Understanding Symptoms Of Severe Anxiety And Stress

Medically reviewed by Laura Angers Maddox, NCC, LPC and Arianna Williams, LPC, CCTP

Updated January 21st, 2025 by BetterHelp Editorial Team

Anxiety is a normal response that can help us face challenges, stay motivated, and defend ourselves from harm. However, when the anxiety response becomes too potent or frequent, it can affect our mental and physical health and, in some cases, signal the presence of an anxiety disorder. Below, we’re going to discuss what severe anxiety is, how symptoms of severe anxiety can manifest, and which treatment options are available for managing severe anxiety.

Anxiety can be difficult to manage regardless of its severity

Online therapy can help you cope

What is anxiety?

Anxiety refers to feelings of nervousness, fear, and worry that often arise out of uncertainty. Most people experience anxiety occasionally, whether it’s related to work, relationships, or other aspects of life. Some individuals, however, live with anxiety that rises to the level of a diagnosable mental health illness. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) outlines several different diagnosable anxiety disorders, such as panic disorder, generalized anxiety disorder, social anxiety disorder, separation anxiety disorder, and specific phobias. According to the Anxiety and Depression Association of America, anxiety disorders are the most prevalent type of mental health condition in the US. Signs of an anxiety disorder can depend on the individual and the specific disorder, but they generally include both mental and physical symptoms like:

Persistent nervousness, worry, and fear
Muscle tension
Rapid breathing
Trouble sleeping
Increased heart rate
Difficulty concentrating
Sweating
Irritability
Gastrointestinal distress

Symptoms of anxiety disorders exist on a spectrum from mild to severe. Symptoms of severe anxiety can also manifest as panic attacks, trouble breathing, extreme avoidance behaviors, and thoughts of self-harm

If you are experiencing suicidal thoughts or urges, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or text 988 to talk to someone over SMS. Support is available 24/7.

Causes of extreme anxiety

While the exact cause of anxiety disorders is unknown, several factors—such as genetic and environmental influences—are thought to contribute to their development. Having a family history of anxiety disorders or other mental illnesses can increase one’s chance of developing an anxiety disorder. Additionally, certain personality traits, such as neuroticism, are associated with some types of anxiety disorders.

Some research also suggests that anxiety is linked to abnormalities in brain chemistry that affect the function of certain regions, including the amygdala, insular cortex, and cingulate cortex. Environmental factors that could increase one’s risk of anxiety can include negative life events like trauma in early childhood or the loss of a loved one. Physical health concerns, like thyroid problems and irritable bowel syndrome, can also relate to symptoms of anxiety disorders.

What does severe anxiety mean?

Severe anxiety is not a clinical diagnosis. Instead, it’s a term that may be used to describe when certain anxiety disorders produce especially intense symptoms, or when a person experiences acute, extreme anxiety symptoms that don’t last long enough to qualify as a disorder.

When a healthcare professional diagnoses people with anxiety, they may sometimes describe the condition’s severity level as mild, moderate, or severe.

Anxiety can be categorized as severe based on a variety of measures. For example, the Beck Anxiety Inventory is a scale that assesses the intensity of anxiety based on an individual’s answers to a series of questions regarding their symptoms. Scores that are in the highest range suggest the presence of severe levels of anxiety.

Severe anxiety may involve feelings of overwhelming worry and nervousness that impair daily functioning to a greater extent than mild or moderate anxiety. A person with severe anxiety, may also go to greater lengths to avoid places or situations in which such feelings often arise. For example, an individual with severe social anxiety may experience such intense self-consciousness that causes them to completely self-isolate, potentially avoiding even work, school, and time with close friends or family.

The physiological effects of severe anxiety could cause more serious physical health challenges as well. It may also require more intensive forms of treatment and increase the likelihood that an individual will develop a comorbid condition—that is, other mental health conditions that co-occur at the same time.

Different types and symptoms of severe anxiety, fear, and worry

Severe anxiety can manifest differently depending on the type of anxiety disorder an individual lives with. For example, some with severe social anxiety disorder may experience intense fear when even thinking about social situations, while someone with generalized anxiety disorder may experience extreme, nearly constant worry about daily life. To understand how severe anxiety may manifest across different situations, it can help to know the various types of anxiety disorders listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Below are some common anxiety disorders and the severe symptoms they may produce.

Generalized anxiety disorder

One of the most common mental health conditions, generalized anxiety disorder (GAD) can lead to intense feelings of fear and worry. Severe symptoms of GAD may include frequent and/or extreme nervousness, gastrointestinal distress, fatigue, irritability, and tension. With GAD, severe anxiety may be related to specific sources, or it could arise for no discernible reason.

As discussed above, the Beck Anxiety Inventory is one example of an evaluation that can assess the severity of anxiety symptoms. According to this 21-question scale, potential symptoms—which include numbness or tingling, fear of losing control, indigestion, and 18 others—may be severe based on the extent to which they impact the individual’s life.

