Five things that can look like anxiety, and why working out which one you're dealing with changes the treatment.
When people feel on edge, sleep badly, can't concentrate and notice their heart racing, "anxiety" is the word most of us reach for. Often that's right. But anxiety is also a very common way for other problems to show up, and sometimes it sits alongside them.
That matters because the treatment for one is not always the treatment for another. Here are five things that can hide behind (or travel with) anxiety.
1. Undiagnosed ADHD
Years of missed deadlines, lost items and constant catching-up can leave an adult feeling permanently tense and behind. The worry is real, but the root may be an attention difficulty that was never recognised. If you also recognise long-standing problems with focus, organisation and restlessness, it may be worth reading about ADHD assessment.
2. Low mood or depression
Anxiety and depression frequently appear together. Poor sleep, difficulty concentrating, irritability and loss of energy can belong to either, and each can make the other worse. If your worry comes with persistent low mood or loss of interest, a depression assessment may be relevant.
3. Trauma
After a frightening or distressing experience, the body can stay on high alert. Being easily startled, avoiding reminders, feeling constantly watchful and having trouble relaxing can look like generalised anxiety. Trauma-related symptoms often need a different approach, which is covered under PTSD assessment.
4. Obsessive-compulsive disorder
Intrusive thoughts and the urge to check, reassure or mentally review can feel like plain anxiety. The pattern is different, though: a thought triggers distress, and a ritual brings brief relief that strengthens the loop. OCD has its own treatment, and you can read more about OCD treatment.
5. Poor sleep
Anxiety and sleep problems feed each other. A racing mind keeps you awake, and exhaustion makes everything feel more threatening. If sleep is a major part of your struggle, see insomnia treatment.
And sometimes it's physical
Racing heart, tight chest, dizziness, tremor and stomach upset are classic anxiety symptoms, but they can also come from other things, including thyroid problems, anaemia, some medications and too much caffeine. A good assessment doesn't assume every physical symptom is anxiety, and it will recommend checks where appropriate. If you have chest pain or feel seriously unwell, seek medical help straight away.
Stress or anxiety?
Stress usually has an identifiable cause and eases when the pressure lifts. Anxiety can keep going when there's no obvious threat, feel hard to control and start shaping your choices, such as avoiding places, people or tasks. If it persists after the stressor has gone, or it's narrowing your life, that's usually a good moment to talk to someone.
What a proper assessment adds
Online quizzes and apps can be a useful nudge, but they can't diagnose. A psychiatric assessment looks at your symptoms, how long they've lasted, how much they affect your life, your medical and mental health history, and whether another condition is involved. The outcome might confirm an anxiety disorder, or it might point somewhere else. Both are useful answers.
Treatment follows from that. For many anxiety disorders, psychological therapy such as CBT is a recommended first-line option, and medication may be considered where it is clinically appropriate.
Getting support
Assessments are available at clinics in London and by secure video consultation across the UK. You can read more about what's involved and how to book on the page for private anxiety assessment with a consultant psychiatrist, and you can also read about Prof. Ahmed El-Missiry.
This article is general information, not medical advice or a diagnosis. If you or someone else is at immediate risk of harm, call 999 or go to your nearest A&E. For urgent but non-emergency advice in England, use NHS 111, or contact Samaritans on 116 123.
