Sometimes referred to as: worry, anxiousness, anxiety disorder, social anxiety

Interview between:

  • Jamila Schwartz, MD

  • Natalie Albanese, MD

Anxiety is a mental health condition involving anxiousness, fear, and worry, often accompanied by physical signs such as tension, sweating, and increased pulse rate. Anxiety can take many forms and can often overall be characterized by a feeling of unease in the body or in the mind.

Cases Per Year (US)

In 2018, 18% of the US population was affected by an anxiety disorder of some kind.

General Frequency

Anxiety currently affects approximately 40 million Americans, and general symptoms are on the rise.


Anxiety impacts physical health and wellbeing. In addition to increasing the risk of insomnia, avoidance behaviors, and chronic stress, it has been associated with an overall increase in mortality.


Symptoms and Causes

What are some of the different ways that anxiety shows up in people?

Anxiety presents in a variety of ways. Some people experience anxious thoughts, excessive worry, panic attacks, social anxiety, or specific phobias.

OCD symptoms, such as intrusive thoughts or compulsive behaviors, and PTSD symptoms—such as flashbacks, hyper-arousal, and avoidance behaviors—are also forms of anxiety.

Furthermore, some people’s anxiety appears in more body-based, somatic ways, such as digestive issues, migraines, headaches, fatigue, muscle tension, dizziness, lightheadedness, tunnel vision, or rapid heart rate.

What is the underlying biology of anxiety?

Anxiety has a variety of potential causes. For some, ongoing symptoms result from a dysregulation of the stress response, either from prolonged stress or a predisposition to drop into a “fight or flight” reaction too readily. In these cases, the hypothalamic pituitary adrenal axis is involved in excessive or inappropriate release of adrenaline and cortisol.

For others, the body seems to have a deficiency or dysregulation of the neurotransmitter GABA (gamma amino butyric acid). In these cases, the brain simply can’t feel calm or relaxed. Potential causes of GABA dysregulation are an imbalance of bacteria in the digestive tract (it seems that gut bacteria play a role in the synthesis of GABA), chronic stress, and a consequence of consuming GABA-modulating agents, such as benzodiazepines and alcohol.

Finally, serotonin signaling can play a role in anxiety. In these cases, anxiety typically coexists with depression. Potential underlying causes of serotonin dysregulation include inflammation, chronic stress, chronic sleep deprivation, and nutritional deficiencies.

When does anxiety typically start for people?

Anxiety can begin at various phases of life, from childhood—where it more typically manifests with stomach aches or headaches—to puberty and adulthood.

If someone experiences an onset of anxiety in adulthood that’s uncharacteristic for their temperament, this can be an indication that there’s a physical basis for the anxiety, such as a medication side effect, inflammation, dysbiosis (microbial imbalance), or nutrient deficiency. It may also be a reflection that the person is experiencing an excessive amount of stress.


Types of Anxiety


Diagnosis and Treatment




Other Interventions



Connect with our physicians

Jamila Schwartz, MD and Natalie Albanese, MD are both members of the Galileo Clinical Team. Connect with one of our physicians about Anxiety or any of the many other conditions we treat.

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