How many times have you said “I’m stressed,” and meant “I’m anxious?” Or mentioned having anxiety, without ever getting an official diagnosis? If you’re like most of us, the answer is probably “a lot.”
Stress and anxiety are two buzzwords that, in casual conversations, we often use interchangeably. But according to mental health experts, the words have different meanings — and one shouldn’t be used in place of the other.
But what’s the difference, exactly? And how much does this difference matter?
[See: Top Medications for Anxiety.]
What Is Stress?
Stress is a “state of worry or mental confusion” evoked by difficult situations known as “stressors,” says Dr. Sandra Pisano, a clinical psychologist and director of behavioral health at AltaMed Health Services in Los Angeles, California. Stressors can be just about anything, including things like problems at work, financial turmoil or friendship disagreements.
Feeling stressed is our body’s natural response to these situations, “that tells us that there is a challenge or threat that needs to be addressed,” says Pisano.
When you start to feel stressed, your body releases cortisol, appropriately dubbed as the stress hormone. Cortisol has other purposes too — including aiding in metabolism control, blood pressure regulation and reducing inflammation — and it affects almost every system of the body. When it comes to stress response, cortisol is known for boosting our energy and increasing our ability to stay alert, sometimes pushing the limits of alertness into a “fight or flight.”
Some physical symptoms of stress include:
— A weakened immune system, which can lead to things like fatigue, increased vulnerability to catching new sicknesses, and a slower healing time for illnesses or injuries. Over time, this can also put people at increased risk for conditions like a heart attack or stroke.
— Upset stomach.
— Nausea.
— Dysregulation of the reproductive system, like missing a period.
— Trouble sleeping or irregular sleep patterns.
— Muscle tension.
Some emotional symptoms of stress include mood changes, like:
— Feeling irritable, angry, or overwhelmed.
— Unable to relax.
— Racing thoughts.
— Sadness.
— A decrease in your sense of humor.
Every person reacts differently to stressors, so not all people will experience the same symptoms, says Pisano. Not everyone can identify their stressor either, but most can, she adds.
Dealing with stressors isn’t fun. But the thing is, when they go away — for example, no more work — so does the feeling of stress. This isn’t the case with anxiety, which is persistent even in the absence of a stressor.
[See: Tips to Manage Stress at Work.]
What Is Anxiety?
Anxiety is the presence of stress symptoms with or without a stressor.
“Clinically, we define anxiety as a behavioral health diagnosis that we can give treatments for. We think of stressors — or stress — as triggers that are bringing on episodes of anxiety,” says Dr. David Merrill, adult and geriatric psychiatrist and director of the Pacific Neuroscience Institute’s Pacific Brain Health Center at Providence Saint John’s Health Center in Santa Monica, California.
Stressors can serve as a trigger for anxiety if they, for example, induce “out of control” or “catastrophic thoughts” that linger after the difficult situation is resolved, says Pisano. But people can also experience anxiety without ever feeling a stressor.
Physical symptoms of anxiety involve cortisol release and are similar to physical symptoms of stress. These can include:
— Shaking.
— Sweating.
— Tremors.
— Feeling flushed.
— Cold sweats.
— A rapid heart rate.
— Muscle tension.
— Nausea or vomiting.
— Rapid, shallow breathing.
— Difficulty breathing.
— Vision changes.
— Muscle twitches.
Emotional symptoms of anxiety are also similar to those of stress, and can include:
— Feeling irritable, angry or overwhelmed.
— Being unable to relax.
— Ruminating on certain things.
— Racing thoughts.
— Sadness.
— A decreased sense of humor.
[See: Tips to Support Someone Having a Panic Attack.]
Anxiety Vs. Anxiety Disorder
Not everyone who feels anxiety is diagnosed with anxiety disorder. In fact, acute anxiety is often an appropriate and natural adaptive response to stressors. However, anxiety becomes disordered when the response is out of proportion with the situation or lasts longer than it should. People with anxiety disorder may also experience anxiety often and “out of the blue,” and “without any clear triggers,” says Merrill.
Anxiety disorders can result in those anxious feelings remaining even long after the stressful situation is over, which can cause people to be preoccupied with anxious thoughts, have physical symptoms, and can change how a person interacts with others.
“That’s when you might want to get therapy for anxiety or try medication for anxiety, or the combination of both,” he adds
Seeing a trained clinician can help you figure out if your anxiety is improved by treatment and, if so, what type of treatment to pursue.
As for how anxious you should be feeling to seek professional help, Merrill says not to set a limit.
“Any kind of signs that jump out should be indicators to seek help,” he adds. “If you’re not able to complete the tasks that you want to, again, whether it’s responsibilities with family or at work or in your personal life, taking care of yourself or if your day-to-day functioning is diminished because of your feelings of anxiety, it’s time.”
Stressors and Post-Traumatic Stress Disorder
Another term related to stress and anxiety that’s sometimes used casually is post-traumatic stress disorder, or PTSD. But PTSD isn’t a term to be used lightly — in fact it is a serious mental health diagnosis that involves intense anxiety induced by a major stressor.
“The terminology is suddenly completely overlapping,” says Merrill. “If you’re just looking at the English word, it’s right there in the name: post-traumatic stress disorder.”
In contrast to general anxiety, “You can’t have post-traumatic stress disorder unless you had the stressor; the exposure to the traumatic event,” Merrill says.
Traumatic events can include witnessing death or abuse, among other things. For example, veterans may experience PTSD from experiences in combat.
Why Mental Health Language Matters
Most people who misuse the terms stress and anxiety probably aren’t doing so maliciously. But that doesn’t mean they haven’t had an unwanted impact. Pisano encourages people to educate themselves on these terms and make an effort to use them correctly and respectfully.
“We don’t want to stigmatize or pathologize people who are dealing with stress or anxiety,” she says. “It is important for everyone to know the difference and access support when needed.”
Our ignorance may be attributed to a larger lack of mental health education in the U.S. and stigma surrounding conditions, she adds. To build this up, Pisano advocates for more open communication, “safe spaces” for people struggling and financial investments in mental health programs to bring down barriers for people who cannot afford care.
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Stress vs. Anxiety: Understanding the Key Differences originally appeared on usnews.com
Update 06/20/23: This story was previously published at an earlier date and has been updated with new information.
