I was wondering how to portray severe anxiety just fyi I don’t want it to seem like I’m romanticizing or do I think it’s cool or whatever I just want to know to portray it properly and some potential causes for it
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and actions that the person does
and the undiagnosed symptoms
Anxiety can be caused from stress or trauma.
As someone who has had anxiety all her life I’ll say it’s definitely an internal struggle so you’ll have to show that through the person’s thoughts but some things can also show anxiety physically like fidgeting or excessive planning.
The realdepressionproject page on Instagram has some posts that shows how anxiety manifests in people. You can check out their page to have a better idea
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for this character he is 10 so i want also show the struggle for undiagnosed children who don’t know how to handle such a big change
Based on my own research on anxiety, I present to you what I’ve gathered. Hope that helps.
Anxiety attacks are similar to fight or flight responses where your body overreacts to stimulants around you and you start to feel intense emotions such as fear and terror.
It can trigger based on what made your character developed anxiety in the first place.
For instance, if I have anxiety because of a car crash, every time I have to drive I start to sweat a lot. When I’m inside the car I might shake and shiver even when it’s scorching outside.
Mild anxiety will have mild symptoms but severe anxiety can have severe symptoms (the more you know) especially when it reaches a peak where panic attack is triggered. It can interfere with daily lives of those with anxiety. And, you guessed it, the more severe it is, the more it interferes with one’s life.
Example of symptoms of anxiety
- Feeling nervous, restless or tense
- Having a sense of impending danger, panic or doom
- Having an increased heart rate
- Breathing rapidly (hyperventilation)
- Sweating
- Trembling
- Feeling weak or tired
- Trouble concentrating or thinking about anything other than the present worry
- Having trouble sleeping
- Experiencing gastrointestinal (GI) problems
- Having difficulty controlling worry
- Having the urge to avoid things that trigger anxiety
I’m not a person with anxiety, so I do not know their internal struggles. I will, however, give you a few tips to portray anxiety properly.
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Like most themes (BIPOC, LGBTQA+ representation included), don’t make anxiety the character’s only traits, or develop the character based on anxiety.
This is to prevent writing a cliche character where they are the perfect representation of anxiety. Readers don’t want that, in fact, they find it offensive. -
Romanization of anxiety: make the character lovable for their personality, not because of anxiety and their inner/outer struggles.
See why the first point is important? If you make a character lovable AND has anxiety, you can dodge romanticizing anxiety when you write romance scenes between the character with anxiety and their loved ones. -
How to portray anxiety: just like your own body, you can’t control whether you have anxiety or not. It’s caused by something unavoidable. If it’s not… It’s not like you can change the past to totally erase the existence of anxiety as if it was never there.
When writing the character fighting their anxiety, don’t make them a total bad*ss all in a sudden because Oh It’S beCAusE oF AnXieTy, not especially when your character’s base personality (unaffected by anxiety) is naturally more conservative and shy.
Okay, if it’s reasonable you can but here’s the catch: Their change should depend on their personality, not the other way round. -
Prevent revolving the story with anxiety and anxiety only. If your plot is about your character fighting against their own demons within themselves, it’s a good idea to include side plots where it lightens up the mood of the story, which also makes some of the sad/scary scenes even more powerful.
This can prevent glorification of anxiety (basically promoting mental health conditions which are just big no-no’s). You can state that your character grew with anxiety, which most people don’t.
What you cannot hint is anxiety makes people grow. No, anxiety doesn’t help people grow. It gives those with anxiety a challenge in their own growth. It’s the people that helped themselves grew. Because if you say so, you’re portraying that people can only grow after they went through a traumatic event. This is not okay. Just, don’t do it at all costs.
Last minute addition: for kids…
Kids are more prone to be traumatized in comparison with adults (but it’s still possible for an adult to be traumatized).
I would say, as a 10 year old the character couldn’t do much on their own. It’s important that adults help the kid to consult a doctor.
I’m not entirely sure if it’s 100% always this case, but most kids that are traumatized at young age tend to develop autism. (if I’m wrong, please correct me)
Regardless, the points on the top still stands even for a kid: their response, their their way of handling the situation, their change should depend on their personality, not the other way round. Not because you need the character to solve their anxiety problems for plot purposes, instead for their own growth.
