Anxiety: Recognizing the Signs and Finding Relief

You know that feeling — your heart races before a big meeting, your stomach knots up before a difficult conversation, or you lie awake at 2 AM replaying everything that could go wrong tomorrow. A little anxiety is a normal part of life. But when worry becomes constant, overwhelming, or starts interfering with your daily routine, it's worth paying closer attention.

As a psychiatric nurse practitioner, I work with people navigating anxiety every day. The good news: anxiety is one of the most treatable mental health conditions. The first step is understanding what you're dealing with.

Anxiety isn't just "being stressed." It shows up in your body, your thoughts, and your behavior — often all at once.

• Racing or pounding heart
• Shortness of breath or feeling like you can't get a full breath
• Muscle tension, especially in the neck, shoulders, and jaw
• Headaches or stomach problems with no clear medical cause
• Fatigue — anxiety is exhausting, even when you haven't done much
• Difficulty sleeping or staying asleep

• Constant "what if" thinking
• Catastrophizing — jumping to the worst possible outcome
• Difficulty concentrating because your mind won't slow down
• Feeling like something bad is about to happen, even when everything is fine
• Perfectionism and fear of making mistakes

• Avoiding situations, people, or places that trigger worry
• Procrastinating on tasks because the pressure feels unbearable
• Seeking constant reassurance from others
• Overplanning or over-preparing as a way to feel in control

If several of these sound familiar, you're not alone — and you're not broken. Anxiety is your nervous system trying to protect you. The problem is when it fires too often, too intensely, or in situations that don't actually require a threat response.

Not all anxiety looks the same. Here are the most common presentations I see in my practice:

Generalized Anxiety Disorder (GAD): Persistent, excessive worry about many different areas of life — work, health, family, finances — that's difficult to control.

Social Anxiety: Intense fear of being judged, embarrassed, or rejected in social situations. This goes beyond shyness; it can make everyday interactions feel unbearable.

Panic Disorder: Recurrent, unexpected panic attacks — sudden surges of intense fear with physical symptoms like chest pain, dizziness, and a feeling of losing control.

Health Anxiety: Persistent worry about having or developing a serious illness, often despite reassurance from doctors.

Specific Phobias: Intense, irrational fear of a specific object or situation (flying, needles, heights) that leads to avoidance.

Here's what the research — and my clinical experience — shows actually works:

CBT is the gold standard for anxiety treatment. At its core, it helps you identify and challenge the thought patterns that fuel anxiety.

Try this: When you notice an anxious thought, ask yourself:

• Is this thought based on facts or assumptions?
• What's the realistic probability this will happen?
• If it did happen, could I handle it?
• What would I tell a friend who had this thought?

This isn't about toxic positivity — it's about accurate thinking, not just positive thinking.

When anxiety spikes, your breathing becomes shallow and fast, which actually makes the physical symptoms worse. Slowing your breath signals your nervous system to calm down.

Try the 4-7-8 technique:

• Inhale through your nose for 4 counts
• Hold for 7 counts
• Exhale slowly through your mouth for 8 counts
• Repeat 3–4 times

Practice this when you're calm so it becomes automatic when you need it most.

When anxiety pulls you into "what if" spirals about the future, grounding brings you back to the present moment.

The 5-4-3-2-1 method:

• Name 5 things you can see
• 4 things you can touch
• 3 things you can hear
• 2 things you can smell
• 1 thing you can taste

It sounds simple, but it works by engaging your senses and interrupting the anxiety loop.

Avoidance is anxiety's best friend. Every time you avoid something that triggers anxiety, you send your brain the message that the threat is real and dangerous. Gradually facing feared situations — in a structured, supported way — is one of the most powerful ways to reduce anxiety long-term.

This is best done with a therapist who can help you build a personalized exposure plan.

These aren't glamorous, but they matter enormously:

• Sleep: Anxiety and poor sleep feed each other. Prioritizing 7–9 hours is genuinely therapeutic.
• Exercise: Even 20–30 minutes of moderate movement significantly reduces anxiety symptoms.
• Caffeine: For many people with anxiety, reducing caffeine makes a noticeable difference.
• Alcohol: It may feel like it helps in the moment, but alcohol disrupts sleep and increases anxiety the next day.

For moderate to severe anxiety, medication can be a valuable part of treatment — not a crutch, but a tool that helps your brain chemistry support the work you're doing in therapy. SSRIs, SNRIs, and other options are safe and effective for many people. This is something we can discuss together to find what's right for you.

Consider talking to a mental health professional if:

• Anxiety is interfering with work, relationships, or daily activities
• You're avoiding things you used to enjoy
• Physical symptoms are frequent and distressing
• You're using alcohol or other substances to cope
• You've tried self-help strategies and aren't seeing improvement

You don't have to be in crisis to deserve support. Reaching out early — before anxiety becomes entrenched — makes treatment faster and more effective.

Anxiety can feel like a life sentence, but it isn't. With the right support, most people experience significant relief. The strategies above are a starting point, but working with a provider who understands your specific situation makes all the difference.

If you're ready to take that step, I'd love to help. Schedule a free 15-minute telehealth consultation in Florida to talk about what you're experiencing and whether we might be a good fit. You can also explore our anxiety and mental health services or learn more about Sabrina's approach.

Sabrina Moraes De Farias Chinea, PMHNP-BC, is a board-certified psychiatric nurse practitioner serving patients throughout Florida via telehealth. She specializes in anxiety, depression, ADHD, and medication management.