Anxiety

What it is

Anxiety disorders are conditions in which anxiety does not go away and can get worse over time [3]. The National Institute of Mental Health groups them into generalized anxiety disorder, panic disorder, social anxiety disorder and phobia-related disorders, and the anxiety is felt across many situations and interferes with daily life and routine activities [1].

Why this guide is written for Black patients

An estimated 19.1 percent of US adults had any anxiety disorder in the past year, and an estimated 31.1 percent experience one at some point in their lives [2]. Past-year prevalence was higher for women, 23.4 percent, than for men, 14.3 percent [2].

The number that shapes this guide is a different one. In 2024, Black adults were 36 percent less likely than US adults overall to have received mental health treatment in the past year, while 12.2 percent reported serious psychological distress against 13.9 percent overall [4]. Distress at close to the same rate, treatment at two-thirds of the rate.

Anxiety is also the condition most often explained away. Constant vigilance, checking exits, rehearsing a conversation with a supervisor or a police officer, sleeping badly before a work meeting, are often described as sensible rather than as symptoms. Both can be true. Vigilance that is reasonable in one setting can still be doing damage when it never switches off.

What to ask a clinician

• Which kind of anxiety does this look like, and what makes you say that?
• Could anything physical be causing this, such as thyroid, caffeine, or a medicine I take?
• What therapy do you recommend, and is cognitive behavioral therapy available to me here?
• If we use medicine, what does it do, how long until it works, and what happens when I stop?
• What do I do during a panic attack, in steps, written down?

What good care looks like

The two main treatments are psychotherapy and medicine, and they are often used together. Cognitive behavioral therapy teaches different ways of thinking and behaving, and medicines used for anxiety disorders include anti-anxiety medicines and certain antidepressants [3].

Good care names what you have rather than treating anxiety as one blur. Generalized anxiety disorder involves persistent excessive worry about everyday matters, anxious thoughts that are hard to control, and physical symptoms such as a pounding or rapid heartbeat and unexplained aches and pains [3]. Panic disorder involves sudden, repeated periods of intense fear when there is no danger, coming on quickly and lasting several minutes or more [3]. The treatment for those two is not identical, so the label matters.

Good care also gives you something to do in the moment, not only something to take. Ask for the panic plan in writing, practice it when calm, and keep a copy where you will find it when your hands are shaking.

Finally, good care checks the body. A racing heart, chest tightness and breathlessness are also cardiac symptoms, and being told it is anxiety without anyone examining you is a reason to ask what was ruled out.

When it is urgent

Chest pain, a racing heart with fainting, or sudden severe breathlessness needs emergency assessment first. Panic attacks and heart problems can feel identical, and it is reasonable to be checked.

If you or someone you know is struggling or having thoughts of suicide, call or text the 988 Suicide and Crisis Lifeline at 988, or chat at 988lifeline.org, and in life-threatening situations call 911 [1]. The line is free, confidential and open every hour of every day.

What to do next

Start with a therapist if the symptoms are interfering with work, sleep or relationships. See Black therapists and ask specifically who does cognitive behavioral therapy.

Ask about a psychiatrist if panic attacks are frequent, if avoidance has shrunk your life, or if medicine is already involved and is not helping. See Black psychiatrists. Save 988 in your phone now rather than looking for it later.