Understanding Anxiety and Anxiety Disorders – with Dr. Shari Lusskin

By on April 11, 2024

This blog is based on a Healthful Woman podcast episode in which Dr. Shari Lusskin joins Dr. Nathan Fox to discuss common concerns about anxiety and when it’s considered “normal.” Dr. Lusskin is a Clinical Professor of Psychiatry, Obstetrics, Gynecology, and Reproductive Science at the Icahn School of Medicine at Mount Sinai and an Attending in Psychiatry at Mount Sinai Medical Center.


Most people will experience some degree of anxiety in their lives whether they are worried about their job, an exam, or some other life event. This is known as situational anxiety and is fairly normal. However, for some, there is a point when this healthy level of worry crosses into an anxiety disorder.

To determine if anxiety has become a disorder, an individual must reflect on how much their anxiety interferes with their degree of functioning. While a little anxiety can actually be beneficial to boost productivity or motivation, too much anxiety can interfere with the ability to concentrate, plan, and be effective.

Some individuals living with anxiety disorders who are aware of their disorder adapt and learn to live high-functioning lives while dealing with anxiety. However, others may not be aware of this disorder and the degree to which it is affecting their lives or the lives of people around them.

Diagnosing Anxiety Disorders

For individuals who think they may have anxiety but are not sure if it is an anxiety disorder, there are a few steps that can be taken to assess the degree of their anxiety.

“As a first step, I like to have the patient fill out a self-screening tool called the Generalized Anxiety Disorder, or Seven Items Scale, or the GAD-7,” explained Dr. Lusskin. The results of this test will give your provider a starting point for where you fall on the scale of anxiety severity.

“Anxiety is a very nonspecific symptom… As a psychiatrist, we try to put it into some sort of diagnostic box, which then guides our treatment,” said Dr. Lusskin.

Anxiety can manifest in many different ways. For example, an individual may be very anxious due to a severe psychiatric disorder such as schizophrenia. Or they could just be an anxious person who’s been anxious since they were born.

Overall, diagnosis in psychiatry is made based on the patient’s history and the in-office evaluation.  During this meeting, it is important to tell the doctor what you’re feeling and to report your family history and general medical history. This includes your obstetric history, any heart, lung, liver, kidney problems, dermatologic problems, and more, as these issues can be connected to psychological issues.

“You want to make sure that you’re covering all those bases,” said Dr. Lusskin. “And if the healthcare provider doesn’t ask, volunteer the information and say, ‘You know, I did have a history of thyroid disease or three of my relatives had it. Could that contribute?’ And then it’s the doctor’s job to rule out those other factors that can contribute.”

Common Forms of Anxiety

There are many forms of anxiety which can be categorized into different groups. Some common examples include the following.

Generalized Anxiety Disorder

Generalized anxiety disorder (GAD) usually involves a persistent feeling of anxiety or dread that interferes with how you live your life. It is not the same as occasionally worrying about things or experiencing anxiety due to stressful life events.

GAD is relatively nonspecific, and there is not one single treatment approach. “You have to tailor it to the individual and their circumstances,” explained Dr. Lusskin.

There are various treatment options for GAD, depending on the individual and their situation. Psychotherapy is a popular option for treating GAD, which works by permanently changing brain chemistry by building new neural connections. Personalized couples counseling and medication are also popular and effective options.


A phobia can be defined as an uncontrollable, irrational, and lasting fear of a certain object, situation, or activity. A common treatment option for specific phobias is known as graded exposure. This involves slowly exposing the individual to the thing they are afraid of until they are more comfortable.

“It can start with even saying the word of the thing they’re afraid of,” explained Dr. Lusskin. “And then you can progress from speaking it to looking at, like cartoon pictures, and then to real pictures, and then gradually expose them to seeing it in real life.”

This approach works because it can desensitize the brain so that individuals can learn to tolerate the stimulus, decreasing anxiety levels. For individuals who are willing to put in the work, this method is often very effective,

Social Anxiety

A person with social anxiety disorder feels symptoms of anxiety or fear in situations where they may be scrutinized, evaluated, or judged by others. There is some connection between individuals with social anxiety and the use of alcohol to calm their nerves in social situations. Unfortunately, this can lead to substance abuse issues. Because of this, in the effort to achieve and maintain sobriety, it’s important to address the underlying anxiety or mood disorder or other psychiatric disorders that may accompany it.

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Maternal Fetal Medicine blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!