Anxiety: How Much Is Too Much?

Differentiating Normal and Excessive Anxiety

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Anxiety is a physical and mental state that is totally natural for everyone to experience at different points in time. After all, it is a state with an adaptive and protective purpose. Sometimes, however, worry can take on a life of its own. But if anxiety is starting to hurt you rather than help you – if it’s difficult to control or nearly impossible with which to cope – it’s time to step back and evaluate the extent of the problem.

When is anxiety a problem?

The point at which worry and anxiety become a problem is somewhat subjective, though there are several different markers of severity and intensity that you might use to evaluate how reasonable or unreasonable your level of anxiety is.

This might be hard to judge from inside the experience, but to start, trying stepping back and asking yourself questions such as:

If the answers to any of these questions give you pause, or if you are finding them tough to answer, consider asking someone you trust about their perception of your anxiety and how it impacts your life.

Anxiety is a problem. Now what?

If you think your worry has gotten out of hand, an expert opinion can help to further clarify this. Meeting with a clinician – a counselor, social worker, psychologist or psychiatrist – can help you to determine if your anxiety issue can be classified as a disorder, and which one.

Clinicians will use diagnostic criteria for anxiety disorders to determine whether or not anxiety is excessive; this typically involves an assessment of how persistent anxiety is, what types of symptoms you experience and for how long they last, and how intrusive it is on your ability to get through life on a day-to-day basis. 

Diagnosis can be tricky. Many anxiety disorder diagnostic symptoms overlap with one another, and it might take some time to tease out the primary problem. Also, some people struggle with more than one type of anxiety disorder. Others can exhibit a number of significant symptoms, but not quite enough symptoms to meet strict DSM-5 criteria for a given diagnosis; in this case, you might be told that you have a “sub-threshold” anxiety disorder. [Reminder: The DSM-5 is the reference used by qualified mental health professionals to diagnose anxiety disorders and other psychiatric conditions.]

Even if your anxiety is of the low-grade variety or does not meet the threshold for a firm diagnosis that does not mean it’s not worth working on. In fact, from a practical perspective, it’s most important to pay attention to how anxiety interferes with your life, no matter how it manifests.

A clinician can help you narrow down what’s wrong or identify helpful interventions, even if unable to determine a specific label for the problem. 

What are some possible next steps to regain control of anxiety?

Speaking with a clinician – a physician or mental health provider -- who knows you is the best way to figure out your next step(s). Depending on the nature and extent of your anxiety, you may find one or a combination of a number of approaches useful. Mild or intermittent anxiety may improve with the use (1) self-help resources (e.g., books, Smartphone apps, online resources) that walk you through a series of exercises related to your anxiety, (2) regular use of relaxation strategies, (3) increased daily activity or implementation of an exercise routine, or (4) any of a number of talk therapies.

For moderate to severe anxiety, cognitive behavioral therapy is the psychotherapy of choice with an encouraging evidence base to support its use. There are also medications that can help with persistent anxiety of any degree. 

To find a qualified clinician, check out referral resources including Psychology Today,  The Association for Behavioral and Cognitive Therapies or The Anxiety and Depression Association. Or, speak with your current physician about seeking a psychiatric evaluation with a recommended mental health provider. For additional resources on mental health, see the Healthy Minds blog, the online resource of the American Psychiatric Association.