I have really bad anxiety and stress in my life right now. its causing physical symptoms, what scares me is the chest pain and tightness. ive been to the er and got a ekg, chest x-ray, and blood work. it was all good. im 23 should i worry?

When stress is enough to interfere with your activities of life you should pursue ways to manage it. Find a life coach/therapist to teach you stress management skills/relaxation. While in training you may uncover hidden issues that trigger the response. Do this work and you may be able to live life without medication or symptoms.

An adjustment disorder is likely and unfortunately ER would be the worst place to have it addressed due to the nature of the work being done in ER focusing on immediately life threatening situations, which yours is not. Establishing with a primary care doc in the area would be best as local resources can be activated and proper treatment initiated.

It is not feasible to provide an opinion without additional history, physical examination may be some tests. It would be prudent to see your doctor to see if you may be depressed. Depression is treatable. Counter-intuitive as it may seem, exercise may help. Start with low intensity exercise such as walking and gradually increase the intensity as tolerated. Drink more water. Wish you good health!