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Worrying too much? Doctors explain when anxiety becomes a problem

It can be complicated to understand what’s "good" anxiety and what is the sign of a disorder.
Woman sitting in the dark bedroom
October 10 is World Mental Health Day. Anxiety disorders involve a persistent worry that negatively impacts a person's life.kitzcorner / Getty Images/iStockphoto
/ Source: TODAY

Throughout her life, Johanna Murphy experienced a persistent feeling that she did everything wrong. A low-level of panic often seemed present, but she simply thought this was how adults felt.

“I thought that the on-edge panicking feeling that I always had was because I pretty much screwed everything up,” Murphy, 47, of Pittsburgh, told TODAY. “It never occurred to me that I had anxiety.”

Murphy’s mother struggled with anxiety throughout her life, feeling too scared to drive across bridges or do anything new. But Murphy didn’t experience anxiety like that and it’s why she never sought help: She simply didn't realize anything was wrong. But at 42, she learned she had anxiety.

“Learning that a lot of my functional difficulties weren’t me being lazy or bad or insufficient, but were a real cognitive thing made a lot of anxiety kind of go away,” she said.

Understanding she had anxiety meant she was better able to cope with it. Now, Murphy uses cognitive behavioral therapy (CBT) techniques and pays attention to her needs, which helps her quell the anxious voice.

“I changed a lot about the way I interact with people,” she explained. “I really respect my body’s need for quiet, which ... gives me the energy to be proactive.”

When anxiety is more than just nerves.

Sometimes, anxiety motivates people to study for a test or react quickly to avoid a car accident, so it can be beneficial.

“Anxiety is a normal response to stress,” Dr. Jody Glance, an assistant professor of psychiatry at the University of Pittsburgh, told TODAY. “If we didn’t have any anxiety, we would be less motivated to run away from bears.”

But anxiety disorders involve a persistent worry that negatively impacts a person’s life. About 2.7 percent of U.S. adults will experience generalized anxiety disorder in a given year and 5.7 percent will experience it within their lifetimes, according to the National Institute of Mental Health.

It can be complicated to understand what’s good anxiety and what is the sign of a disorder. What’s more, anxiety impacts physical health, causing people to think their problems are physical not mental.

“Anxiety is a brain-body phenomenon,” Dr. Ken Duckworth, medical director of the National Alliance on Mental Illness (NAMI), told TODAY. “We know there is a correlation between anxiety and physiological problems and GI symptoms are tied to it.”

Understanding symptoms can help people distinguish normal and worrisome anxiety. They include:

  • Rumination that has no end or solution
  • Alcohol or drug use to self-medicate
  • Worry that interferes with daily activities
  • Nausea
  • Headaches
  • Restlessness
  • Thoughts that the worst can happen
  • Heart palpitations
  • Shortness of breath

When anxiety makes it difficult for people to accomplish daily tasks, that’s a sign it has surpassed normal worrying.

“The difference between the ordinary experience with anxiety over a threat or fear and a more generalized condition is how is it affecting your functioning,” Duckworth said.

When people experience insomnia and an inability to concentrate; rely too heavily on drugs or feel jittery, their nerves likely are an anxiety disorder.

“It’s excessive anxiety about everyday things and an inability to control these worries,” Thea Gallagher, clinic director at the Center for the Treatment and Study of Anxiety in the Perelman School of Medicine at the University of Pennsylvania, told TODAY. “The more you worry about something isn’t correlated with the fact that it is going to get done.”

Treating anxiety:

Anxiety makes people feel lousy, but there are many treatment options.

“The data show that evidence-based CBT really works for anxiety disorders,” Gallagher explained. “You’re really learning some skills and ways to manage it.”

Gallagher asks her patients to record how often they worry, what they worry about and how long they worry about it. Then, she gives them strategies to cope.

“We think of worrying [as] thought garbage. It is a waste of cognition on something you can’t control,” she said.

Instead, she encourages her patients to change how they are thinking by asking them: “What would you rather be thinking about (other than) all these negative scary unhealthy concerns?”

While often overlooked, Duckworth advocates people with anxiety engage in regular physical activity.

“You have to down-regulate your body’s feeling of anxiety. Taking a brisk walk, running on a treadmill … this takes it down,” he said.

Several antidepressants also work well to treat anxiety. Treatment varies based on the individual and the experts stressed asking for help is not a sign of weakness.

“There has always sort of been this thread running through our culture that you should be able to take care of your mental health yourself,” Glance said. “That is a false belief.”

Gallagher said seeking treatment often provides relief and urged people to ask for help as soon as they notice a problem.

“If there is an option to suffer less why wouldn’t we take that option?” she said.