Signs & Symptoms of Anxiety

This resource booklet has been localised for the Hong Kong context and translated to Traditional Chinese by Coolminds, a mental health initiative run by Mind HK and KELY Support Group. For more information on Coolminds, please visit

Thank you to the Black Dog Institute for donating their resources and for allowing us to adapt this. For the original version of this resource, please refer to the Black Dog Institute’s website:

What this fact sheet covers:

  • When anxiety is a problem
  • Types of anxiety disorders
  • Signs and symptoms of anxiety

Everyone experiences anxiety

Feeling anxious in certain situations can help us avoid danger, triggering our ‘fight or flight’ response. Sometimes though, we can become overly worried about perceived threats – bad things that may or may not happen. When your worries are persistent or out of proportion to the reality of the threat, and get in the way of you living your life, you may have an anxiety disorder.

In Hong Kong,

  • Over half of the university students show symptoms of an anxiety disorder, according to research conducted by the University of Hong Kong in 2016
  • According to a 2018 survey by Hong Kong Playground Association, over a third of young people scored moderate to extremely severe on the Anxiety scale (of the DASS21)

When does anxiety become a problem?

It’s normal to feel anxious in high pressure situations such as:

  • A job interview
  • When you’re speaking in public
  • When you’re experiencing change in your life or work environment and you’re uncertain what the future will hold.

To a degree, this anxiety can help us, making us stay focused and alert.

When we’re very anxious, we have intense feelings of worry or distress that are not easy to control. Anxiety can interfere with how we go about our everyday lives making it hard to cope with ‘normal’ challenges.

Anxiety becomes a problem when you start to feel anxious most of the time and about even minor things, to the point where your worry is out of control and interfering with your day to day life.

What are anxiety disorders?

Anxiety disorders are a mix of:

  • Psychological symptoms: frequent or excessive worry, poor concentration, specific fears or phobias e.g. fear of dying or fear of losing control
  • Physical symptoms: fatigue, irritability, sleeping difficulties, general restlessness, muscle tension, upset stomach, sweating and difficulty breathing
  • Behavioural changes: including procrastination, avoidance, difficulty making decisions and social withdrawal

Severe anxiety is a feature of a group of mental health disorders including:

  • Generalised anxiety disorder
  • Social phobia
  • Specific phobia
  • Obsessive compulsive disorder (OCD)
  • Panic disorder
  • Separation anxiety disorder
  • Agoraphobia
  • Post-traumatic stress disorder (PTSD)

Other types of anxiety disorders include:

  • Substance/medication-induced anxiety disorder
  • Anxiety disorder due to a medical condition

It’s important to seek help to manage severe anxiety. There are many effective treatments for anxiety, and you can feel better.

Factors for developing anxiety

There is a range of contributing factors for developing anxiety. The factors could be:

  • Biological – genes (family history)
  • Personality traits
  • Brain chemistry
  • Life events, such as trauma and long-term stress
  • A combination of above factors

Signs and symptoms

While there are many types of anxiety disorder, there are some common signs and symptoms.

You might be feeling:

  • Very worried or afraid most of the time
  • Tense and on edge
  • Nervous or scared
  • Panicky
  • Irritable, agitated
  • Worried you’re going crazy
  • Detached from your body
  • Feeling like you may vomit

You may be thinking:

  • ‘Everything’ is going to go wrong’
  • ‘I might die’
  • ‘I can’t handle the way I feel’
  • ‘I can’t focus on anything but my worries’
  • ‘I don’t want to go out today’
  • ‘I can’t calm myself down’

You may also be experiencing:

  • Sleep problems (can’t get to sleep, wake often)
  • Pounding heart
  • Sweating
  • ‘Pins and needles’
  • Tummy aches, churning stomach
  • Lightheadedness, dizziness
  • Twitches, trembling
  • Problems concentrating
  • Excessive thirst

When these constant repetitive thoughts and feelings take over, we can:

  • Feel overwhelmed
  • Lose sleep
  • Feel exhausted
  • Start to avoid social situations

Some of these symptoms can also be signs and symptoms of other medical conditions, so it’s always best to see a doctor so they can check them properly.

There is an online Anxiety Self-test on the Black Dog Institute website.


To be diagnosed with an anxiety disorder, a combination of symptoms

  • Is present on most days for more than six months
  • Interferes with your ability to function at work or at home

It is common to experience a low mood secondary to excessive worry and the two conditions – clinical depression and anxiety disorder – can occur at the same time.

It’s important to get help to treat anxiety disorders. Left untreated, anxiety can last for a long time. It can become exhausting, debilitating and get in the way of us living our everyday lives. There are a range of effective treatments for anxiety, and you can get better. Visiting a doctor or a mental health professional is a good starting point when seeking help for anxiety.

Key points to remember

  • Anxiety is normal, everyone experiences anxiety at some time.
  • Anxiety becomes a problem when it interferes with your day to day life
  • Anxiety disorders are a combination of psychological, physical and behavioural symptoms
  • A range of factors can contribute to anxiety disorders
  • Signs and symptoms of anxiety vary

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