Everyone gets a fright or anxious from time to time—when speaking in public, for example, or when experiencing financial difficulty. For some people, however, anxiety becomes so often, or so forceful, that it gradually takes over their lives.
How can you relate if your everyday anxiety has crossed the line into a disorder? It’s not easy. Anxiety comes in many shades—such as panic attacks, phobia, and social anxiety—and the difference between an official diagnosis and “normal” anxiety isn’t always clear.
If you experience any of the following symptoms regularly, you may want to talk with your doctor.
1. Sleep problems
Hard time falling asleep or staying asleep is linked with a wide range of health conditions, both physical and psychological. And, of course, it’s not unusual to toss and turn with anticipation on the night before a big speech or job interview.
But if you disturbingly find yourself staying awake, worried or agitated—about specific problems (like money), or nothing in particular—it might be a sign of an anxiety disorder. By some estimates, fully half of all people with GAD experience sleep problems.
Another tip-off that anxiety might be involved? You wake up feeling wired, your mind is racing, and you’re unable to calm yourself down.
2. Chronic indigestion
Anxiety may begin in the mind, but it often shows itself in the body through physical symptoms, like chronic digestive problems. Irritable bowel syndrome (IBS), a condition characterized by stomachaches, cramping, bloating, gas, constipation, and/or diarrhea, “is basically an anxiety in the digestive tract,” Winston says.
IBS isn’t always related to anxiety, but the two often occur together and can make each other worse. The gut is very sensitive to psychological stress—and, vice versa, the physical and social discomfort of chronic digestive problems can make a person feel more anxious.
Panic attacks can be terrifying: Picture a sudden, gripping feeling of fear and helplessness that can last for several minutes, accompanied by scary physical symptoms such as breathing problems, a pounding or racing heart, tingling or numb hands, sweating, weakness or dizziness, chest pain, stomach pain, and feeling hot or cold.
Not everyone who has a panic attack has an anxiety disorder, but people who experience them repeatedly may be diagnosed with panic disorder. People with panic disorder live in fear about when, where, and why their next attack might happen, and they tend to avoid places where attacks have occurred in the past.
Social anxiety disorder doesn’t always involve speaking to a crowd or being the center of attention. In most cases, the anxiety is provoked by everyday situations such as making one-on-one conversation at a party, or eating and drinking in front of even a small number of people.
In these situations, people with social anxiety disorder tend to feel like all eyes are on them, and they often experience blushing, trembling, nausea, profuse sweating, or difficulty talking. These symptoms can be so disruptive that they make it hard to meet new people, maintain relationships, and advance at work or in school.
Persistent self-doubt and second-guessing is a common feature of anxiety disorders, including generalized anxiety disorder and OCD. In some cases, the doubt may revolve around a question that’s central to a person’s identity, like “What if I’m gay?” or “Do I love my husband as much as he loves me?”
In OCD, Winston says, these “doubt attacks” are especially common when a question is unanswerable. People with OCD “think, ‘If only I would know 100% for sure whether I was gay or straight, either one would be fine,’ but they have this intolerance for uncertainty that turns the question into an obsession,” she says.
Reliving a disturbing or traumatic event—a violent encounter, the sudden death of a loved one—is a hallmark of post-traumatic stress disorder (PTSD), which shares some features with anxiety disorders. (Until very recently, in fact, PTSD was seen as a type of anxiety disorder rather than a stand-alone condition.)
But flashbacks may occur with other types of anxiety as well. Some research, including a 2006 study in the Journal of Anxiety Disorders, suggests that some people with social anxiety have PTSD-like flashbacks of experiences that might not seem obviously traumatic, such as being publicly ridiculed. These people may even avoid reminders of the experience—another symptom reminiscent of PTSD.
7. Compulsive behaviors
In order to be diagnosed with obsessive-compulsive disorder, a person’s obsessiveness and intrusive thoughts must be accompanied by compulsive behavior, whether it’s mental (telling yourself It’ll be all right over and over again) or physical (hand-washing, straightening items).
Obsessive thinking and compulsive behavior become a full-blown disorder when the need to complete the behaviors—also known as “rituals”—begins to drive your life, Winston says. “If you like your radio at volume level 3, for example, and it breaks and gets stuck on 4, would you be in a total panic until you could get it fixed?”
8. Muscle tension
Near-constant muscle tension—whether it consists of clenching your jaw, balling your fists, or flexing muscles throughout your body—often accompanies anxiety disorders. This symptom can be so persistent and pervasive that people who have lived with it for a long time may stop noticing it after a while.
Regular exercise can help keep muscle tension under control, but the tension may flare up if an injury or other unforeseen event disrupts a person’s workout habits, Winston says. “Suddenly they’re a wreck, because they can’t handle their anxiety in that way and now they’re incredibly restless and irritable.”