Panic disorder

Panic disorder is a condition that causes a person to have panic attacks. A panic attack is an episode of severe anxiety characterized by sudden, intense fear and dread—even without an apparent cause—that can produce serious physical and emotional reactions. Severe panic attacks often happen unexpectedly, potentially causing an individual to experience extreme fear, rapid breathing, chest pain, and an elevated heart rate.

Severe panic disorder may be diagnosed based on various assessments. For example, the American Psychiatric Association (APA) developed a scale for measuring the severity of panic disorder that is based on the frequency of common symptoms. Symptoms that may indicate severe panic disorder if they manifest frequently enough include those in which the individual experiences any of the following:

had thoughts of losing control, dying [...] or other bad things happening because of panic attacks”
“left situations early, or participated only minimally, because of panic attacks”
“needed help to cope with panic attacks”

Phobias

Specific phobias are characterized by persistent, severe, and excessive anxiety or fears of a specific object, situation, or activity that is generally not harmful. For the most part, the individual knows their fear is irrational, but it can still trigger anxiety symptoms. Specific phobias can cause severe distress and worry—to the point that some people go to extreme lengths to avoid what they fear. Examples of phobias include the fear of spiders, heights, or needles.

As with panic disorder, the APA has developed a scale for measuring the severity of phobias that is based on the frequency of symptoms felt in response to common fears like certain animals, storms, or enclosed areas. According to this inventory, symptoms like sudden fear, avoidance, and tension may be severe if they’re experienced more often than not.

Anxiety can be difficult to manage regardless of its severity

Online therapy can help you cope

Social anxiety disorder

Social anxiety disorder (SAD) is characterized by symptoms of anxiety that arise in social situations. SAD is often related to a fear of being judged by others or embarrassed in front of others. According to the National Institute of Mental Health, 7% of US adults live with social anxiety disorder. Severe symptoms of social anxiety disorder can include serious physical symptoms (e.g., rapid heart rate), social isolation, extreme behavioral inhibition, and even selective mutism.

Again, the American Psychiatric Association provides guidance on when social anxiety disorder is considered severe. According to the APA’s scale, the Severity Measure for Social Anxiety Disorder, if an individual experiences certain symptoms more than half the time, they may have severe social anxiety.

Separation anxiety disorder

A person with a severe separation anxiety disorder will typically feel anxious and fearful about separating from those with whom they are attached, such as a parent or romantic partner. Separation anxiety disorder symptoms can include being persistently worried about losing the person closest to them, being reluctant to go out or sleep away from their home or without that person, and experiencing nightmares about separation. Symptoms often develop in childhood, but can carry over into adulthood.

Agoraphobia

Agoraphobia is a fear of situations from which it would be difficult to escape if a person were to experience panic or other challenging feelings. According to the DSM-5, there are five situations that may trigger agoraphobia:

Using public transportation
Being in open spaces
Being in enclosed spaces
Standing in line or being in a crowd
Being outside the home alone

An individual must experience at least two of these to be diagnosed with the disorder. Symptoms of agoraphobia (nervousness and fear that are irrational given the actual danger present) may be severe if they occur in a wider variety of places, more frequently, or in combination with panic disorder.

Managing severe anxiety, stress, nervousness, and restlessness

Psychotherapy and medication are common treatments for anxiety disorders. Talk therapy—such as cognitive behavioral therapy (CBT)— can help participants reduce anxiety by talking through their feelings, identifying the sources of their symptoms, developing stress-management techniques, and learning about related health topics. Anti-anxiety medications—which are often reserved for symptoms of anxiety that are more frequent, persistent, or troublesome—can also be a crucial component of a treatment plan for severe anxiety in some cases.

There are several lifestyle changes you can make that may also help reduce the severity of anxiety symptoms. These include things like exercising regularly, eating nutrient-dense foods often, limiting alcohol and caffeine, and getting plenty of sleep. Joining a support group can also be helpful for people living with severe anxiety, particularly social anxiety.

Addressing panic attacks and symptoms of severe anxiety in therapy

If you’re experiencing anxiety of any intensity that is causing you distress or interfering with your life, help is available. Seeking the support of a therapist is usually the recommended first step. However, some people experience increased anxiety symptoms at the prospect of calling therapy offices to find a provider, commuting to in-person appointments, and speaking about their symptoms with someone they don’t know face to face. In cases like these, online cognitive behavioral therapy can be a more approachable alternative. With a platform like BetterHelp, you can get matched with a licensed therapist and meet with them from anywhere you have an internet connection.

