UNC Health Care
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Spot These Surprising Symptoms of Anxiety 

Living with high levels of anxiety can be a dramatic experience. People who are panicking sometimes fear they’re having a heart attack because they feel chest pain and shortness of breath. Others might experience gastrointestinal distress and need to rush for the bathroom. 

But anxiety isn’t always so obvious. Chronic anxiety often manifests in subtler ways. 

If you suspect your anxiety level is elevated because of the coronavirus disease 2019 (COVID-19) pandemic, watch out for these signs from UNC psychologist Amanda Harp, PhD. (The good news, as you’ll see at the end: There are several things you can do about it.) 

1. You’ve been practicing a lot of avoidance.

Almost everyone struggles with procrastination and putting off tasks at least some of the time. But if you’re feeling anxiety about something—a work assignment or a phone call to a friend, for example—and you decide to distract yourself by napping or watching TV instead, notice whether it is a temporary escape or if it goes on for hours or days, Dr. Harp says. 

This is one example of avoidance, a tactic many people with anxiety problems use to protect themselves from anxious thoughts and feelings. You might avoid driving on the highway because you’re nervous about car crashes. Or you might avoid working out too hard because you are afraid of your heart beating too fast and causing a health problem. 

Unfortunately, avoidance has consequences, Dr. Harp says. “The minute you feel better about not doing something, the anxiety is reinforced.”

2. Most of your emotions seem to be negative ones. 

People with anxiety often struggle with some of the same emotions people with depression face, including guilt, shame, incompetence and feelings of failure. 

People with anxiety and depression are “more prone to ‘collecting’ negative emotions,” Dr. Harp says. It can be hard to notice if you’ve become especially negative. It can help to ask a partner or close friend for an honest assessment. 

3. You’re snapping at a loved one, or you’re always about to lose it.

Managing anxiety is a heavy load on the body and mind, so people with anxiety often struggle with irritability and overreact to even minor setbacks, such as a broken toaster or being five minutes late to a friend’s house. 

“It feels totally insurmountable in the moment, and every impediment just feels like the last straw,” Dr. Harp says. “You might feel, ‘I just don’t have the bandwidth to deal with this.’” 

This is an example of when anxiety can be challenging to relationships. Let’s say you’re hyper-focused on keeping the bathroom clean, and your spouse leaves a glob of toothpaste in the sink. Instead of simply wiping it up or asking him or her to do so, you might yell or feel that your efforts were “all for nothing” if you’re dealing with high levels of anxiety. 

4. You sleep “enough” but never feel rested. 

If you sleep the recommended seven to nine hours a night and still feel tired all the time, or if you have trouble going to sleep or staying asleep, anxiety could be at play. 

People with anxiety problems often feel both very restless and very fatigued, Dr. Harp says. 

“I don’t think you get that full rest,” she says. “I think you’re still hypervigilant even in your resting state.” 

5. You’re relying on unhealthy coping strategies. 

Sometimes avoidance goes a step further into behaviors that aren’t healthy but might make you feel better temporarily. This could include binge-eating, drinking too much alcohol, using recreational drugs or gambling. It could even include things that might be viewed as “positive,” such as working too much or exercising too much. 

The problem is that these activities can actually increase anxiety and feelings of shame and guilt. They might cause relationship problems, too. 

What to Do if You’re Struggling with Anxiety 

If you think your anxiety might be getting out of control, take heart: Anxiety is common and highly treatable, Dr. Harp says. More than 30 percent of people will have an anxiety disorder in their lifetimes, and there are several therapies and medications that can help. 

If you feel your anxious thoughts and persistent worries are interfering with your daily life and functioning, you can raise your concerns to your primary care provider, who can talk about symptoms and options for treatment. You also can find a mental health professional who can help. 

If you already have a therapist you like and trust, check in with him or her about your feelings. 

And for people who aren’t ready or able to start therapy, there are several evidence-based apps for anxiety and depression, as well as self-guided therapy books. One author whom Dr. Harp recommends is Steven C. Hayes, PhD, who helped develop an approach called acceptance and commitment therapy, or ACT. Cognitive behavioral therapy (CBT) and exposure and response prevention (ERP) are also effective, Dr. Harp says. 

“The focus is on gaining broader perspective,” she says. “When you can increase your tolerance of anxiety and distress, you can focus on what you really value in life.” 


Struggling with anxiety? Talk to your doctor. If you don’t have one, find one near you.