Anxiety is an adaptive process that is critical for our survival, said L. Kevin Chapman, Ph.D, an associate professor at the University of Louisville and a licensed clinical psychologist in private practice, specializing in anxiety disorders.

It prompts “us to pay attention to both internal and external events.” But when anxiety becomes acute, uncontrollable or chronic, it can interfere with our lives.

And that’s when seeking professional treatment is key.

Here’s a list of the obvious and not-so-obvious signs that it’s time to get treatment.

  • Your anxiety prevents you from engaging in social, academic, occupational or enjoyable activities, or you engage in them but with great distress, Chapman said. For instance, you stop driving or visiting certain places, because this makes you anxious; you’re not able to give speeches in class or presentations at work; you can only leave the house after performing certain rituals.
  • You engage in safety behaviors, Chapman said. This is any behavior to temporarily relieve your anxiety and distress. He gave these examples: you don’t drive on the interstate (preferring “the scenic route”); only speak to familiar people at work events; avoid eye contact in social situations; and carry your cell phone just in case you need to call someone when you’re in an anxiety-provoking situation.
  • You can’t leave your house because you fear losing control and panicking, said Bill Knaus, Ed.D, a licensed psychologist and author of The Cognitive Behavioral Workbook for Anxiety. “Thus, you live in a highly restricted comfort zone.”
  • You don’t voice or prioritize your personal concerns, wants and wishes in order to avoid potentially unpleasant encounters, Knaus said. “Thus, your neighbor borrows your lawnmower and keeps it for the season. A local merchant overcharges you for a service, and you pay up and say nothing.”
  • You experience physical sensations of anxiety, Chapman said, including: shaking; shortness of breath; heart palpitations; smothering sensations; and hot and cold flashes. “[M]any individuals with panic, in particular, are initially observed — or driven to — an ER setting due to the fear of having a heart attack.”
  • You can’t stop worrying. “Chronic worriers report difficulty turning worry ‘on and off’ like a light switch whereas ‘normal’ worriers report being able to turn off worrisome thoughts while engaging in problem solving,” Chapman said. This kind of worry can last for hours and includes “muscle tension, difficulty concentrating, sleep disturbance and irritability.”
  • You regularly worry about the future; ruminate about past mistakes; and dread having to meet daily challenges, Knaus said.
  • “You have an intolerance for uncertainty and an intolerance for feeling anxious,” he said. For instance, a common factor in anxiety is intolerance for tension, he said.
  • “[Y]ou make mountains out of molehills,” Knaus said. For instance, you regularly imagine the worst-case scenario. “Exaggeration is a common factor in anxiety.”
  • You have a restrictive phobia. Knaus shared this example: You’re petrified of flying, but your boss requires you to travel outside the country. If you don’t get on a plane, you’ll lose your job.
  • You avoid seeking opportunities and taking risks, Knaus said. “You settle for a safe mate, a safe job, a safe life, but you still don’t feel safe.”
  • You’re self-conscious about doing well. “You don’t want to appear ‘better’ or others might reject you,” Knaus said.
  • You’ve tried “everything” besides therapy, and nothing has helped to reduce your anxiety, Chapman said.

If you’re experiencing these signs, you might be wondering what to do next. Chapman and Knaus shared these suggestions:

  • “Start with acceptance,” Knaus said. “Whatever the reason you suffer from anxiety, it is not your fault.” Maybe you’re overly sensitive to negative sensations in your body, startle easily or had poor role models, he said. “Although anxieties are part of your ‘self,’ they are not the whole of you.”
  • Find a therapist who specializes in anxiety disorders. Cognitive-behavioral therapy (CBT) is “the gold standard for a broad range of different anxieties and co-existing conditions,” Knaus said. It’s “an evidence-based method that helps people overcome anxiety thinking, tolerate unpleasant anxiety sensations, and engage in problem-related corrective behaviors.”Chapman suggested visiting these websites to find a therapist: Association for Behavioral and Cognitive Therapies; Anxiety and Depression Association of America; and the International OCD Foundation.
  • Try a cognitive-behavioral workbook on anxiety, written by doctoral-level mental health specialists, Knaus said. “[This] can be as effective as therapy for a sub-group of people with anxiety.”
  • Practice self-care. “Daily life is filled with stresses and strains, and they add to what psychologist Bruce McEwen calls the allostatic load factor, or wearing and tearing the body with stress,” Knaus said. These wearing and tearing effects can perpetuate a vicious cycle of increased vulnerability to stress and more anxiety. There are many things you can do to reduce the load, he said, including: getting adequate sleep and exercise; avoiding smoking and drinking excessively; and healthfully navigating negative emotions.

Experiencing excessive anxiety can feel scary, uncomfortable and confusing. Fortunately, anxiety is highly treatable. And you can get better. If you’re struggling with anxiety, seek professional help for proper evaluation and treatment.