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thank you so much this is really helpful 
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I have diagnosed general and social anxiety, and if you need someone on hand to consult or ask for specific things my DMs are always open!
It’s going to be different for everyone, so I can only give my experience and what I’ve heard others say and learned through therapy, but I’m happy to help how I can!
Thank you for also wanting to portray it well and correctly, that’s really appreciated!
Some General Things
- Anxiety Attacks aren’t exactly an official term, and they aren’t Panic Attacks; they’re different things, especially in the fields where Anxiety is diagnosed. Panic Attacks are a sudden rush or attack of anxiety or fear, and they can be absolutely hell to go through. They can occur out of nowhere or have some trigger, and they can be really intense. Anxiety Attack can vary in meaning from person to person, and some therapists I’ve seen aren’t fond of it, but that doesn’t mean it’s not 100% valid for someone with anxiety to use and connect with.
- Everyone experiences some level of anxiety, but having the disorder means you experience it consistently and to a greater degree. Basically, your fight, flight, freeze response is broken and it can set off out of nowhere.
- Anxiety lies. It’s irrational. Most people with anxiety know it’s lying, but it’s a really strong and nasty voice and weasels it’s way in anyway, and it takes a lot of work to learn to work with it.
- Medication does not take your anxiety away, it helps make it more manageable. Not everyone goes down that path, and if they do, it can take some time to find the right medication. Personally, I hate it. It makes my brain feel foggy and that just makes me more anxious, and my therapist has said I’m not alone in that.
- Anxiety doesn’t need to have a trigger to develop, it can be genetic and or something your born with. However, it can absolutely be caused by an event or trauma! It can also be underlying but only really show itself after something. If your character has it caused by a trauma, remember that anything can be traumatic! It doesn’t have to be big or dramatic, it can be falling on the sidewalk. For that person, maybe it was who saw them, or how people reacted. To them, it was traumatic.
- You can be anxious about some things, and not at all about others. It can be really random with what it attaches to. An example of that for me, is my parents are musicians so I’m very used to being on stage, but class presentations and band lessons were really anxiety inducing.
- Tess’ post above is pretty accurate and a good source!
In regards to a 10 year old with anxiety who I think you’re saying will be undiagnosed, their experience will depend a lot on their parents and their school and how accepting and understanding they are of the anxious behaviors.
They may have trouble going into classes, or school all together. It could lead to a lot of missed days and some trouble with the school board, and some lectures from well meaning teachers. I unfortunately had to deal with this when I reached eighth grade, and the school saw me as this manipulative child master mind controlling my poor adult parents. There was a risk I would be taken from my parents because I missed so many days of school. I don’t think the school reaction would be that intense for a 10 year old, but that’s a show of how environments can be unaccepting. Thankfully my parents got it eventually and I have an amazing therapist and I’m on the road to healing now.
Since the character is so young, they may not know what’s going on or that it’s even the normal version of anxiety exactly, only that they can’t and that that’s the only thought running through their head, or that they can’t stop thinking about whatever their anxiety clings to. They might think they’re just socially awkward, or too stressed. They might need to plan their whole day ahead and plan for every possible occurrence to be able to do it.
The anxiety could also become more prevalent as they age, like they could go out to eat when they were five but now they suddenly can’t anymore.
If their environment is accepting, it may lead to a diagnosis or things adjusted to fit them better. Maybe they’ll have a friend who really gets it, or a parent that’s really understanding. Even just one person being in your corner can make it so so much better.
They may also seek reassurance, and need to go it slow with things. Like sit in the school parking lot way at the back for a week, and then slowly move closer.
There might be struggles to find a therapist, or they might get stuck with a bad one, which can be another part to it.
Being quiet and on your own a lot is I think another thing kids with anxiety are often like? Some can be so anxious they can’t speak.
I don’t want to be too detailed, but when the anxiety is triggered it can be a lot of all consuming racing thoughts. Panic attacks can be like that as well, and at least for me it’s like I’m in a whole different kind of state when I’m in one. I’m aware and I know what I’m needing, but I can’t breathe and nothing matters anymore other than getting out of it and calming again. Something else takes over and I’m not really seeing, I’m just on base survival mode. It can be terrifying and so so sudden. It’s kind of blurry in the moment and after.
