I'm a worrier. I worry and stress and agonize over too many things. I have fears and paranoia. When these thoughts enter my mind, I have to take a step back and decide if this is inspiration from God (usually not) or my own anxieties taking the lead (usually so).
It takes practice to learn how to tell the difference between our own anxiety and when God is really trying to speak to us through the Holy Spirit. But you can know when you need to listen and when you need to ignore the thoughts in your head.
When God is speaking to you, it's not likely that he will come stand in front of you in the flesh. No, but he will help you "hear" him through thoughts and feelings. Religious leader, Craig Christensen said, "if any of us lack wisdom, we can ask God in faith and receive answers...by the power of the Holy Ghost, who speaks to us through inspired thoughts and feelings." When we are earnestly seeking answers in faith, God will answer us in a quiet way that we can recognize.
But, how do you know if it's your inner voice, or inspiration from God?
To know if it's your own thoughts or actually from God, you have to understand how the Spirit feels. In Galations 5:22-23, it says, "But the fruit of the Spirit is love, joy, peace, longsuffering, gentleness, goodness, faith, meekness, temperance". Putting it simply, if an answer or prompting is from God, you won't feel fear, trepidation, stress or worry, but instead you'll have feelings of peace and happiness. Even if the task at hand or the answer can be overwhelming, you can still be at peace when it is something God has told you to do.
While we need to seek to be ready to actually listen for God's voice, he's not going to speak to us in ways we do not understand. Religious leader Carole Stephens explains, "Our Savior will...speak to us in a voice we recognize when we come to Him—for he knows us. He meets us where we are." No matter our level of understanding, God does want to communicate with us through prayer and through the influence of the Holy Spirit. Whether we respond better to thoughts, feelings or other means, that is the way God will try to communicate with us.
When we are worried, stressed or fearful, we can pray to God and ask him to help us know what we are to do. He can calm us and send peace. If our worries are unwarranted, he can calm the anxious thoughts in our minds and help us refocus on what he needs us to be concerned about. God doesn't use fear tactics, though he can sometimes be very direct in answers. When God speaks, we will feel it in our hearts and minds. He speaks in terms of peace, not anxiety.