When should I see a doctor about anxiety or anger?

Five pages in this library are about a feeling or a freeze that advice has not fixed, and each one says where the advice stops and a doctor starts. Treat natural anxiety cures as extras is a story of a cure for anxiety set beside what the NHS says. When anger beats the pause, get help for it is anger that is over before you can choose. Do a sum in your head when you can’t start is not being able to pee when others are near. Write down the panic, then check it later is crying at criticism or panicking when someone shouts. Say it was not about them when you snap is snapping at someone you love after a bad day. None of them is a diagnosis, and this answer is not one. The emergency lines come first.

If you have chest pain that is tight or squeezing, or that spreads to your arm, neck or jaw, or you are short of breath, call 911 in the US or 999 in the UK. Treat natural anxiety cures as extras says a panic attack can feel like this, and the NHS notes that most panic symptoms can also be symptoms of other conditions. If anxiety has brought thoughts of harming yourself or ending your life, call or text 988 in the US, or call Samaritans on 116 123 in the UK, at any hour, free. Write down the panic, then check it later puts the same two numbers first: one person who asked about this described their panic as close to suicidal, and some people say self-help is not enough at that edge. That page says it is not enough there either, and that relying on self-help can delay the treatment you need.

If someone is in danger right now, or you are afraid you will hurt someone, get away from them first and call 911 in the US or 999 in the UK. When anger beats the pause, get help for it also says that if the anger has turned into thoughts of ending your life, call or text 988 in the US, or call Samaritans on 116 123 in the UK, at any hour, free. It is for everyday anger, not an emergency: calming techniques are not made for a real threat to your life, and one person warns they may be ineffective or dangerous when survival instincts take over.

Do not do fast-breathing or breath-holding exercises in or near water. The Royal Life Saving Society says hyperventilation should not be done before breath-holding, because of the risk of shallow water blackout, and that you should not resist the urge to breathe under water. Some people say a well-known breathing and cold-water method has been linked to deaths, and one person says not to do its breathing while submerged. The anxiety page says it cannot check that claim, but the rule it points to is sound. One person also says that if breathing exercises make you want to hurt yourself, or bring physical distress, do not rely on them alone.

If your anxiety comes with physical symptoms like a racing heart, see a doctor first. Racing hearts have causes other than anxiety. One person says an elevated heart rate and other symptoms could be thyroid problems or low blood sugar, which need medical attention and not just a change of mind. The NHS says an overactive thyroid can cause nervousness, anxiety and irritability and an unusually fast heartbeat, and that a blood test can often show whether symptoms come from a thyroid problem. Anxiety itself can also bring a noticeable heartbeat, the NHS says, and its page on panic attacks lists a racing heartbeat, chest pain and shortness of breath. One person warns against relying on acceptance alone if unexplained physical symptoms such as a fast heartbeat persist, as they may mask a medical condition. One person says that if you feel detached from reality, which is called derealisation, you should not rely on diet and exercise alone, and should tell a doctor. Write down the panic, then check it later has some people saying that what looks like mental weakness can be a physical condition, and some people saying undiagnosed asthma, so a doctor is the first door if the episodes are new, severe or come with breathlessness.

If anxiety is severe, or not lifting, see a GP or your doctor. The NHS says to see a GP if you think you might have generalised anxiety disorder, or if you have been diagnosed and treatments are not helping. It names talking therapy, usually cognitive behavioural therapy, and medicines, usually an antidepressant of the SSRI type, as the usual treatments. In the UK you can refer yourself to NHS talking therapies for anxiety without seeing a GP, if you are registered with one and aged 18 or over (16 or over in some areas). In the US, start with your doctor or a licensed therapist; the SAMHSA National Helpline, in the Resource Bank below, can point you to local treatment. One person says self-help is not enough for some people, such as those with a neurological condition or a severe disorder, and that they need professional help. Write down the panic, then check it later has some people saying that if the symptoms include suicidal thoughts or you cannot function, cannot work, cannot stop crying, then mindfulness and books are not enough, and that leaning on them can delay the treatment that would work. If you are already in treatment and it is not helping, the NHS says to go back to your doctor.

People disagree about whether medicine is needed, and both sides have been through it. One side says medicine can be life-saving, and that brushing it aside in favour of natural fixes is short-sighted and can do harm. The other says diet, facing fears and acceptance can manage or even cure anxiety without medicine, and some say they did well after stopping it. What decides it, on both sides, is how severe the symptoms are, how a person’s body responds to the medicines, and whether the anxiety comes from a physical or a behavioural pattern. The NHS names talking therapy and medicine as the main treatments for panic disorder, and lists exercise, sleep, less caffeine and no alcohol as things to try alongside, not instead. The NHS also says not to stop an antidepressant suddenly or without talking to your doctor. How long treatment takes is argued: one person says therapy and medicine can take months or years to show their full effect, while the NHS says antidepressants usually start to work in 1 to 2 weeks and can take up to 8 weeks to work fully. One person warns that some side effects can last after stopping, and one person warns against taking an allergy medicine for anxiety without medical supervision. Any medicine for anxiety is a question for a doctor or pharmacist, as is whether to start, change or stop any medicine.

