Most of us have made peace with a certain baseline of worry. We call it a busy season, a rough patch, or a personality quirk. However, there’s a line between the ordinary stress of being alive and something that controls a significant part of our lives, and most people cross it long before they realize it.
The tricky part about anxiety is how reasonable it sounds at the moment. Nearly every sign has a ready explanation, which is exactly why the serious ones so often go unnoticed until they’re harder to ignore.
About the expert: To understand where that line sits, I interviewed Gil Lichtshein, MD, a board-certified psychiatrist in Boca Raton, Florida, who treats children, adolescents, and adults using evidence-based care. He walked me through the signs worth taking seriously, from the physical symptoms people misread to the moment toughing it out stops working.
Key takeaways
Anxiety that shows up almost daily and disrupts your functioning is more than ordinary stress.
Physical symptoms like stomach upset, chest pain, jaw clenching, and poor sleep are often misread.
Avoiding people, places, and plans is a behavioral warning sign that anxiety is shrinking your world.
An anxiety disorder resembles situational anxiety that never resolves, according to Dr. Lichtshein.
Alcohol, marijuana, and smoking tend to deepen anxiety rather than relieve it.
Anxiety is a treatable medical condition, and help can include therapy, medication, or both.
When everyday stress becomes something more
Stress comes and goes. A clinical level of anxiety tends to settle in and stay. Asked how to tell the difference, Lichtshein said the clearest tell is frequency and reach. “When the anxiety is happening almost every day, or it’s affecting most of the day nearly every day, and starting to impact or affect your ability to function on a day-to-day basis, it is a sign that it is more than ordinary stress,” he explained.
In other words, the question isn’t whether you feel anxious. It’s whether the anxiety has begun running your calendar, your sleep, and your choices.
The physical symptoms people don’t realize are anxiety
Anxiety is often imagined as a purely mental state, but it announces itself in the body first for many people. Lichtshein traced this back to biology. “Anxiety is closely related to your fight or flight response, which releases stress hormones that can cause physical symptoms to help you survive,” he shared.
That ancient survival circuitry is why the symptom list is so long and so easy to misread. He pointed to gastrointestinal complaints as some of the most common: nausea, diarrhea, vomiting, general stomach upset, and that unmistakable knotted feeling in the gut. The fallout can also show up as chest pain, sudden sweating, or heart palpitations. Sleep is another frequent casualty, and not only in the form of insomnia. Vivid dreams and chronic fatigue can be part of the picture too, the psychiatrist observed, along with muscle tension, jaw clenching and TMJ, and restless legs.
When asked what people most often get wrong about these symptoms, he stressed one caveat above all: the body should be checked before the mind is blamed. “It’s important to rule out physical causes of symptoms before assuming it is anxiety-related,” Lichtshein advised.
Stomach trouble, chest tightness, and muscle tension are among the physical symptoms of anxiety that get blamed on other causes.
(MAYA LAB)The subtle signs that are easy to explain away
The danger of anxiety is partly that it’s so reasonable-sounding. We have a ready excuse for nearly every symptom. Pressed on the warning signs people tend to dismiss, Lichtshein noted that they routinely get filed under “just stress,” “being tired,” or “personality quirks,” brushed off until they compound into something harder to ignore, such as panic attacks, burnout, chronic health problems, or strained relationships and slipping performance at work.
The rationalizations feel responsible at the moment. The cost is that the underlying problem gets a long runway to grow.
Situational anxiety versus an anxiety disorder
Everyone feels anxious before a big presentation or a hard conversation. That kind of anxiety has an expiration date. A disorder does not. “An anxiety disorder is pathological,” Lichtshein told me. It interferes with how you function, and it recurs nearly every day. Also, it reaches into your daily life rather than passing through it.
He offered a memorable way to picture the distinction. An anxiety disorder, he noted, “is kind of like situational anxiety that never goes away.”
How anxiety quietly shrinks your world
Some of the most telling signs aren’t symptoms at all. “Anxiety has a significant behavioral component,” Lichtshein explained when the conversation turned to the habits anxiety reshapes. People begin steering around whatever makes them uneasy, and over time those small detours redraw the map of a life.
He described the logic behind it as “out of sight, out of mind” thinking. The invitations declined, the places no longer visited, the people gently avoided: each one felt like a minor, sensible choice, which is exactly why the pattern can go unnoticed until the world has narrowed considerably.
Each declined invitation can feel like a small, sensible choice, which is why avoidance often goes unnoticed, Dr. Gil Lichtshein noted.
