More than 20%  of Tennesseans are living with some type of mental illness. For many, it’s anxiety.

And yet, many people don’t realize they may have an anxiety disorder, because they’ve normalized the constant feelings of stress and worry.

“I think sometimes people don’t fully understand how bad they feel until they feel better,” says Dr. Judith Lynn Overton, a psychiatrist and medical director at BlueCross BlueShield of Tennessee.

What anxiety looks like

Uncontrolled worrying is a very common symptom of generalized anxiety disorder (GAD). If excessive worrying causes significant distress to you more often than not for at least six months, that’s a sign that something may be wrong.

But worrying, all by itself, doesn’t equal anxiety. Other common symptoms include:

• Restlessness or a feeling of being keyed up
• Irritability
• Tendency to become easily fatigued
• Difficulty concentrating
• Muscle tension
• Sleep problems
• Gastrointestinal problems
• Having an impending sense of danger looming over you

You may not experience all of those symptoms, but you may realize that several of them do apply. And that’s when an expert will suggest that you may be affected by a general anxiety disorder. “We have an expression: worry plus three, think GAD,” says Dr. Overton.

Here are some specific ways those symptoms might be affecting you:

• Your neck and shoulders are always sore and painful.
• You have problems falling asleep.
• You’re exhausted during the day from not getting enough quality sleep at night.
• You feel jittery or wound up, and you can’t seem to dial it down.
• You can’t focus on your work or any other task requiring your full attention.
• You’re irritable, and find yourself snapping at people for the least little thing.
• You’re feeling uncomfortable from a persistent case of indigestion.
• You might sweat more than usual and feel your heart racing, (especially when you’re not exercising).

“Sleep trouble is pretty common, which results in a lower resiliency toward stress,” says Dr. Overton. “You can’t cope as well, so when those day-to-day stressors come up, they have more wear and tear on you.”

Who does anxiety affect — and what can you do about it?

Some people seem to be at greater risk for developing an anxiety disorder. And it tends to affect women more often than men. The National Institute of Mental Health suggests that shyness is often a factor. Negative or traumatic childhood experience can also be a factor. A family history of anxiety or other mental illness may play a role, too.

If you feel like you’re suffering from anxiety, the good news is there are treatment options. Here are some options to consider talking about with your doctor or counselor:

1. Lifestyle changes. Are certain aspects of your lifestyle contributing to the problem? You might be able to improve your sleep hygiene, which may help you feel better rested (think: making your bedroom more conducive to sleeping and sticking to a regular schedule). You might take up exercise, including some relaxation exercises or mindfulness exercises. Or you might want to cut back on the caffeine you’re consuming, since it can exacerbate anxiety in some people, suggests Dr. Overton.
2. Therapy or support group. Psychotherapy might be able to help you, as you talk through your anxiety with a trained professional. You can look for patterns of responses to triggers and develop coping skills and stress management strategies. And some people find comfort in a support group where they can talk about their anxiety with others in the same boat.
3. Medication. Medication won’t cure your anxiety, but it can make you feel better. Your primary care provider may be willing to prescribe an antidepressant or anti-anxiety drug for you, or you can consult a psychiatrist. Buspar (buspirone) is a commonly prescribed anti-anxiety agent, says Dr. Overton, as well as selective serotonin reuptake inhibitors like Lexapro (escitalopram) and Zoloft (sertraline). There are other options that doctors can sometimes prescribe for short-term use, such as benzodiazepines, but Dr. Overton cautions, “Those can be highly effective but with long-term use, you can become physically dependent.”

If your anxiety is interfering with your ability to carry out your daily activities of living your life, don’t brush it off. Talk to your doctor today, so you can start exploring your options. (You’ll also want to rule out any possible underlying medical conditions that could be a factor, too.)

“The overwhelming majority of individuals with generalized anxiety disorder who are committed to a course of treatment improve dramatically,” says Dr. Overton. “But it takes some time, and it’s usually a multi-modal attack. It’s not like you’re going to go in and get a pill to take and then be OK right away.”

Get more information about specific health terms, topics and conditions to better manage your health on bcbst.com. BlueCross BlueShield of Tennessee members can access wellness-related discounts on fitness products, gym memberships, healthy eating and more through Blue365®. BCBST members can also find tools and resources to help improve health and well-being by logging into BlueAccess and going to the Managing Your Health tab.