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My experience as a kid with anxiety:
• I was too afraid to put my hand up in class. Apart of that fear was I didn’t want everyone to look at me, I didn’t want to humiliate myself in front of everyone by letting them know I didn’t understand what was on the board or what we were studying or if I had gotten an answer wrong.
• I would look down or pretend to be busy writing whenever the teacher was scanning the room to pick out someone to ask a question.
• If I was picked out to read something from the board/book aloud, I could feel myself panicking internally and symptoms seeping through to the outside: my face going red, my voice seizing up, sweating, nervous shaking.
• My face would heart up, my heart would race and I’d feel an overwhelming sense of nervousness and sometimes an extreme urge to run away from the situation whenever we had speeches to present or awards to collect in front of the school.
• I dreaded being nominated for anything because it normally meant walking up on stage or having responsibilities over other students and I just didn’t have the confidence or belief in myself for those.
• I was afraid of mingling with kids I didn’t know. I wasn’t sure how to speak to them, socialize with them, befriend them, work with them, so I avoided them and only hung out with my friends (who befriended me).
• If I was placed in a group or pairing with kids or a kid I didn’t know, I’d normally speak only when spoken to. I didn’t have much confidence to “break the ice” and I didn’t really know how to continue conversations (still don’t).
I’m 22 now, but my anxiety is pretty much still just as bad. The only upside is that I’m no longer in a school environment and I have medication to help ease my symptoms. I guess my biggest internal struggle is believing I’m not good enough and that I’m always going to mess up and humiliate myself. I guess I have a strong inferiority mindset that dreads humiliation, comparison and rejection so I try everything to avoid situations that have those possibilities.
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To all the people who shared their experience i am so grateful for you to tell me and help me with my story it really is very kind of you to share personal experiences with anxiety 
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This is my life in a nutshell and everyone just says it’s shyness. No, it’s not, shyness does not paralize me like my anxiety does. I was scared into staying in my seat when my I thought to go check for my teacher since they were at least ten minutes late (My phone had no charge so idk how long they were exactly) because I thought people who judge me for getting up and looking.
For the OP, honestly it is so scary and most people around you will call it shyness unless they have personal experience with it. I told my cousin I have it and he told me “No, you don’t. You just don’t want to talk”. I have been called rude so many times beacause of my anxiety, it’s made me re-write texts so many times and then not end up sending it at all. And it makes me scared of responses and how many likes I get. I will agree to avoid the overwhelming feeling of people telling me why I am wrong even if they asked for my opinion. I have tried to control it so many times and only recently admitted it to people to be shut down. It’s been a few years since I have been ten so I cannot exactly remember how bad it was then but probably quite similar. I do get a few times where I feel confident and anxiety is not controlling me as much but it never really goes. I can’t even be comfortable around people I know well. I have even been scared of talking to my parents and I think it might have stemed from being told I am in the wrong all the time and feeling like the odd one out by my family and siblings. I hope sharing this helped you somehow!
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I actually like/use the term anxiety attack because my anxiety/attacks are always caused by triggers. I consider panic attacks to be completely random and for no apparent reason and my mom suffered with particularly bad ones.
Although I’m not a doctor, I’ve heard this a lot that panic attacks get mixed up with anxiety attacks when they’re actually quite different. I’ve never had a panic attack but I again have a mom who had and I do understand the feeling. It feels like having a heart attack and all the blood from your body rushes to your heart because it thinks that you’re dying.
Cuz often times your body with other anxiety when it gets bad is your body thinking you’re in danger so that’s why you get anxious and that response.
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For me, anxiety has different levels.
There is the general anxiety where I worry a lot about different things. This one is annoying but not that bad but clouds my mind with thoughts and distractions. It’s not debilitating and I can deal with it.
But there is another type of anxiety that is focused around a fear or trigger that is terrible. Your brain does terrible things and lies and tricks you until you’re convinced of something ridiculous and awful. My fear is throwing up and that’s what this anxiety would surround. I would think almost daily about throwing up and worrying about it. On some days I would eat lots of fruit and light things like that to convince myself that I wasn’t going to get sick because I could eat. I would get dizzy and worry that if I walked to the kitchen I would see a trashcan or a sink and that would make me throw up. It’s that irrational and that bad.
