Stress vs. Anxiety: How to Tell the Difference and What to Do About It

We hear a lot about anxiety these days. Although it has long existed as a common mental health concern, anxiety has become even more widespread since the onset of the COVID-19 pandemic. In fact, data from the CDC and the American Psychological Association (APA) show a notable spike in reported anxiety symptoms since 2020. Whether it’s friends, colleagues, or clients, it seems like nearly everyone is feeling "anxious" or "stressed"—and many use the terms interchangeably.

But while stress and anxiety share overlapping emotional and physical symptoms, they are not the same thing. Understanding the difference is a key first step in getting the right support—and in knowing whether you're experiencing a situational response or something that may require clinical treatment.

What Is Stress?

Stress is a physiological and emotional response to a specific challenge or demand.

Stress arises when something in your environment requires your attention, energy, or adaptation. It’s a natural part of life and can even be motivating in short bursts. However, chronic or unmanaged stress can have long-term consequences for both mental and physical health.

Common causes of stress include:

• Relationship conflicts

• Deadlines or workload

• Financial difficulties

• Chronic illness or caregiving responsibilities

• Systemic stressors like discrimination or lack of safety

Stress can manifest both physically and emotionally:

• Headaches or digestive issues

• Irritability, mood swings, or feeling “on edge”

• Trouble sleeping or chronic fatigue

• Difficulty concentrating ("brain fog")

Chronic stress, in particular, has been associated with inflammatory responses in the body, increased cortisol levels, hormonal imbalances, sleep disorders, and even cardiovascular complications. Over time, it can mimic or contribute to the onset of anxiety disorders if not properly addressed.

What Is Anxiety?

Anxiety is marked by persistent, excessive worry—even in the absence of a clear stressor.

Unlike stress, which is usually a direct response to a known challenge, anxiety is characterized by ongoing apprehension about what might go wrong. While short-term anxiety can be a normal part of life, anxiety disorders involve symptoms that are intense, long-lasting, and interfere with daily functioning.

Common signs of anxiety include:

• Excessive worry that is hard to control

• Physical symptoms like racing heart, muscle tension, or shortness of breath

• Avoidance of situations that might trigger fear

• Restlessness or feeling constantly “on alert”

• Difficulty enjoying life, making decisions, or maintaining work and relationships

Anxiety disorders are diagnosed when symptoms persist for six months or more, and include conditions such as:

• Generalized Anxiety Disorder (GAD): Persistent, wide-ranging worry with physical symptoms like sleep disturbance or fatigue.

• Panic Disorder: Recurrent panic attacks involving intense fear and physiological symptoms like chest pain or dizziness.

• Social Anxiety Disorder: Fear of social or performance situations that leads to avoidance and significant distress.

• Obsessive-Compulsive Disorder (OCD): Intrusive thoughts (obsessions) and/or repetitive behaviors (compulsions) that interfere with daily functioning.

• Specific Phobias: Intense fear of particular objects or situations (e.g., flying, needles, public speaking).

So… Am I Stressed or Anxious?

This can be a tricky distinction, especially because stress can trigger anxiety, and chronic anxiety can feel stressful. Here’s a simple way to think about it:

• Stress is usually tied to a specific, identifiable cause and may lessen when the situation improves.

• Anxiety often persists regardless of external circumstances and may feel vague, uncontrollable, or disconnected from any obvious event.

If your worries last for months, impact your ability to function or feel joy, or you find yourself avoiding life in meaningful ways, you may be experiencing more than situational stress—and professional support can help.

Evidence-Based Treatments for Anxiety and Chronic Stress

Both mild stress and clinical anxiety disorders respond well to a range of integrative, evidence-based treatments. Here are a few of the most researched and effective options:

✅ Cognitive Behavioral Therapy (CBT)

CBT helps you identify and shift unhelpful thoughts, reduce catastrophizing, and change avoidance-based behaviors. It is considered a first-line treatment for anxiety disorders by the American Psychological Association (APA) and the National Institute for Health and Care Excellence (NICE).

✅ Acceptance and Commitment Therapy (ACT)

ACT builds psychological flexibility, helping you learn to accept uncomfortable thoughts and emotions while moving toward your values. A 2015 meta-analysis found ACT to be as effective as CBT for treating anxiety and depression.

✅ Exposure and Response Prevention (ERP)

Particularly effective for OCD, panic disorder, and phobias, ERP involves gradual, supported exposure to feared stimuli while preventing compulsive or avoidant responses—helping you break the fear-avoidance cycle.

✅ Mindfulness-Based Therapies

Approaches like Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) help you anchor your attention in the present moment and build awareness of thought patterns. Studies show mindfulness can reduce amygdala reactivity, improve emotional regulation, and enhance nervous system resilience.

✅ Integrative Health Approaches

For both stress and anxiety, attention to sleep hygiene, nutrition, movement, hormonal balance, and nervous system regulation can greatly improve outcomes. Breathwork, body-based practices (like yoga or progressive muscle relaxation), and self-compassion interventions are powerful tools for long-term healing. Medication management can also be an important consideration and the combination of medication + therapy can be a comprehensive treatment plan approach for many individuals.

Coping Starts with Awareness—and Support

Understanding whether you’re experiencing stress, an anxiety disorder, or a blend of both is an essential step toward healing. While lifestyle changes can reduce mild stress, clinical anxiety often requires professional support to break entrenched patterns and build new skills.

You can begin today by asking:

• How long have I been feeling this way?

• Is it interfering with my ability to enjoy life or complete daily tasks?

• Am I avoiding important aspects of life due to fear or overwhelm?

• And most importantly: Do I want to create a meaningful life in spite of my anxiety?

  
  

If you’re ready to explore support for anxiety, perfectionism, burnout, or stress-related symptoms, I’m here to help. I specialize in working with high-achieving, anxious adults who want to move from coping to thriving using CBT, ACT, mindfulness, and integrative therapy.👉 Click here to schedule a consultation and begin your journey back to balance.

About the Author:

Dr. Jennifer Olson-Madden is a licensed psychologist and expert in Acceptance and Commitment Therapy (ACT) and Cognitive Behavioral Therapy (CBT), dedicated to helping clients achieve purposeful and successful outcomes through inspired and committed action. With over 15 years of licensure in Denver, CO, and more than two decades of experience in anxiety and chronic stress. She not only practices ACT professionally but also integrates its principles into her own life daily.