Everyone worries or gets frightened from time to time. These are normal, even healthy, responses to threatening situations. But if you feel extremely worried or afraid much of the time, or often feel panicky, consider talking with your doctor.

Anxiety can make you so uneasy around people that you isolate yourself, missing out on social events and potential friendships. It can fill you with such obsessive thoughts or inexplicable dread of ordinary activities that you cannot work. Anxiety disorders can be mild, moderate, or severe, but overcoming them generally takes more than just “facing your fears.” Many people need help in dealing with these problems.

There has long been a stigma surrounding getting help for anxiety. People are ashamed to admit to phobias and persistent worries, which seem like signs of weakness. Add to that the tendency of people with anxiety to avoid others, and you have perhaps the biggest obstacle to relief and recovery. Without treatment, many individuals become more fearful and isolated. In extreme cases, they are so imprisoned by their anxiety that they are unable to leave home.

Sigmund Freud regarded anxiety as the result of inner emotional conflict or external danger. While these factors often contribute to anxiety, scientists now know that anxiety disorders are biologically based illnesses. Sophisticated brain imaging enables scientists to trace the neural pathways of fear and anxiety. In the process, they’ve discovered certain brain abnormalities in anxiety sufferers. Research also suggests that genes may contribute to these abnormalities. This growing knowledge about anxiety has already led to safer, more effective treatments.

Anxiety disorders, which include panic attacks and phobias, affect about 19 million American adults and millions of children. For every individual with an anxiety disorder, many more are affected by it, including spouses, children, other relatives, friends, and employers.

The good news is that there are many therapies to help control anxiety and improve quality of life for sufferers. Medications can, in many cases, reduce or eliminate symptoms. Several types of psychosocial therapy, especially cognitive-behavioral therapy, also help by teaching people to adopt more positive thought and behavior patterns. Some medications under development may even help prevent anxiety disorders in people genetically predisposed to them.