One time I was at a restaurant and we were waiting for the food and I wasn’t hungry. I was staring at this bread getting increasingly dizzy and these thoughts about vomiting at this dinner spinning around in my head. I couldn’t stop them and my brain was convincing me that I was about to throw up. So I did the best thing I could and told my relatives at the table I was having an anxiety attack and needed to leave. I wasn’t even sure I had anxiety but I had thought that I did and it was better than giving into the anxiety and saying that I would throw up.
It’s a constant battle and constant cycle with your brain telling it that you’re not going to throw up, you’re okay, you’re fine but that only made it worse and continued the cycle. It wasn’t until I was formally diagnosed with generalized anxiety disorder and started going to therapy that I could actually deal with this. I no longer worry about vomiting every day, it still can be bad sometimes. Meds can help me a lot, I still worry but hardly about vomiting anymore. That fear of mine really clouded over the actual issues I was facing, every time I would be worried about something I’d think about throwing up. Now I worry about something and it’s just that issue. Which takes a lot of weight off my shoulders and is much more manageable.
If your character faces anxiety or a fear, don’t use it to be something that other characters comfort. Don’t use it to romanticize. A lot of people go through anxiety or other issues so it might be better for your character to find others that understand.
As for severe anxiety, when I’m really anxious I can’t really speak. I often obsessively tap. I do something because my body feels out of control. I get dizzy, sometimes a bit nauseous, and it just feels like you’re stuck in your thoughts. And for me an anxiety attack is a build up of this and that extreme moment when it happens.
So yeah I’d give your character a fear because fears can really make anxiety worse because they can really mask it and other issues your character is facing internally.
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That’s absolutely understandable, I like the term too! I was having a lot of trouble wording that bit and had to just stop because I was so anxious and it didn’t feel right, and if it came across as me saying it wasn’t valid to use or connect with, I am so so sorry! It absolutely is, and I’ll edit my post in a moment to fix that, that’s completely on me and my bad.
Terms aren’t set in stone and they evolve over time, and I definitely think anxiety attack should be considered an official one and looked into more because it describes an experience we don’t really have one for yet. Only you can truly know your mind and experience and of anxiety attack fits that that’s a-okay!
This is honestly what I was trying to say, so thank you for that! I was trying to get at how they aren’t the same thing and an interchangeable term, because I see them mixed up a lot. They aren’t the same thing, and when representing things like anxiety it’s super important to use the correct terms. There’s already a lot of misinformation and wrong conceptions, and even if it’s all fictional it can lead to someone second guessing getting a diagnosis. An Episode story (it portrayed it correctly and thoughtfully and everything, but it and the research I did stemming from that didn’t cover more of the nuanced things, or the types of OCD I have) was actually part of the reason why I dismissed having OCD when my therapist brought it up for the first time, and it took me a couple years to realize “you know what maybe I do have it actually” and get officially diagnosed. Please don’t let this ward you (or anyone else) off from portraying it though! As long as you do it with research and care, you’re a lot more likely to actually help someone realize it might be something they deal with!
Oh! Another thing with how to portray severe anxiety; during moments where the character is really wrapped up in it, they may not be aware of what’s going on around them, or they could be hyper aware. It’s a very consuming feeling where you get progressively more anxious. Those scenes in movies and shows where the surroundings start to blur and the sound fades out really fit how I feel in that moment, and as a visual person in general I really like those portrayals.
Some other anxiety things with me:
- Even though I know it’s not going to happen, I am still terrified of something popping up in the windows at night and sometimes I’ll have to run up the stairs because I work myself up so much I start feeling like something is watching me and I have to book it. I’m an adult now but young me absolutely felt that too. Not being able to see what’s in the dark is the perfect way for my anxiety to get to me, because I can’t 100% say no.
- I would also hide behind my hair in school when the anxiety started to grow, and even though the nurse had a space in her office where I could go, I didn’t want to because it was a really exposed area and kids could see me there and that’s embarrassing and super anxiety inducing. I didn’t want anyone to know or see what I was going through and I already felt like everyone was judging and looking down on me and that would only make it worse.
- Feeling safe and secure are super important things as well, and being startled or surprised can really set off my anxiety.
