There is no "bad enough" line
Many people wait to call a therapist until anxiety feels unbearable. That wait is understandable. Worry tells you it can handle things on its own, and asking for help can feel like an overreaction. But therapy is not only for emergencies or diagnoses. It is also for the stretch where you are coping, just at a cost that keeps rising.
NIMH draws the line this way: occasional anxiety is a normal part of life, but it should not control your life. If anxiety does not go away and begins to interfere with your daily activities, NIMH says it may be an anxiety disorder. You do not have to decide which side of that line you are on before you call. Sorting that out is part of what a first appointment is for.
Signs worth taking seriously
The American Psychological Association (APA) suggests considering therapy if you worry excessively, expect the worst or feel constantly on edge, or if problems are not improving despite your own efforts and help from family and friends. Everyday versions of that can look like:
- Worry that jumps from topic to topic and is hard to switch off, even when things are going fine
- Lying awake running through tomorrow, or waking at 4 a.m. with your mind already racing
- Physical signs NIMH lists, such as muscle tension, headaches, stomachaches, sweating or feeling lightheaded
- Turning down invitations, putting off calls or avoiding driving, meetings or appointments
- Needing reassurance from others, or rereading emails many times before sending them
- Feeling irritable or restless, or having trouble concentrating at work
- Using alcohol or other substances to take the edge off, which the APA names as a reason to seek help
The pattern matters more than any single item. One sleepless night before a big presentation is ordinary. Months of sleep shaped by worry are worth bringing to a professional. If you are still unsure whether this is stress or something more, Anxiety vs. Everyday Stress walks through the difference.
A practical two-week check
NIMH offers a simple way to think about timing. If you have had milder symptoms for less than two weeks, such as feeling stressed or worried but still able to take care of yourself and others, it suggests trying some self-care first:
- Regular exercise, regular meals and 7 to 9 hours of sleep
- Time with people you trust
- Meditation or slow breathing exercises
- Low-stress activities you enjoy, or volunteering
NIMH's GAD guide also notes that cutting back on caffeine and getting enough sleep can reduce anxiety symptoms when paired with standard care. If these steps do not help, or symptoms get worse, NIMH's advice is to talk to a health care provider. If symptoms have been severe for two weeks or more, it recommends seeking professional help.
One way to use this tonight: write down three things. When the worry started, what it has stopped you from doing, and what you have already tried. That short note answers most of what a clinician will ask first.
If your body is sounding the alarm
Anxiety often shows up physically, and physical symptoms deserve a medical look. NIMH notes that a provider may do a physical exam to make sure an unrelated physical problem is not causing your symptoms. A racing heart, shortness of breath or dizziness can have medical causes, so a primary care visit is a sensible early step. If you ever have chest pain or trouble breathing and are not sure why, get medical care right away rather than assuming it is anxiety.
A clean checkup does not mean nothing is wrong. It often means the next step is a mental health professional. Physical Symptoms of Anxiety explains why the body reacts the way it does.
Who to call first
NIMH suggests talking with a health care provider such as a primary care doctor, psychiatrist, psychologist or clinical social worker. Any of these is a reasonable door. Your primary care doctor can rule out medical causes and refer you. A psychologist, counselor or clinical social worker can provide therapy. A psychiatrist or psychiatric nurse practitioner is the right call if you want to discuss medication. Psychologist, Psychiatrist or Counselor? explains the Michigan license types and how to check one.
What to say when you call
Many people put off the call because they do not know what to say. You do not need your whole history. NIMH's tips for talking with a provider suggest being specific about when symptoms started, how severe they are and how often they happen. Something like this is enough:
- "I've been dealing with worry that's hard to shut off for about six months."
- "It's affecting my sleep and I've started avoiding some things at work."
- "I'm looking for therapy, in person or by video. Do you work with anxiety in adults?"
- "What are your fees, and do you take my insurance?"
Bring a list of any medications and supplements you take, since NIMH recommends sharing all of them with a provider. If you have had therapy before, note what helped and what did not.
Seeing Dr. Lehmann for anxiety
Dr. Lehmann is a licensed clinical psychologist who has worked with adults since 1997. In anxiety therapy she combines practical ways to manage worry day to day with an insight-oriented look at where the pattern came from and what keeps it going. Appointments are daytime, Monday through Thursday, at the Franklin office in Oakland County or by telehealth for adults located in Michigan. She does not prescribe medication, and with your written permission she can coordinate with your physician or psychiatrist. What Therapy for Anxiety Looks Like With a Psychologist describes the work session by session.