means having a mental health condition and a substance use disorder at the same time. Treatment can address both.[13]
If you have been drinking heavily for a long time, suddenly stopping can cause withdrawal—a physical reaction that may include nausea, a racing heart, or seizures. It can be life-threatening. Seek medical advice about stopping safely. Similarly, do not abruptly stop a prescribed anxiety medication without discussing it with your prescriber.[14][12]
Treatment for Anxiety Disorders
Effective anxiety treatment often includes talk therapy, medication, or both. The choice depends on the disorder, severity, other health conditions, preferences, and response to previous care. A treatment plan can change as you learn what helps.[6][5]
Cognitive Behavioral Therapy and Exposure
Cognitive behavioral therapy (CBT) helps you identify and change unhelpful patterns of thinking and behavior. For anxiety, this can mean looking at what you fear will happen, checking that prediction, and practicing a different response. CBT has been extensively studied for GAD, panic disorder, and social anxiety.[6][5][7]
Therapy does not require you to push every anxious thought out of your mind. In Yale Medicine's explanation of CBT, psychiatrist Christopher Pittenger describes the aim as “responding better to them and lessening their potency.”[15]
That distinction can help you describe progress. For example, you could discuss whether you stayed in a conversation you wanted to have, even while worrying about being judged. The goal you work toward should fit your own situation.
Exposure therapy is a CBT approach that helps people gradually approach feared situations instead of continuing to avoid them. For panic disorder, a therapist may guide practice with feared body sensations, such as a racing heart. For social anxiety, the work may involve progressively practicing social situations. The exercises should fit the condition and a plan developed with your therapist.[5][7]
A useful question is: “What will we practice during and between sessions, and how will we know it is helping?” Therapy involves more than receiving reassurance. Your provider should explain the approach and how it relates to your goals.[3]
Other Therapy and Support Options
Acceptance and commitment therapy (ACT) helps people notice difficult thoughts without judging themselves for having them, while working toward activities and goals that matter to them. It may use mindfulness—paying attention to what is happening in the present without judging it. Acceptance here concerns your response to thoughts and feelings.[6][16]
NIMH describes growing evidence for ACT in GAD and social anxiety. The right approach should match your symptoms and preferences, rather than assuming every therapy works the same way for every disorder.[6][7]
Therapy may take place individually or in a group. Support groups can also offer connection and encouragement, but they are not a replacement for professional treatment when it is needed.[3][6]
Medications for Anxiety
A prescriber can explain whether medication is appropriate and compare benefits, side effects, and interactions. Common options have different roles:[12]
- SSRIs and SNRIs: These are two groups of antidepressants also used for anxiety disorders. The names stand for selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors. They generally take several weeks to begin helping and are not immediate-relief medicines.[6]
- Buspirone: This may be used for GAD. It is taken regularly and needs time to work, rather than being used only during a sudden episode.[6]
- Benzodiazepines: These can reduce symptoms quickly, but tolerance and physical dependence are concerns. Providers generally prescribe them for short periods and plan carefully how to lower the dose or stop.[12]
Tolerance means the same dose has less effect over time. Physical dependence means the body has adapted to a medicine and can have withdrawal symptoms if it is stopped suddenly or the dose is reduced too quickly. Benzodiazepine withdrawal can cause life-threatening seizures. Ask your prescriber how to make any change safely.[6][12][17]
Choosing a medication requires extra care when substance use or other prescriptions are involved. Tell your prescriber about alcohol, nonprescription medicines, and supplements. Do not change a dose or stop treatment on your own.[12]
Ask what side effects to watch for, when to check in, and what to do if symptoms worsen. Antidepressants carry a warning about increased suicidal thoughts or behavior in some children, teenagers, and young adults, especially early in treatment or after a dose change. Monitoring matters at every age.[12]
If you are in crisis or thinking about suicide, call or text 988.[4]
What Can Help You Cope With Anxiety?
Self-care skills can support treatment and help you handle stressful moments. They do not replace an assessment when anxiety persists or disrupts daily life.[18][6]
- Practice a calming skill: Try a guided relaxation, breathing, or mindfulness exercise and notice whether it helps you settle.[18]
- Notice patterns: A brief journal can help you identify triggers and approaches that help. Bring relevant observations to therapy.[18]
- Support sleep and routine: Aim for regular meals, movement, and a consistent sleep schedule.[18]
- Consider caffeine: Excess caffeine can worsen anxiety. Discuss its role if you notice a connection.[18][2]
- Stay connected: Reach out to people who respond supportively instead of facing everything alone.[18]
Avoidance may feel helpful in the moment while leaving the underlying fear in place. If anxiety is shrinking your daily life, ask a therapist about a gradual approach to activities you want to return to. You do not have to force yourself through overwhelming situations without a plan.[7]
If worries keep repeating without a useful next step, explore how to stop overthinking, including examples for nighttime worries and relationships.