- While grocery shopping, if someone else is in the same isle as me I have to leave and go to a clear one until they’re gone. If someone is already there I have to wait. I also tend to hide somewhere while my mom is checking out, because I get really anxious about people seeing what I eat or buy.
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When you relate a little too much to this thread 
it may be time to consult my doctor
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My anxiety manifests in multiple different ways. There are even some things that I didn’t realize were due to anxiety until I started therapy years ago.
Anxiety basically controls what I do throughout the day. First thing when I wake up, I check my work messaging app, to see what type of cases have come in to the hospital. That way, I know what to expect when I get to work on my next shift. I will actually check it several times a day, even on my days off. That way, I can constantly mentally prepared for how busy I might be when I do go to work.
I then go through and check all my messages (email, texts, etc). Depending on the message, I may or may not respond right away. A lot of times, I have to sit and think about what I want to say. Sometimes that takes a few minutes, a few hours, days, weeks… Thinking about replying to some messages sometimes is a source of increased anxiety. Sadly, sometimes I do forget to respond because so much time has passed. This results in people thinking I ghost them, when really, I’m trying to just reduce my anxiety by waiting to respond.
I don’t really go out into public. In fact, my husband does 99% of the shopping. Being around people makes me feel uncomfortable and increases my anxiety. When I’m around a lot of people, it feels like they’re standing right in front of my, breathing hot air in my face. This was even pre-Covid. It’s like putting your hand in front of your face, and breathing hot air out… but multiplied by 100. Sometimes it literally makes my head hurt, but that’s for other reasons.
Sometimes, I get frustrated VERY easily. One of those “undiagnosed” symptoms. When my anxiety levels are high, the smallest things get under my skin. Stupid stuff. I remember once, before I got on meds, I was playing a card game with some friends, and I was getting so irritated at not getting the right cards. After I was on meds for a while, playing the same game, I had a lot more fun, cause it didn’t bother me. I call them my “Give A ****” pills cause they make me not be bothered by small things.
Anxiety makes me overthink EVERYTHING. What to say, what to wear, even what to eat. It makes me not want to interact with people, sometimes my own family. I make sure that all my appointments are scheduled for right when I get off work, because I know if I get home, the thought of leaving again will increase my anxiety. I consciously and subconsciously avoid anything that may make me uncomfortable.
When my anxiety is high, I either don’t eat at all, or I eat too much. Sometimes the pit in my stomach makes me literally nauseous, and I won’t eat for a few days. Other times, when it’s increased, but not high enough to make me nauseous, I’ll eat just to take my mind off of whatever is worrying me. There are other coping mechanisms, and some really aren’t healthy, so I won’t go into them. Writing has actually helped a lot, because it has become a form of a coping mechanism. It helps to keep my mind off of whatever is causing distress.
But then, comes the attacks. There are two types. Triggered attacks and Spontaneous attacks.
The spontaneous ones are when for absolutely no real reason, I just start panicking. It’s been since right after my son was born, and I wasn’t taking meds because I didn’t know how they’d effect him. That one, my husband had to physically sit me down on the sofa, and told me to breathe. He breathed with me, until I could get my breathing back under control.
More recently, I’ve had triggered attacks. That’s more tied to PTSD, but it still has the same effect. We were driving through a construction zone on the way home from vacation. This semi got right behind me, and started getting right on my bumper, then backing off, then doing it again. He was trying to get me to go faster (speed) but it just sent me into an attack (I was rear-ended in a car wreck years before). I was driving, but I couldn’t see straight. All I could see was him hitting me with my kids in the back of the car. Once again, my husband started breathing with me, and I was able to calm down enough to get through the construction zone without crashing.
Just last week, I had an idiot get right on my bumper. It wasn’t as bad, because we weren’t in a construction zone, but my grip got real tight on the steering wheel, and I started my breathing techniques.
Hope this helps, and if you have any further questions, let me know.
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Oh no definitely, don’t feel bad! I mean, we both have anxiety lol I just wanted to clarify that point about panic attacks.
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Wow, thanks so much for researching this!! Those are really helpful points I’m glad you spent so much time on this for us! 
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It isn’t much 
The part where I had to spend a little time researching is the symptoms of anxiety, whereas the representation part (as mentioned above, BIPOC, LGBT+, etc…) applies to most themes.
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