Do You Worry? The Breakdown of Anxiety

July 22, 2014



by Dr. Lenny Powell


I admit that I worry.

I worry about many things – waking up on time to start my day, getting to work after driving through rush hour traffic, seeing my patients in a timely manner, completing my office notes, and presenting my patients to Dr. Jen when I forgot to write down a patient’s medication list or recent labs.

If you happen to catch me in the middle of a shift, I might seem rushed or panicked, constantly on the move to my next destination, my mind racing as fast as my feet can take me. In the mix of all this is a silent rumination of trying to manage all the details of whatever I’m working on or whom I’m seeing. Do things sometimes go awry? Yes. A series of calamities that others might look at and say, “That’s nothing, don’t worry about it” often does not strike me the same way.

“I’ve got three more patients to see and it’s already 3:30! Did I really spend 35 minutes of a 15-minute visit talking to Mrs. Smith about quitting smoking? How can this be? What if I don’t go back and check that box on that screen? What if I don’t add that line to my assessment and plan? What about this, or that? ” This can be a lot sometimes, but most of this worry dissipates when I manage to finally complete all of my tasks for the day.

I worry, yes – but does this make me anxious? Do I have an anxiety disorder?

Worry is a normal response to uncertainty.1 When this worrying becomes excessive and unable to be controlled, our state moves beyond worry into anxiety. Anxiety is defined as excessive and unrealistic worrying about everyday tasks or events. Anxiety may be specific to certain objects or rituals.2

Anxiety disorders – of which there are several – are the most common mental health problems in the United States2. Anxiety is an umbrella term used to encompass disorders such as generalized anxiety disorder, panic disorder, post-traumatic stress disorder, social anxiety disorder, and obsessive-compulsive disorder. These disorders often co-exist. Let’s look at each of these1,2. Generalized anxiety disorder is best described as constantly worrying. Panic disorder is having the sudden surge of overwhelming fear that may occur without warning or reason (panic attacks). Post-traumatic stress disorder may develop after witnessing or experiencing extremely traumatic events such as military combat, a criminal assault, or a car accident. Social anxiety disorder is an overwhelming fear of being scrutinized by others. Obsessive-compulsive disorder is characterized by recurrent and ritualistic behaviors to reduce anxiety such as excessive hand washing. Of these, generalized anxiety disorder is the most common.

The National Institutes of Mental Health estimates that 40 million Americans aged 18 or older have an anxiety disorder and women are twice as likely as men to develop anxiety.

What are signs that you may have an anxiety disorder? Here are some questions to consider2:

  • Do you feel nervous, anxious, or on edge?
  • Do you find yourself unable to stop worrying or controlling your worrying?
  • Do you worry too much about different things?
  • Do you have trouble relaxing?
  • Do you find it hard to sit still?
  • Do you become easily annoyed or irritable?
  • Do you feel afraid that something awful is going to happen?

If you’ve answered yes to two or more of those questions and your symptoms have persisted for at least one month2, you may have an anxiety disorder. Even if you don’t have these exact symptoms, but you are concerned about what you are feeling, make sure to keep a diary of your symptoms and discuss these with your physician.

There are many great treatment options for anxiety and it is possible to live a very full life with a diagnosis of an anxiety disorder. Counseling and medications have been shown to be almost equally effective. Other tips included making sure to get enough sleep, managing your time by prioritizing your activities, and avoiding alcohol, caffeine, nicotine, and sedatives which can make your symptoms worse. Make sure you see your doctor because anxiety can be caused by other underlying medical conditions.

If untreated, anxiety can lead to fatigue, muscle tension, restlessness, and a decline in your ability to do things you need or want to do. In addition, untreated anxiety has been shown to cause an increased risk of alcohol or drug abuse. But, there is hope and there are good treatments. What is most important is to discuss your symptoms with your physician.

“Okay!” I tell myself, standing outside the next patient’s room. “Take a few deep breaths. This will be fine,” I tell myself. As I knock on the door, I start my usual line as I enter the room, “Hello, I’m Dr. Powell, …”

Dr. Powell

Dr. Lenny Powell is a third-year Family Medicine resident at Rowan University School of Osteopathic Medicine. He presently has the pleasure of rotating with Dr. Jennifer Caudle on a Medicine in the Media rotation exploring how the use of various media (television, radio, internet, and print) disseminates medical knowledge to the public. Follow him on twitter: @drlennypowell at



Information in this article is for informational and educational purposes only and is not intended to provide medical consultation or serve as a substitute for medical advice provided by a physician or qualified medical professional.


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