The Different Levels, Stages and Types of Anxiety, Explained

When you're trying to sleep or work or socialize but your thoughts and body sensations are getting in the way, it might be time to learn more about the different levels of anxiety and seek out help.

According to the American Psychiatric Association (APA), anxiety disorders affect about 30 percent of American adults at some point in their life — and the Anxiety and Depression Association of America (ADAA) pegs it as the nation's most common form of mental illness.

Here, learn more about anxiety, which ranges from mild to moderate to severe, and the six types of anxiety disorders.

Being anxious is not the same as having an anxiety disorder, says Silver Spring, Maryland-based Lynn Bufka, PhD, senior director of practice transformation and quality for the American Psychological Association.

"In most instances, mild anxiety doesn't warrant a diagnosis," Bufka says. "It's assumed that most people will eventually experience some reasonable level of anxiety. It's routine and to be expected."

The APA characterizes anxiety as a normal response to real threats requiring attention and alertness. Anxiety disorders, though, are a disproportionate and potentially crippling state of mind that can undermine work and relationships.

Anxiety becomes problematic "when it elevates to the point where it starts to have a significant impact on a person's quality of life," Bufka says. "That's when it crosses over into the realm of a disorder."

"At a moderate level, it's not necessarily debilitating or overwhelming every aspect of your life," Bufka says. "But you start to notice that the stress is interfering with your day-to-day."

Her rule of thumb for recognizing moderate anxiety is "when it distracts from your usual tasks for more than an hour a day."

When an anxiety disorder turns your life into a 24/7 all-encompassing "struggle with misery," Bufka says, the end result is a "worst case scenario:" severe anxiety.

"This is when your anxiety becomes unmanageable and interferes with all domains of life, meaning that you're basically no longer able to perform basic roles: work, school, relationships, parenting," she says. "It's a constant battle and challenge — and the patient just doesn't have the skills to manage it."

Types of anxiety vary, per the APA, and affect varying rates of U.S. adults:

• ‌Phobias‌ (7 to 9 percent of U.S. adults): uncontrollable fear and avoidance of a harmless thing, situation or activity (like flying)
• ‌Agoraphobia‌ (2 percent): unjustified, crippling fear of being trapped in a specific physical setting, triggering avoidance
• ‌Social anxiety disorder‌ (7 percent): fear of embarrassment, humiliation or rejection in a social setting (like meeting new people or public speaking)
• ‌Separation anxiety disorder‌ (1 to 2 percent): inappropriate distress over losing contact with someone close
• ‌Panic disorder‌ (2 to 3 percent): recurring panic attacks
• ‌Generalized anxiety disorder (GAD)‌ (2 percent): persistent and excessive worry of everyday things with tension and physical symptoms

Many tests can assess anxiety, but per a September 2015 questionnaire review in ‌Occupational Medicine‌ (‌OM‌), the most frequent one deployed is the 12- to 15-minute Hamilton Anxiety Rating Scale (HAM-A).

According to the National Institute of Neurological Disorders and Stroke (NINDS), the HAM-A is principally used to diagnose generalized anxiety disorder (GAD).

"It's a tendency to continuously worry about a lot of everyday things in ways that are not that helpful [like] money, work, health — which translates into physical issues," Bufka says, such as:

• Muscle tension
• Stomach upset
• Shortness of breath
• Racing pulse
• Teariness or irritability

The OM review notes HAM-A ranks telltale general anxiety symptoms from 0 (no problem) to 4 (serious problem), including:

• Mood swings
• Tension
• Fear
• Insomnia
• Depression
• Memory/concentration problems
• Aches/pains
• Blurred vision
• Hearing trouble
• Heart, lung and gastrointestinal trouble
• Dry mouth
• Headaches
• Restlessness

The APA notes several effective treatments for anxiety, after first consulting a mental health professional:

• Cognitive behavior talk therapy
• Meditation techniques
• Support groups
• Medications

Stages of anxiety recovery happen gradually. "There are phases in the way treatment unfolds," Bufka says. "Patients first have to learn to understand their anxiety. To get a name for it and come to appreciate why they're experiencing it. Improvement won't follow a clear mathematical slope upward. There will be ups and downs. And progress will be incremental — but there will be progress."