Self-help is an extra, and some of it is worth trying. Some people say that improving your physical health, with food, exercise, sleep and fewer stimulants such as caffeine and alcohol, lowers how anxious you are day to day. The NHS says much the same: get enough sleep, exercise regularly (running, walking, swimming and yoga), eat regular meals, and do not use alcohol, cigarettes, gambling or drugs to relieve anxiety. It also advises against lots of coffee, tea, cola or energy drinks, because the caffeine can disrupt your sleep. Some people say that accepting an anxious feeling without judging it lets it pass sooner, and the people who describe acceptance say it has limits: one person calls it a cheat code for mild anxiety, not necessarily for full panic attacks, and one says it can feel like being gaslit when the anxiety is triggered by real problems, such as eviction or homelessness. Write down the panic, then check it later is one method: write down what you are certain is about to happen, and check later how often the feared thing arrived. Some people say the gap between the fear and the written history is what slowly retrains the alarm. For the middle of an attack, the NHS suggests breathing slowly and deeply and reminding yourself that the attack will pass, and one person says breathing may not be possible in a severe attack because the body can stop the lungs expanding, and that counting coloured objects or imaginative distraction are alternatives. On facing what you fear, some people say avoiding it has never cured anyone’s anxiety, and the word that matters is wisely: one person corrected the “face your worst fear” version, saying exposure has to be done in small steps or it can reinforce the avoidance, and some people add that exposure done alone is risky for anxiety rooted in trauma, or for severe panic. The NHS describes cognitive behavioural therapy as done with a therapist, with practice between sessions. How to do exposure safely without a therapist is not covered. If you have no energy for any of it, the anxiety page says that is a reason to see a doctor, not a failure.

If your anger often moves faster than you can choose, that is a reason to ask a doctor or therapist for help, and until you have it, leave the room as soon as you notice the early signs. The page says that is not an excuse and not a verdict on your character: it is a sign that this needs more than willpower. The people who answered the advice that rage is always a conscious choice pointed out that fight-or-flight reactions can bypass logical control, and that some neurological conditions cause involuntary rage episodes without warning. People on the other side say a moment of choice is always there, and what decides it, they say, is a person’s neurological makeup and whether the trigger is everyday annoyance or a real threat. The page does not settle it, and says what to do next is the same either way. It is not an excuse for what you do: one person says that even in the depths of rage some thinking is still going on and decisions are still being made, so you are responsible for your actions, and not controlling the first second is a reason to get help, not a reason to stop being accountable for the second, third and fourth.

What people do before they get help. Learn your early signs: one person names a flushed head, stuttering and a racing pulse. Some people say that when you feel the heat rising, the one thing that works straight away is to leave in person. The page called “Calm down” can pour fuel on the fire suggests saying you need a moment and saying when you will be back; one person says leaving can itself cause a scene, and another points out you cannot always leave, for instance from a car on a highway. What to do when leaving is not possible or not safe is not covered, and it is worth raising with a therapist. Some people say a lot of what feels like anger is hunger or irritability from low blood sugar. The NHS lists running, walking, swimming and yoga, suggests mindfulness to help you notice when anger is starting, and suggests giving yourself time to think before you react. It also advises against using alcohol, cigarettes, gambling or drugs to relieve anger. Some people say suppressing anger entirely is unhealthy, and that the aim is to feel it without losing control and then let it go. One person warns that pushing it down can build until it comes out as an outburst.

When anger needs more than technique, here is where to start. The NHS says to see a GP if you are struggling to cope with anger, or if what you are doing to help yourself is not working, and says you can refer yourself directly to a talking therapies service for free cognitive behavioural therapy and other support. In the US, the American Psychological Association says that if your anger feels really out of control and is affecting your relationships and important parts of your life, you might consider counselling, and that a psychologist or other licensed mental health professional can work with you on your thinking and your behaviour. Start with your doctor or a licensed therapist; the SAMHSA National Helpline can point you to local treatment. Some people say that when anger is severe, self-help may not be enough, and that medicine for depression combined with talking therapy, in particular cognitive behavioural therapy, can be needed to change how you react. One person says medicine reduced how strong and how fast their emotional spikes were, which made the move into rage easier to notice and control, though it still took practice over time; one person found their antidepressant numbing and not a fix. Whether medicine is right for you is a question for a doctor. Some people say anger can be a defence against sadness or depression, because staying angry gives energy where sadness brings paralysis, and in some people sadness brings thoughts of suicide. If anger is covering a low like that, it is one more reason to talk to a doctor. Whether it is ADHD, trauma or just personality, the page cannot tell you: one person says being irritable all the time and snapping at people can be a sign of ADHD, and that diagnosis and management can reduce reactive anger; another that long-running anger is often a sign of unprocessed trauma, and that working through it can change how quickly you react; and one person adds that mental-health problems such as anxiety make this much harder, and cannot be stopped by wishing. Whether either fits you is a question for a doctor or therapist, and a good question to bring to the first appointment.