(Tirachard Kumtanom)The different types of anxiety, and why the difference matters
Anxiety isn’t a single condition. Asked to lay out the forms it takes, Lichtshein outlined several distinct ones. There’s generalized anxiety, which he characterized as worrying about essentially everything, and social anxiety, which surfaces specifically in social situations. There are specific phobias, discrete fears tied to particular triggers, and there are panic attacks, which he described as brief, intense episodes of dread and doom.
Naming the right one isn’t academic hairsplitting. “It’s important to differentiate the type of anxiety because the best treatment depends on the underlying cause,” he emphasized. Two people can look similarly anxious on the surface while needing very different paths forward.
When to stop toughing it out and call a professional
Plenty of people treat endurance as a virtue, white-knuckling their way through symptoms for months or years. Asked where the threshold sits, Lichtshein drew it clearly: the moment anxiety starts taking a toll on your functioning, your physical health, your relationships, or your ability to hold down a job, the time for toughing it out is over. “Basically, when your anxiety starts impairing your day-to-day life, it’s time to seek professional help,” he said.
What effective treatment actually looks like
The good news, and the part many people don’t expect, is how concrete and effective the help can be. When asked what someone should anticipate from treatment, Lichtshein noted that the toolkit is broad. “Effective help includes cognitive therapy, behavioral therapy, and pharmacotherapy, either individually or in combination, depending on the individual,” he said. There’s no single prescription; the plan is built around the person.
He also gave a clear yardstick for knowing it’s working, and it moves in a specific order. “You’ll know it’s working when you’re thinking differently, which then leads you to act and behave differently and feel different,” he explained. Thought shifts first, behavior follows, and feeling catches up.
Treatment for anxiety can include cognitive therapy, behavioral therapy, and medication, tailored to the individual.
(VH-studio)The habits that make anxiety worse
People reaching for relief often grab the nearest thing, and the nearest thing frequently backfires. Asked what people try on their own that tends to deepen the problem rather than ease it, Lichtshein named three culprits: “Alcohol, marijuana, and smoking.” The short-term calm they seem to offer comes at the expense of the longer-term picture.
If shame is keeping you from getting help
For many, the hardest barrier isn’t the symptoms. It’s the embarrassment of needing help at all. Pressed on what he would tell someone who feels nervous or ashamed about reaching out, Lichtshein reframed anxiety as ordinary medicine. “That anxiety is no different than diabetes or high blood pressure,” he said. “It’s a medical condition that can be treated.”
Anxiety is common, and it’s treatable
If this article feels uncomfortably familiar, the most reassuring fact may also be the most useful one. Asked what first step he’d want a reader to take, Lichtshein pointed to the bigger picture. “Anxiety is very common, and while it can be chronic and recurring, it’s also very treatable,” he offered. Recognizing the signs is the first step. Reaching out is the next.
Anxiety can be chronic, but it’s also very treatable, and recognizing the signs is the first step.
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If you need support now: If you or someone you know is struggling or in crisis, the 988 Suicide and Crisis Lifeline offers free, confidential support 24 hours a day, 7 days a week. Call or text 988, or chat at 988lifeline.org.
Please note: This article is based on an original interview conducted by Yahoo with Gil Lichtshein, MD, on June 7, 2026. It is for informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Anxiety affects everyone differently, and the signs described here are general guidance, not a diagnostic checklist. If you’re concerned about your mental health, talk with a qualified healthcare provider or a licensed mental health professional about your specific situation.
More about our expert:
Gil Lichtshein, MD, known to patients as Dr. Gil, is a board-certified psychiatrist in private practice in Boca Raton, Florida.
(Gil Lichtshein, MD)
Gil Lichtshein, MD, known to patients as Dr. Gil, is a board-certified psychiatrist in private practice in Boca Raton, Florida, where he diagnoses and treats children, adolescents, and adults across a range of psychiatric conditions. He is certified in both general psychiatry and child and adolescent psychiatry by the American Board of Psychiatry and Neurology. Dr. Lichtshein earned his medical degree from the University of Illinois College of Medicine in Chicago, completed his psychiatric residency at the University of Maryland and Sheppard Pratt, and finished a fellowship in child and adolescent psychiatry at the University of Maryland Medical Center in Baltimore. He previously held a faculty appointment as an assistant professor of psychiatry and behavioral sciences at Albert Einstein College of Medicine in New York. His practice emphasizes up-to-date, evidence-based treatment aimed at improving patients’ outcomes and quality of life.
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