Anxiety, depression, and insomnia: what they look like
Three of the most common concerns we see in internal medicine — and they often show up together. Understanding them individually can make it easier to put words to what you're feeling.
Anxiety, depression, and insomnia are three of the most common concerns we see in internal medicine, and they often show up together. But each one has its own set of signs, and understanding them individually can make it easier to put words to what you're feeling and know what to bring up at your next visit.
Here's a closer look at each one — and when it's time to talk to a doctor.
Anxiety
Anxiety is more than everyday worry. It's a persistent sense of unease, fear, or dread that can show up even when nothing is obviously wrong, and it often comes with physical symptoms alongside the mental ones.
Common signs include:
- Excessive worry that's hard to control, even about small things
- A racing heart, chest tightness, or heart palpitations
- Restlessness or feeling constantly "on edge"
- Muscle tension, headaches, or jaw clenching
- Stomach issues, nausea, or GI discomfort
- Trouble concentrating or a mind that won't slow down
Depression
Depression doesn't always look like sadness. For many people, it shows up as a loss of interest in things they used to enjoy, low energy, or a general sense of flatness that's hard to explain.
Common signs include:
- Persistent low mood or a sense of hopelessness most of the day, nearly every day
- Loss of interest or pleasure in activities you'd normally enjoy
- Noticeable changes in appetite or weight
- Fatigue or low energy, even after resting
- Difficulty concentrating or making decisions
- Feelings of worthlessness or excessive guilt
- Sleeping too much or too little
Insomnia
Insomnia is trouble falling asleep, staying asleep, or getting restful sleep — even when you have the opportunity for a full night's rest. It can be short-term (tied to a specific stressor) or chronic, and it often coexists with anxiety and depression rather than standing alone.
Common signs include:
- Taking a long time to fall asleep most nights
- Waking up frequently during the night
- Waking too early and being unable to fall back asleep
- Feeling unrefreshed even after a full night in bed
- Daytime fatigue, irritability, or trouble concentrating
- Increasingly worrying about sleep itself, which can make it worse
When to see a doctor
It's normal to have occasional bad days, restless nights, or stretches of worry. But it's worth reaching out to a doctor if you're noticing:
- Symptoms of anxiety, depression, or insomnia lasting more than two to three weeks
- Symptoms that are interfering with work, relationships, or daily functioning
- Insomnia that isn't improving despite good sleep habits
- Using alcohol or other substances to cope with sleep, mood, or anxiety
How telehealth internal medicine can help
Anxiety, depression, and insomnia can each have a purely medical component — thyroid dysfunction, iron or vitamin deficiencies, and hormonal changes can all mimic or worsen these symptoms — so a proper workup matters. A telehealth internal medicine visit can review your symptoms and history, order bloodwork to rule out underlying medical causes, and talk through next steps — whether that's lifestyle changes, medication, or a referral for additional support — all without an in-person visit.