Marla Genova had resigned herself to a career in dry cleaning. The then-teenager couldn't imagine doing anything less isolating or mundane than what she did at that post-high school job: sitting at the dry cleaner's, mostly alone, until the one time each day the clothes were delivered. "Basically, I just sat there," says Genova, who's now 40 and lives in Bristol, Connecticut. "I could have seen myself sitting there forever."
Genova may have looked apathetic, unambitious or even unintelligent, but what she really was was anxious. She didn't receive an official diagnosis – social anxiety disorder – until she was screened for anxiety during an awareness event at college, even though she'd always known something was wrong. Soon after the diagnosis, she enrolled in a social phobia group research study that taught cognitive behavioral therapy. There, Genova began trusting she could do a lot more with her life than sit.
"[The CBT program] changed my entire way of thinking, and I was able to apply it to other parts of my life as well," says Genova, who spent 20 years conducting clinical research on anxiety disorders and other behavioral and public health issues before launching Socially Speaking, a social performance and anxiety coaching business.
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Anxiety – as it refers to a set of disorders including social anxiety disorder and generalized anxiety disorder, which Genova also has – affects more than 18 percent of the U.S. adult population each year, making it the most common mental illness in the country, according to the Anxiety and Depression Association of America.
"Anxiety is definitely becoming more common. … Chances are, you know someone who suffers from it," says Angelique Mason, a family nurse practitioner at Hahnemann University Hospital in Philadelphia who often sees patients with a range of anxiety disorders. Indeed, a 2018 American Psychiatric Association poll found that Americans are "markedly" more anxious than they were just one year ago.
And yet, just over one-third of people with anxiety get treatment, ADAA reports, likely in part because many of its manifestations are so ubiquitous (hello, lack of sleep or feeling overwhelmed) and not initially – or even ever – associated with anxiety. For example, feelings of apathy, fatigue, irritability and even anger – not just worry – can signal anxiety issues, says Kristina Hallett, a clinical psychologist and executive coach in Hartford, Connecticut. Problems that seem strictly physical like headaches, chest pain, numbness, rashes, hair loss and more can be linked to anxiety disorders, too.
That's not to say these symptoms are always or even usually due to anxiety, or that anxiety as an emotion rather than a psychiatric diagnosis is a bad thing. "Anxiety is a normal part of the human experience and, in many ways, evolutionarily valuable, helping us to survive and thrive" by keeping us alert to potential dangers, explains Dr. Zachary Kelm, an osteopathic psychiatry resident at Ohio State University.
But anxiety disorders can disrupt your daily life and warrant treatment, which is highly effective. The first step, though, is recognizing their symptoms. Here are some lesser-known signs that what you're experiencing may, in fact, be more than run-of-the-mill anxiety: