How do I know if I need therapy for anxiety? 8 signs it might be time to reach out

As an anxiety therapist in New Jersey, one of the most common questions I hear is, "How do I know if my anxiety is bad enough for therapy?" Maybe you've thought:

"What if I'm making a big deal out of this?"

"I should be able to handle this-- everyone is stressed."

"Other people have it worse."

"I'm still getting things done that I need to."

That's a fair question if you're not familiar with the therapy world, so I want to give you a quick answer: You don't need to be in crisis or meet every diagnostic criterion to benefit from therapy. If anxiety is interfering with your relationships, sleep, decision-making, work, or overall quality of life, therapy may be a helpful way to understand what's happening and figure out how to improve your responses.

Anxiety exists on a spectrum, and the way it affects your daily functioning varies based on a lot of combined factors. (Think: stress levels, sleep quality, present circumstances at work or home, current phase of life, available support network, other temporary stressors)

Something that is bothering you now may not have bothered you in the past, and vice versa, so you may have convinced yourself that you handled it before and you should be able to handle it again.

Therapy for anxiety can be beneficial if you find yourself in a chronic state of stress or worry, if your stress or worry feels out of proportion to the circumstance, if you're feeling particularly stuck in cycles of completely overthinking, or if you're having more difficulty functioning than usual. If you're trying to determine if you would be a good candidate, here are 8 signs it may be a good time to explore therapy.

SIGN #1: YOUR MIND RARELY FEELS "OFF"

You have noticed that you are struggling to turn down the worries, or the volume of the worries. You're always overthinking about next steps, analyzing details, and preparing- usually for the worst case scenario. The vibe of your efforts to be "thorough" is rooted in fear or negativity, it's not just being type-A or detailed oriented. And when you're feeling this way--you can't sleep, despite being exhausted, and it's difficult to find long lasting relief.

SIGN #2: YOU'RE AVOIDING THINGS TO FEEL LESS ANXIOUS

Everyone has things they're afraid of, or feel nervous about. Clue #1 here is when you notice that you're starting to do things the hard way, or trying to find a work-around instead of going from point A to point B in a straight line. For example, you'll leave 3 hours early to take 2 buses and an Uber instead of driving 30 minutes to meet a friend since the route is unfamiliar. Or you'll only see doctors who offer online scheduling because if you have to call to inquire, you automatically eliminate this option and feel really disappointed because you loved that provider's reviews and website. This Clue is about anxiety creating stressful inconveniences, even though you're technically getting things done.

Or there is Clue #2: complete and utter avoidance. Maybe you will ignore the clear need for a tough conversation (or what you're assuming will be a tough conversation) with a friend or loved one and sweep it under the rug, to the detriment of your feelings towards them. Or you might completely refuse to date because you can't imagine the vulnerability it takes, even though getting married and starting a family is something you value highly. This Clue, on the other hand, leaves you without any closure, or just feeling unhappy.

In both of these types of avoidance, the resulting emotions for you are negative and not how you want to be living.

SIGN #3: ANXIETY IS MAKING YOUR WORLD SMALLER

Anxiety thrives in the unknown; You've started saying no to opportunities because you're just not sure enough that it will go well, who else will be there, or how you will be perceived. Over time, relationships start to diminish because you're not watering them, new experiences are limited, you never put your name in for the promotion, and change of any kind is essentially nonexistent. Even things that were familiar or exciting in the past (like seeing an old group of friends or taking a vacation) are feeling overwhelming. You may feel stuck, or even like you're taking steps backwards.

SIGN #4: YOU SPEND A LOT OF TIME SEEKING REASSURANCE

This may be one that you don't notice as quickly, because it presents itself as being thoughtful, considerate, or thorough. You're making sure everyone is on board, you're triple checking that another person isn't upset, you're spending more time on Google than you'd like to admit, you're asking your partner for the 12th time some version of "are you mad at me?," or you're checking emails/texts so frequently that no other work gets done.

How do you know when this type of pattern actually becomes a problem? Well- start noticing your own feelings about a person or situation: Do you feel completely unsettled or stuck until someone gives you clear permission to proceed? Are you not doing the things you want to do because someone hasn't "okayed" it for you? Is the reassurance providing temporary relief in the moment, but not changing the actual confidence you have in yourself next time you need to make a decision? This is something that comes up a lot!

SIGN #5: YOU'RE MENTALLY EXHAUSTED.

You spend so much time worrying that you're actually mentally exhausted from running in circles... and frustrated by it! You're tired, you're forgetting things or making mistakes that you don't normally make. Decision fatigue has kicked in (Don't you dare ask me, 'what's for dinner!') and you're having trouble relaxing when you do have spare time.

SIGN #6: YOU CAN'T STOP OVERTHINKING. ...EVEN THOUGH YOU KNOW IT'S NOT HELPFUL.

You know catastrophic thinking isn't helpful or encouraging, and you certainly don't want to be doing it. This is really common, and there's a lot to say about this-- but working 1:1 with a therapist can help you identify more about what's driving this pattern for you, specifically. Past experiences, learned behaviors, acute stressors, or obsessive or OCD-like thought loops are keeping you in this territory, and you need help breaking free.

SIGN #7: YOU'RE CONSTANTLY PUTTING EVERYONE ELSE'S NEEDS BEFORE YOUR OWN

Maybe it's fawning which is a learned response to fear. Maybe you just want to be a good daughter/son/friend. Except the way this pattern shows up for you is beyond just being helpful or flexible. It's actually to the point where you're feeling resentful, annoyed, exhausted, or way behind with your own responsibilities and self care-- all of which trigger your own anxiety and affect your own quality of life.

Here at Taking Care Therapy, I'm always reiterating the importance of taking care of yourself first (or nearly first) so that you can show up as your best self for all the people and things you care about most. It's not selfish, it's responsible.

SIGN #8: YOU'VE BEEN WAITING UNTIL IT GETS "BAD ENOUGH" TO BE ABLE TO CALL SOMEONE

There's a good chance you've been thinking about it for a while, but you think you need a good enough reason. (See Sign 1, where I said you don't need to be in crisis.) I want you to ask yourself, "A good enough reason for who?" One thing I've learned is that anxious people delay therapy. Why? Because that's what anxiety does. It makes you question yourself, it makes you worry about what will happen, it makes you uncertain or uncomfortable. Therapy isn't about proving that your anxiety is "bed enough." It's about getting support for something that's making life harder than it needs to be.

If you found yourself thinking, "that sounds like me" while reading one or more of these signs, it may be worth having a conversation. You don't need to be completely certain to reach out. In fact, uncertainty is one of anxiety's favorite tricks.

In therapy, you will begin to understand your nervous system's responses, start noticing patterns, learn to respond differently, build tolerance for uncertainty, practice setting boundaries, and develop self compassion. Any other personal goals you want to bring to the table are always encouraged, such as working on your relationships, improving your communication, or better managing stress.

Can going to therapy be a little uncomfortable? Absolutely. Starting the conversation can feel like the hardest part. But finding a therapist who helps you feel safe, understood, and accepted can make all the difference. You deserve support before you actually fall apart.

Until next time, Take Care.

LM