If you keep snapping at the people closest to you, a doctor can look for causes that are not about them. Say it was not about them when you snap is mostly about repair: say plainly that you snapped and that it was not about them, and on a rough day tell them before it happens. It also says that when it keeps happening, look under it. Some people say irritability is often a sign of something underneath: an unmet need, an old hurt, stress that has piled up. Some of it is physical. One person says irritability can come from poor sleep, side effects of a medicine or an overactive thyroid, and that those should be ruled out before you assume it is only psychological; another adds chronic illness and hormones. The NHS lists feeling irritable and intolerant of others as a symptom of depression, and says to see a GP if you have symptoms of depression for most of the day, every day, for more than two weeks. It also lists nervousness, anxiety, irritability, mood swings and difficulty sleeping among the symptoms of an overactive thyroid, and says a blood test can often help find out if that is the cause. Some people say agitation and feeling upset can be signs of depression and not only friction in the relationship. If you think a medicine you take is changing your mood, ask the doctor or pharmacist who gave it to you, and do not stop a prescribed medicine on your own. If low mood or irritability comes with thoughts of harming yourself, that is urgent: in the US call or text 988 (911 if you are in immediate danger); in the UK call Samaritans on 116 123 (999 if you are in immediate danger); elsewhere, your local emergency number. If your temper has ever turned into hitting, threats, or making someone afraid of you, a page of tips is not the right tool: the NHS says to see a GP if you are acting in an abusive or violent way, and the same goes for a doctor or therapist in the US.

If you cannot start to pee when others are near, see a doctor first if it also happens when you are completely alone. Do a sum in your head when you can’t start is about not being able to start when other people are near, which is called shy bladder or paruresis. It is not the same as being unable to pass urine at all. If you cannot pass urine at all, or only a dribble, and you have pain or swelling low in your belly, treat it as an emergency: the Cleveland Clinic says a sudden inability to urinate, particularly with abdominal or pelvic pain, needs the emergency room straight away, because untreated retention can lead to urine infections, bladder damage and kidney problems. In the US go to the emergency room, and call 911 if you cannot get there or you feel very unwell. In the UK go to A&E or call 999, and call NHS 111 if you are not sure which. And see a doctor first if it also happens when you are completely alone, if your stream is weak or slow, or if you take regular medicines: the International Paruresis Association says people should rule out physical causes, such as medicines or prostate conditions, before they start psychological treatment. If you notice pain or blood, see a doctor too. For the freeze itself, many people say that doing a hard sum in your head, multiplication or division rather than simple counting, distracts you from the social anxiety and lets the body relax enough to start, and some people say a stall gives the privacy and the psychological distance that is often needed. The UK Paruresis Trust describes it as a social anxiety disorder and says the cause is a freeze response. If it keeps ruling your days, some people say severe cases are best treated with professional therapy, specifically exposure therapy, and not just self-help tricks; the Trust describes graduated exposure as small steps, and says it takes several sessions. The page does not suggest alcohol to get started.

Who these pages are not for. If your anxiety is about something real, such as money, housing or safety, the problem itself needs attention first. If getting through the day is already too much, the tips above ask for energy you may not have, and that is a reason to see a doctor, not to try harder. If you are living with someone else’s anger and are frightened of it, the anger page cannot make them change: in the US, the National Domestic Violence Hotline is 1-800-799-7233, at any hour, or text START to 88788; in the UK, the National Domestic Abuse Helpline, run by Refuge, is 0808 2000 247, free and open around the clock. If your anger has hurt or frightened someone close to you, or you are afraid it will, the same US hotline takes calls from people worried about their own behaviour, and in the UK the Respect Phoneline, 0808 802 4040 on weekdays, is for people worried about their own abusive behaviour. If your trouble is the reverse, that you rarely feel or show anger even when something is wrong, Anger is a boundary alarm is closer to where you are. If you are a woman with a shy bladder, the page says it has less to offer than it should, because what people shared was about urinals. And the pages are written for readers in the US and the UK, so the numbers here are for those two countries. Each experience in these pages is one person’s or some people’s, not a study, and nothing here is medical advice.