Everyone feels anxious sometimes. Before an exam, an interview or a difficult conversation, a racing heart and a worried mind are normal. Anxiety becomes a problem when it is frequent, intense, hard to control, or gets in the way of everyday life. This guide explains the main signs of anxiety, what can cause it, and how to decide when it is time to get help.
What is anxiety?
Anxiety is the body's alarm system responding to a perceived threat or uncertainty. It prepares you to act by raising your heart rate, tightening your muscles and sharpening your attention. In small doses that is useful. In an anxiety disorder, the alarm goes off too often, too strongly, or without a clear danger, and it is hard to switch off.
Emotional and mental symptoms
- Persistent worry that is hard to control, often about many different things.
- Feeling on edge, tense or unable to relax.
- Expecting the worst or imagining worst-case scenarios.
- Irritability and a short temper.
- Difficulty concentrating, or your mind going blank.
- A sense of dread or that something bad is about to happen.
Physical symptoms
Anxiety is not "all in the head". Many people notice it first in the body:
- A pounding or fast heartbeat.
- Shortness of breath or a feeling of tightness in the chest.
- Sweating, trembling or shaking.
- Muscle tension, headaches, or a stiff neck and jaw.
- Stomach upset, nausea or changes in appetite.
- Dizziness or feeling light-headed.
- Trouble falling asleep or staying asleep.
- Feeling tired all the time despite resting.
Because these symptoms can also come from medical conditions such as thyroid problems, heart rhythm problems or anaemia, it is wise to see a doctor if you have chest pain or other physical symptoms that worry you, rather than assuming they are anxiety.
Behavioural signs
Anxiety also changes what people do. Common patterns include avoiding situations that trigger fear, procrastinating, seeking constant reassurance, checking things repeatedly, or struggling to make decisions. Avoidance feels like relief in the short term, but it usually keeps anxiety going in the long term because you never learn that you can cope.
Different types of anxiety
- Generalised anxiety: ongoing, excessive worry about many everyday things. In diagnostic criteria the worry is present more days than not for at least six months.
- Panic attacks: sudden waves of intense fear with physical symptoms such as a racing heart, breathlessness and a feeling of losing control. They usually peak within minutes.
- Social anxiety: intense fear of being judged or embarrassed in social situations.
- Specific phobias: strong fear of a particular object or situation, such as heights, flying or injections.
- Agoraphobia: fear and avoidance of places where escape might be difficult, such as crowds or public transport.
Common causes and risk factors
Anxiety rarely has a single cause. Researchers point to a mix of factors:
- Biology and genetics: anxiety tends to run in families.
- Personality: people who score high on the trait of neuroticism tend to experience negative emotions more often.
- Life experiences: trauma, prolonged stress, bereavement, or a difficult childhood can raise risk.
- Current stressors: work pressure, exams, financial worries and relationship problems.
- Health and lifestyle: lack of sleep, high caffeine intake, alcohol, certain medicines and medical conditions can trigger or worsen anxiety.
Normal worry or an anxiety problem?
A useful way to decide is to ask four questions:
- How intense is it? Is the fear out of proportion to the situation?
- How long has it lasted? Weeks or months, rather than a few days around a stressful event?
- How hard is it to control? Can you stop worrying when you try?
- How much does it interfere? Is it affecting your sleep, work, studies, relationships or health?
If you answer yes to several of these, it is worth taking a closer look.
Taking a screening questionnaire
A validated questionnaire can help you put numbers to what you are experiencing. The GAD-7 is a seven-question scale that asks how often you have been bothered by anxiety symptoms over the last two weeks. The Penn State Worry Questionnaire focuses on how excessive and uncontrollable your worry is, and the DASS-21 measures anxiety alongside depression and stress. You can take all of these for free, in English, Hindi or Hinglish, on our anxiety test page. For a step-by-step explanation of the most widely used scale, read our guide to the GAD-7.
Remember that a screening result is not a diagnosis. It tells you how you have been feeling, not why, and only a qualified professional can diagnose an anxiety disorder.
What helps
- Therapy: cognitive behavioural therapy (CBT) is one of the best-studied treatments for anxiety. It helps you notice and challenge anxious thoughts and gradually face feared situations.
- Medication: in some cases a psychiatrist may recommend medicines. This is a decision to make with a doctor.
- Lifestyle changes: regular exercise, consistent sleep, less caffeine and alcohol, and time outdoors can all reduce symptoms.
- Relaxation skills: slow breathing, progressive muscle relaxation and mindfulness practices can calm the body's stress response. You can measure your mindfulness on our mindfulness test page.
- Talking to someone: sharing what you are going through with a friend, family member or counsellor reduces isolation.
When to see a professional
Consider speaking to a doctor, psychiatrist or clinical psychologist if your anxiety lasts for weeks, is getting worse, causes panic attacks, leads you to avoid important things, or comes with low mood or thoughts of self-harm. In India you can also call Tele-MANAS at 14416, a free government mental-health helpline. If you are in immediate danger, contact your local emergency services.
If your anxiety comes with feelings of low mood, take a look at our depression test page as well, and read how burnout, stress and depression differ.