How to Tell Whether Treatment Is Helping
Agree on specific goals with your provider. Examples might include returning to a class, attending a meeting, or spending less time caught in worry. Ask when you will review progress and what options you have if the approach is not helping. Improvement can take time, and setbacks do not mean that treatment has failed.[3][5]
How to Find an Anxiety Therapist Near You
Start with a provider who has experience treating the anxiety pattern you are experiencing. Your primary care provider, insurer’s directory, local health department, or a mental health professional directory can help you find options. Students may also have access to services through their school.[4]
When contacting a provider, ask:
- “Do you treat my main concern, such as panic attacks, ongoing worry, or social anxiety?”
- “What training do you have in CBT or other approaches you recommend?”
- “Do you work with people in my age group and with any other conditions I have?”
- “How will we set goals and review progress?”
- “Do you accept my insurance, what will I pay, and when could we begin?”
Ask about professional qualifications and verify costs directly before booking. The closest office is one consideration. The provider’s experience, your ability to attend, and feeling comfortable enough to discuss concerns also matter.[3][4]
Is Online Therapy an Option for Anxiety?
Online therapy can be an effective way to receive anxiety treatment. It may make appointments easier to attend when travel, distance, or scheduling is a barrier. It still needs to involve an appropriate provider and treatment approach.[19][6]
Before choosing online care, discuss:
- Treatment fit: Can the provider assess your symptoms and deliver the approach you need remotely?
- Privacy and technology: Do you have a private place to talk, a suitable device, and a reliable connection?
- Cost and coverage: Does your plan cover these appointments, and what services are included?
- Support between visits: How do you contact the provider, and what should you do if urgent help is needed?
Ask the service to confirm that it can treat someone of your age in your location. Discuss whether you also need an in-person assessment, visits to check how medication is working, or coordinated substance use treatment as well. An online appointment or message service does not replace emergency care.[19][3][13][12]
Supporting a Loved One With Anxiety
Listen without dismissing the fear or telling the person to “just relax.” Ask what they are finding difficult and what kind of help they would welcome. You might offer to help locate a clinician, write down questions, or accompany them to an appointment if they want support.[5][7]
Children and teens may show anxiety through school avoidance, stomachaches, difficulty joining activities, or intense worries about performance. A pediatric or mental health provider can help assess the pattern. Choose someone with relevant experience treating young people and ask how parents or caregivers can be involved.[6][7][3]
You do not have to wait until anxiety affects every part of life to ask for help. If persistent worry, fear, or avoidance is interfering with daily activities, consider starting with your primary care provider or an anxiety therapist. Discuss any other mental health concerns with your provider as well.[4][5]
If you are in crisis or thinking about suicide, call or text 988.[4]
Frequently Asked Questions About Anxiety Disorders
Can Anxiety Cause Chest Pain or Shortness of Breath?
Panic attacks can involve chest pain and difficulty breathing. Those symptoms can also have serious medical causes, so do not diagnose them as anxiety yourself. Call 911 for sudden chest pressure or pain with symptoms such as shortness of breath, sweating, or pain spreading to your jaw or arm.[5][8]
Does Having a Panic Attack Mean I Have Panic Disorder?
No. A panic attack can occur without panic disorder. Panic disorder involves repeated, unexpected attacks plus ongoing worry or changes in what you do to avoid another attack. A clinician can evaluate the pattern and check for other explanations.[5]
Can Anxiety Be Treated Without Medication?
Yes. Talk therapy (psychotherapy) is an established treatment, and some people use it without medication. Others benefit from medication or combined care. Discuss your preferences, symptom severity, and other health needs with a provider rather than assuming one approach is right for everyone.[6]
How Long Does Anxiety Treatment Take?
Can I Get Therapy for Anxiety Online?
Yes. You can receive anxiety therapy through online appointments. Look for a qualified provider with relevant experience, confirm costs and whether the service can treat someone of your age in your location, and discuss whether online care fits your needs. You also need suitable technology and enough privacy to participate.[19]
What Should I Say at My First Anxiety Appointment?
Get Treatment Help
If you or someone you love is struggling with addiction, getting help is just a phone call away, or consider trying therapy online with BetterHelp.
Exclusive offer: 20% Off BetterHelp*Following links to the BetterHelp website may earn us a commission that helps us manage and maintain AddictionHelp.com. *Get 20% off your first month of BetterHelp. Offer valid for new BetterHelp users only. Offer cannot be combined with insurance.
- Fact-Checked
- Editor
