What Are the Symptoms of Anxiety?

• What does anxiety feel like in the body and the mind?
• When is it time to get help?

By Dr. Douglas Cowan, Psy.D., MFT

If you found this article, you may be feeling something right now that frightens you. A racing heart. A tight chest. Shaky hands. A mind running too fast to catch.

First, hear this: you are not broken. What you are feeling has a name. What has a name can be understood, and what is understood can be helped. Read this slowly. You do not need to rush.

Anxiety is common. In a large US study, about 18 percent of adults, nearly one in five, had an anxiety disorder in a given year (1). You are far from alone.

What is happening in the body

Anxiety is a nervous system response, not a thinking error. Deep in the brain, the amygdala scans for danger and sounds an alarm, faster than conscious thought. Your body then floods with adrenaline and cortisol. Your heart speeds up, your breathing changes, your muscles tighten, and your attention narrows to look for threats.

That is a healthy system doing its job. The trouble comes when the alarm fires too easily, too often, or for too long. You did not choose this, and you cannot always think your way out of it in the moment. You can, however, retrain it over time.

The full picture of symptoms

In the body

• Pounding or racing heart
• Chest tightness
• Shortness of breath or feeling like you cannot get enough air
• Dizziness or lightheadedness
• Tingling or numbness in the hands, feet, or face
• Sweating, hot flashes, or chills
• Nausea or an upset stomach
• Muscle tension in the neck, shoulders, and jaw
• Trembling
• Tiredness that does not match what you did

In the mind and emotions

• Constant worry or racing thoughts
• Trouble concentrating
• A sense that something terrible is about to happen
• Feeling on guard all the time
• Irritability
• Feeling flooded by small things
• Trouble falling asleep, staying asleep, or waking early with dread

In behavior

• Avoiding places, people, or tasks that trigger worry
• Asking again and again for reassurance
• Putting things off because they feel too big
• Struggling to make even small decisions

Clinicians diagnose generalized anxiety disorder when excessive worry is present most days for at least six months, is hard to control, and comes with symptoms such as restlessness, fatigue, trouble concentrating, irritability, muscle tension, or sleep problems (2). Panic attacks, social anxiety, and specific fears have their own patterns.

Panic attack or heart attack?

This question sends many people to the emergency room, and that is fine. The symptoms overlap, and doctors find panic disorder in a meaningful number of people who come in with chest pain (3). Even experts cannot reliably tell the two apart from symptoms alone.

So the rule is simple. If you have chest pressure or pain, pain that spreads to your arm, jaw, or back, trouble breathing, or you are not sure, call 911. Being checked is never an overreaction. A doctor who tells you it was panic has given you very good news.

What helps

Rule out medical causes. Thyroid problems, heart rhythm problems, medication effects, and too much caffeine can all look like anxiety. See your doctor first if you have not had a checkup.

Learn one slow-breathing skill. In a trial of 5 minutes a day for a month, a breathing practice with a long exhale lifted mood more than mindfulness meditation (4). Breathe in for four counts and out for six, and practice when you are calm. See our breathing guide.

Name what is happening. “My alarm just went off” calms the thinking brain better than “I am dying.”

Get cognitive behavioral therapy. CBT is one of the best-studied treatments for anxiety (5). It teaches you to face fear in small steps and to test anxious thoughts.

Move, sleep, and connect. Regular movement, a steady sleep schedule, and time with people you trust all lower the baseline.

Ask about other options. For anxiety that is strong or lasting, some people also explore neurofeedback or cranial electrical stimulation (CES) with a qualified provider. The research on both is still growing, so they work best as part of a larger plan.

Start today

• Take our GAD-7 check-in. It takes about two minutes and gives you a clear picture (6).
• Make a doctor’s appointment if you have not had a checkup.
• Practice the breathing skill for five minutes tomorrow morning.
• Reach out to a therapist or counselor who works with anxiety.

You are not broken. Your alarm has become too sensitive, and a sensitive alarm can learn a new setting.

You can get your life back, and help is closer than you think.

This article is for education and is not a substitute for professional diagnosis or treatment. If you are in crisis, call or text 988 in the United States.

References

1. Kessler, R. C., Chiu, W. T., Demler, O., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 617-627. https://doi.org/10.1001/archpsyc.62.6.617
2. American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). American Psychiatric Publishing.
3. Greenslade, J. H., Hawkins, T., Parsonage, W., & Cullen, L. (2017). Panic disorder in patients presenting to the emergency department with chest pain: Prevalence and presenting symptoms. Heart, Lung and Circulation, 26(12), 1310-1316. https://doi.org/10.1016/j.hlc.2017.01.001
4. Balban, M. Y., Neri, E., Kogon, M. M., Weed, L., Nouriani, B., Jo, B., et al. (2023). Brief structured respiration practices enhance mood and reduce physiological arousal. Cell Reports Medicine, 4(1), 100895. https://doi.org/10.1016/j.xcrm.2022.100895
5. Hofmann, S. G., Asnaani, A., Vonk, I. J. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive Therapy and Research, 36(5), 427-440. https://doi.org/10.1007/s10608-012-9476-1
6. Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092-1097. https://doi.org/10.1001/archinte.166.10.1092