You’ve probably noticed that terms once used only within the confines of a therapist’s office are now deployed unthinkingly to describe experiences that are merely uncomfortable. A car backfires and someone says it has ‘given them anxiety’. Spilling a round of drinks in front of others results in ‘PTSD’ – or ‘OCD’ until they are cleared up. On TikTok, I’ve seen someone’s ‘ponytail era’ or syrup stains on a hardwood floor being described as severely traumatic. Likewise, the everyday use of language that surrounds anxiety conditions – words like ‘worry’, ‘fear’, ‘rumination’, ‘panic’, and ‘anxiety’ itself – makes it easy to underestimate just how debilitating anxiety-related illnesses can be.
As a journalist, I’ve spent years interviewing experts and people living with anxiety for my book How to Eat an Elephant (2026). I also have my own personal experience with anxiety. In 2019, I was diagnosed with generalised anxiety disorder (GAD), post-traumatic stress disorder (PTSD) and chronic insomnia, which I have since rowed back from, over months and years. My hope is for more people to recognise just how serious anxiety can become, not least so they know when to get the help they need – but also to appreciate that it’s an essential, unavoidable part of life.
It’s normal to feel anxiety during challenging life moments or periods of intense change. To sweep mild and transient issues into the language of disorder helps no one, and particularly not those who really are struggling with mental ill health. Nerves help us make decisions quickly, weigh up risk, and compete at the top of our game. The professional golfer Tiger Woods put it well in an interview in 2015: ‘I care about what I do and when I’m not nervous is the day I quit … I want to feel the rush, I want to feel the nerves.’
So we need some anxiety in our lives, but we also need to know when it has outstayed its welcome or grown to unhelpful and life-altering proportions. Anxiety conditions are the most common form of mental illness, affecting a third of us in our lifetime, according to best estimates. Data from the NHS in England suggest that 7.5 per cent of adults are currently living with GAD, the most common anxiety disorder. Despite this, global data show that only one in four people with an anxiety disorder will receive any form of treatment for it, which is particularly frustrating given how highly treatable anxiety is.
The consultant psychologist Elena Touroni says confusion around anxiety creeps in because we use it to describe such a wide spectrum of experience: ‘It’s used for both the nerves before a presentation, and the experience of someone whose anxiety is shaping every decision they make, narrowing their world and affecting their sleep, their relationships and their ability to function.’
According to Touroni, it’s not surprising that people struggle to locate themselves on that spectrum, or to recognise when what they are experiencing has crossed into something that warrants proper support. ‘The line between normal and clinical is not obvious and can feel quite subjective to people who don’t have specialist support,’ she says. ‘I regularly work with people who have been managing a significant level of anxiety for years without recognising it as anything other than just how they are. They have adapted to it and it has become their baseline.’
Doctors typically look at how significantly symptoms interfere with your ability to function day to day
This resonates with me. Before I ended up in a psychiatric hospital in 2019, I had spent seven years struggling on and off with insomnia and anxiety to varying degrees. I sought concerted help only right at the end, when I was going multiple nights a week with just three or so hours of sleep – sometimes spending whole nights awake – utterly unable to switch off and, by then, having intrusive thoughts about suicide and self-harm. It sounds dramatic now – and it was – but it felt easier at the time to try to carry on and pretend nothing was wrong, hopeful things would get better on their own, particularly given I knew so little about anxiety.
So how do experts make a diagnosis of clinical anxiety? In the absence of a failsafe test, doctors typically look at how long you’ve had symptoms, their severity, and how significantly they interfere with your ability to function day to day.
‘What distinguishes a clinical anxiety disorder is not the presence of anxious thoughts, jitters or that horrible knot in the pit of your stomach,’ says Touroni, ‘but what happens to them over time. In clinical anxiety, the symptoms are more intense and persistent and, crucially, they do not lift once the perceived threat has gone. The nervous system either stays in a state of high alert long after the trigger has passed, or it begins firing in the absence of any clear trigger at all. Clinically, if someone has been experiencing this for six months or more, we would look seriously at whether they are dealing with an anxiety disorder.’
I knew things were escalating when I kept getting ill (my immune system was having a hard time with the insomnia), my mood had plummeted, and I started having panic attacks at night. I was anxious about feeling anxious and not sleeping. Everything was compounding and, as a result, I wanted to go out less.
Touroni explains that many people go for years carrying the physical and emotional toll of managing an anxiety disorder. This is a shame as ‘anxiety disorders are among the most treatable conditions we see in psychological practice.’ She adds: ‘Getting the right name for something is not a small thing, as it changes what feels possible and can have a huge impact on a person’s quality of life.’
Now – seven years after being hospitalised – I’m pleased to say anxiety is not a defining feature of my life, it’s just another brick in the wall of my personality. What helped me most when I was in crisis was being taken out of my home environment for a couple of weeks, medication (sertraline, an SSRI antidepressant, in the mornings and amitriptyline, a tricyclic antidepressant that can help with sleep, in the evenings), cognitive behavioural therapy, and learning how anxiety as a pathological illness functions in the mind and body.
I know I have a tendency towards anxiety, but I also now know what helps me steer away from it in pressing moments: prioritising sleep, work-life balance, managing stress, eating well, saying ‘no’ and being self-compassionate, among other things.
It’s my tendency towards anxiety that makes me so enjoy life. I am quick to think and feel
The psychologist and researcher Nick Grey puts it like this: ‘Can we cure anxiety? No, because it’s part of the human condition. If someone’s goal is I never want to feel anxious again, then no, that won’t happen. But if the goal is about overcoming a chronic anxiety problem in which the person is stuck, then absolutely, that can happen. You can’t get rid of anxiety, but you can absolutely overcome chronic anxiety problems.’
The psychologist Rollo May was of a similar opinion. I like what he wrote in The Meaning of Anxiety (rev ed, 1977):
Anxiety cannot be avoided, but it can be reduced. The problem of the management of anxiety is that of reducing the anxiety to normal levels, and then to use this normal anxiety as stimulation to increase one’s awareness, vigilance, zest for living.
True to his perspective, I’ve come to see that it’s my tendency towards anxiety that makes me so enjoy life. I am quick to think and feel. And while I now recognise the need to pay better attention to anxiety when I feel it – weighing up what my mind and body are trying to tell me rather than pretending it doesn’t exist and pushing the sensation away – I wouldn’t change my underlying sensitive nature for anything.
If reading this has made you reflect on whether you’ve been living with problematic anxiety, it may help to have a sense of how long it could take to learn to manage it better. It could be months or years, depending on what the issue is and how long it has existed. Not days. In many cases, not even weeks. Too often, we put pressure on ourselves to ‘get better’ immediately once we realise we are sick or struggling. Grey says: ‘People assume if things haven’t changed quickly enough, then there’s no hope. But recovery is an up and down rollercoaster route. There’s always hope, even if you’ve had an anxiety problem for decades.’
Anxiety, then, is not always the enemy, but we should treat it with respect. That’s why our relationship to it matters: so we can recognise and meet it when it spills into something pathological.