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Ask a Physician: Is it stress or something more?

Waguih IsHak, MD
Medical Director, Outpatient Psychiatry Services
Department of Psychiatry and Behavioral Neurosciences

Anxiety, or excessive worrying, can create an exaggerated sense of mistrust and fear, leading someone to avoid interacting with other people. It is important for a doctor to determine the extent to which anxiety is affecting a person's ability to perform at work or manage home responsibilities. It is also important to know how long these feelings have existed.

A doctor would also want to find out whether a person's anxiety is rooted in a medical cause. For example, thyroid problems (increased thyroid function) or heart problems (such as arrhythmias) need to be ruled out. A thorough evaluation also involves assessing if the anxiety is potentially connected to the use of medications, alcohol or illicit drugs.

To rule out (or in) a medical cause for anxiety, start by scheduling an appointment with a primary care physician. If a medical cause is ruled out, a psychological evaluation would be next. That will determine if psychiatric support is needed.

Resources at Cedars-Sinai
  • Department of Psychiatry and Behavioral Neurosciences
  • Depression Clinical Trials at Cedars-Sinai


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