Online therapy

The results of a growing number of studies indicate that online cognitive behavioral therapy may help individuals alleviate or better manage anxiety—including symptoms that are more intense. For example, in one study, findings suggest that participants experienced significant improvements in symptoms of severe anxiety following an online cognitive behavioral therapy program. The study also mentions that online therapy “has the potential to increase reachability and availability” of CBT.

Takeaway

Severe anxiety can be difficult to live with and may potentially lead to serious mental, physical, and emotional effects. Understanding the symptoms of severe anxiety as well as how they may be managed may help you know when to seek out professional support.

Frequently asked questions

Read more below for answers to questions commonly asked about this topic.

Is severe or extreme anxiety a mental illness?

Everyone experiences occasional anxiety—about important or stressful matters like work or weddings, for instance. However, intense or severe anxiety on a regular basis may be an indication of an anxiety disorder such as social phobia (social anxiety disorder), generalized anxiety disorder, or even posttraumatic stress disorder.

Other anxiety disorders include obsessive compulsive disorder and panic disorder, and the ICD-11 recognizes “other specified anxiety disorders.” These are unspecified anxiety disorders that clearly cause distress but don’t meet the criteria for any other listed anxiety conditions. Only a mental health specialist, such as a psychiatrist, can accurately diagnose mental disorders, including anxiety.

What are the symptoms of severe anxiety and stress?

According to the National Institute of Mental Health, people with anxiety disorders experience various physical and psychological symptoms such as sweating, shortness of breath, and feelings of dread that persist or repeat for several months.

What triggers panic attacks and anxiety disorders?

While there is no one cause of most anxiety disorders, there are several risk factors that can increase someone’s chance of developing one, such as a family history of anxiety disorders and certain chronic diseases. The development of posttraumatic stress disorder specifically can be more directly linked to traumatic events, but it’s not a guarantee that someone will develop the condition after something traumatic.

What happens if I leave my fear, worry, or anxiety untreated?

Leaving an anxiety disorder untreated can make anxiety symptoms worse in the long run, or may put you at a risk of developing other mental health concerns like depression.

Can you treat fear, worry, stress, and anxiety disorders without medication?

Yes, it just depends on the individual. Some people find that anti-anxiety medications just aren’t that helpful or come with intolerable side effects. While medication may still be appropriate for some, others may find that non-medication methods like psychotherapy, support groups, and lifestyle changes (such as exercising regularly) better reduce their symptoms.

What are other symptoms of severe anxiety?

There are many emotional and physical signs of anxiety. For example, someone might experience emotional symptoms like unrealistic worry, worsening sleeping habits, a sense of impending danger, feeling restless, and trouble concentrating, among many others. Physical symptoms of severe anxiety can include a rapid heartbeat, stomach issues, and a higher risk of developing a physical health condition or serious complications.

Are nervousness and restlessness symptoms of severe anxiety?

Nervousness and restlessness are common symptoms for some people experiencing intense anxiety, although these symptoms are also often present for people with mild to moderate anxiety. Nervousness and situations that trigger anxiety disorders can make anxiety worse. To explore how restlessness and nervousness impact you, talking to a mental health provider may be helpful. They can help you determine whether effective treatments like exposure therapy or cognitive-behavioral therapy (CBT) may relieve anxiety for you.

Only a mental health professional or doctor can treat anxiety disorders, treat depression, and support physical symptoms caused by anxiety. When you seek treatment, you can also ask about how medication may reduce your anxiety and improve your overall well-being. Do not start, change, or stop a medication without consulting a doctor and explaining your full medical history.

The BetterHelp platform is not intended to provide any information regarding which medication or medical treatment may be appropriate for you. The content provides generalized information that is not specific to one individual. Do not take any action without consulting a qualified medical professional.

What is the most serious form of anxiety?

All forms of anxiety and anxiety disorders are serious. However, anxiety stemming from a traumatic event or an anxiety disorder co-occurring alongside post-traumatic stress disorder (PTSD) may be especially severe. People with PTSD may be more likely to experience frequent panic attacks or panic disorder, as well.

What are the physical symptoms of anxiety?

Physical symptoms of anxiety often include the following, but can be different for each individual:

Tremors or shakiness
Stomach pain or more frequent bowel movements
Headaches
Sweaty or clammy skin
Brain fog
Chest pain (especially during a panic attack)
Shortness of breath or hyperventilation
Heart palpitations or a racing heart
Gas and indigestion
Tingling in the skin
Dizziness or a sense that you might pass out

Does anxiety go away if you ignore it?

Anxiety doesn’t tend to go away if you ignore it. For some people, distraction may be a helpful coping skill in some situations. However, ignoring a problem can tend to make emotions more intense over time. For support with your anxiety, you may benefit from talking to a therapist online or in your area.

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The information on this page is not intended to be a substitution for diagnosis, treatment, or informed professional advice. You should not take any action or avoid taking any action without consulting with a qualified mental health professional. For more information, please read our terms of use.

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