We hear a lot about anxiety these days. Although anxiety has been pervasive long before the COVID-19 pandemic, since 2020, it seems like almost everyone we know describes feeling anxious, or “having anxiety."
Anxiety is an encompassing term because it is used interchangeably to describe a state of experience related to a time-limited stress or stressful context AND it refers to an official mental health diagnosis due to its implications on functioning and mood in longer term ways. Both stress and anxiety are indeed emotional responses. But it might be helpful to distinguish whether you might be experiencing stress vs anxiety.
Stress is a reaction to a trigger that can be either short-term (e.g., an interpersonal conflict, a deadline or goal that you are needing to meet), or it can be long-term (e.g., a chronic illness, discrimination). It usually has an existing cause which activates a reaction.Stress can result in physiological issues (e.g., digestion problems, brain fog, fatigue) and mental or emotional difficulties (e.g., anger and irritability, feeling “frazzled”). Stress can be resolved once the stressor or trigger has diminished, though certainly chronic stress (stress that doesn’t seem to resolve over time or the additive effect of stress after stress after stress) has significant implications on functioning with outcomes reported like inflammatory responses in the body and chronic pain, sleep issues or even sleep disorders, hormonal disruption, cognitive dysfunction, and persistent emotional distress.
Anxiety, rather, is not simply a reaction to stressors, but is marked by persistent and excessive worrying, regardless of whether a stressor exists. The worries tend to be about a fear of something that might go wrong. A key to knowing if your worries reflect an anxiety disorder is the level of intensity of apprehension you have even if there isn’t a clear reason for it, and the duration of time that anxiety is experienced. Anxiousness that occurs over months, and persistently and negatively affects mood and functioning, would be classified as an anxiety disorder. The negative effect on functioning in this case might look an inability to enjoy activities (due to avoidance rooted in fear), or an inability to maintain work or interact with others. There are specific types of anxiety disorders that might result from a specific phobia/fear (like fear of being in public, or of flying, or of being in social situations). Generalized anxiety refers to hard-to-control worries (and oftentimes physical symptoms) occurring most days over six months or more and is generalized to a variety of issues. Panic disorder is an intensified attack of anxiety marked by physiological symptoms (e.g., heart racing, trouble breathing). Obsessive-compulsive disorder is an uncontrollable experience of recurring thoughts (obsessions), or repetitive behaviors (compulsions), or BOTH, which causes significant interference in one’s life day to day.
Stress and mild anxiety can be treated effectively with integrative coping strategies that target physical health: good sleep hygiene, proper nutrition/hydration, exercise, mindfulness; as well emotional wellbeing: self-compassion, support seeking, community involvement, and engagement in pleasurable activities. Acute, or short-term, stress can often respond well to physiologically supportive techniques like breathwork or physical activity, or behavioral coping like effective communication skills, boundary setting, and perspective-taking. Chronic stress, or when stressors last for a long duration of time, might result in more pervasive symptoms that require interventional strategies that also center on: distress tolerance skills, progressive relaxation or other mindfulness-based exercises, defusion/”unhooking” from unhelpful thoughts, self-compassion strategies, values clarification and committed action based on these values, as well as individualized attention to diet/nutrition, hormonal or nervous system support (if indicated), sleep hygiene, executive functioning support, and social support.
Anxiety disorders can be effectively managed by evidence-based, empirically supported clinical intervention. Medication management can often be particularly helpful and indicated for some people, especially when utilized in conjunction with behavioral psychotherapies. Gold standards in the treatment of anxiety disorders include: cognitive behavioral therapy (CBT) which help individuals work through maladaptive thoughts (worries); exposure and response prevention (ERP) therapies, which involves assisting individuals in facing anxiety triggers in safe and systematic ways to break fear cycles that contribute to the anxiety; acceptance and commitment therapy (ACT) which facilitates in letting go of controlling thoughts and emotions that contribute to anxiety and choosing engagement in activities that align with chosen life values; and, mindfulness-based therapy which teaches paying attention to the present moment in non-judgmental and non-attached ways so as to bring awareness to habitual thinking that leads to anxious spirals.
You can use this information to begin to assess for yourself whether you are having a situational reaction to an event (stress), or monitor the duration of your distress and the impact it is having on your daily life to decipher if an anxiety disorder might be present. Seeking professional support to screen for and/or diagnose, and to learn skills for coping with either issue, is useful and can help you navigate your experience in a way that can lead to a life of vitality. It’s also important to recognize that stress and anxiety can be helpful sometimes! Stress can be a positive motivator, facilitating action, or productivity, or creativity. Anxiety can help you to be aware of your environment and your experience and it can tell you a lot about what matters to you. Your willingness to acknowledge your experience, gain more understanding of the function of your emotional response (why it’s happening), and take action to support yourself will undoubtedly help you cope more effectively and bring you back to thriving!
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