Stress vs. Anxiety: How to Tell Them Apart

The American Psychological Association’s (APA) latest Stress in America report gauged the average American’s stress level at 5 out of 10. Sources of stress range from current affairs (e.g., politics, environment) to the rising cost of living. The silver lining here is that the level has stayed the same over the years.

While stress may be a natural reaction, it doesn’t necessarily mean it’s a good thing. It can lead to a host of mental health problems when left to compound over time, namely anxiety. The Anxiety & Depression Association of America (ADAA) estimates that around one in five American adults and one in three children suffer from anxiety-related disorders.

Stress and anxiety may be synonyms according to the typical thesaurus, but mental health treats them differently. And given the state of the world right now, let alone that of the U.S., knowing the difference is more crucial than ever.

Stress is Normal, Excessive Anxiety Isn’t

Anything that disrupts a body’s balance causes stress, whether it's hitting your toe against the drawer or worrying about next month’s rent. When that occurs, the body responds with a pair of systems that prepare it for the challenge.

The first is the sympathetic-adrenal-medullary (SAM) system, a short-term response that boosts the production of epinephrine and norepinephrine. Also known as adrenaline and noradrenaline, respectively, they’re involved in the body’s fight-or-flight response. They increase blood pressure and the delivery of glucose and oxygen to the muscles.

The second is the hypothalamic-pituitary-adrenal (HPA) system, a long-term response that releases corticosteroids to help the body recover from stress. One well-known hormone in this case is cortisol, which manages blood sugar, reduces inflammation, and shuts down body functions not needed for managing stress.

These systems working together are how a person experiences certain symptoms of stress, ranging from headache to insomnia. Once the cause of stress, called a stressor, goes away or is resolved, the symptoms decline over time.

With excess anxiety, however, the body remains in a state of alertness even if the stressor is no longer a factor. Because of this, the symptoms remain and start wreaking havoc and affecting a person’s lifestyle. For example, prolonged insomnia leads to a higher risk of health problems and difficulty concentrating and completing tasks during work hours.

The National Institute of Mental Health (NIMH) characterizes anxiety as a persistent feeling of dread that refuses to go away. You may have resolved the problem or situation, but you can’t help but fear that it might happen again in the future.

Unlike stress, which can be resolved by dealing with the stressor, anxiety-related disorders are treated through intervention. Treatment combines medicine, cognitive behavioral therapy, and lifestyle changes to help people cope with the symptoms. Get help from mental health professionals if you or a loved one struggles to live their everyday life.

Stress Has a Trigger, Anxiety Can Have None

Stress takes various forms, based on the nature of the source, the duration of the stress, and the body’s response to it. Below are the most common ones.

Identifying the root cause allows you to consider ways to address it—and more often than not, there’s more than one solution available. For instance, if you’re engaged in an intense argument with a friend or loved one, maybe you can take a break until cooler heads prevail. Then, try to stick to the matter at hand while finding common ground.

Anxiety, on the other hand, is a different story. Sometimes, the cause is either nonexistent or, in the case of generalized anxiety disorder (GAD), blown way out of proportion. In fact, researchers are still unsure what actually causes GAD, though they believe that stressors can contribute to one’s risk for it.

There are criteria for diagnosing GAD, however. According to the NIMH, there needs to be proof that the person is struggling to allay their worries daily for at least six months. Also, they must exhibit at least three of the following symptoms:

• Restlessness or feeling “on edge”
• Fatigue or constant exhaustion
• Having trouble focusing on things
• Irritability or feeling agitated
• Muscle tension
• Sleep problems

A more prevalent but equally mysterious form of anxiety is social anxiety disorder (SAD). Studies show that SAD has a lot to do with parts of the brain involved in fear and anxiety, along with genetics. Diagnosis is simpler, as it only requires the person to show an intense fear of social situations for at least six months and that they interfere with their daily life.

As anxiety can’t be pinned to a single cause, it can’t be cured the same way as diseases are treated. The medications used in treatment, while effective in relieving anxiety and other mental illnesses, are carefully controlled because frequent use increases the risk of drug dependence.

Stress Isn’t Always Harmful

The term “stress” is often used in a negative light. After all, to be “stressed out” means to feel the strain of a physically and mentally taxing situation. But it’s important to know that stress isn’t always harmful.

You may have heard of the word “distress,” but have you heard of the word “eustress?” It’s stress that benefits one’s health (given the Greek prefix “Eu-” meaning “good”) by fostering positive emotions. Eustress manifests when a person can expect a rewarding experience after completing a stressful task, such as passing the exam or finishing a fun run.

Eustress revolves around the Yerkes-Dodson Law, a psychological principle that suggests a rise in arousal coincides with improved performance. Arousal, in this context, refers to a state of alertness or excitement. At the midpoint between apathy and anxiety, performance reaches its peak before declining as arousal continues to rise.

But whether or not eustress is a thing, stress in general can be beneficial. A 2021 study on the benefits of a stressor-free lifestyle found that people leading such lives reported better well-being but less cognition than those who deal with stress. The study’s authors believe that the negative emotions associated with stress inspire people to be better.

Meanwhile, the same doesn’t necessarily apply to anxiety. Some argue that good anxiety exists in the same plane as eustress, but others like psychiatry author Rafa Euba caution against labeling anxiety as excitement. He argues that the euphoria after a rollercoaster ride isn’t the same as the kind of anxiety that hampers the lives of many.

That said, Euba also recognizes that anxiety can be beneficial in normal doses. If too much anxiety stays in the system for too long, this is no longer the kind of anxiety anyone wants. It pays to know what counts as good and bad.

Phobias are Anxiety Disorders

Fear is similar to stress in two aspects. First, it’s also a natural human reaction—a crucial mechanism that warns the body to exercise caution in dangerous situations. Without the capacity to be afraid of, say, a bear attack, your body won’t have any way to tell you to seek safety.

Second, and more importantly, fear turns into anxiety when it turns into a phobia. Mental health professionals define it as an irrational fear of something like an item, animal, or event. Phobias are considered anxiety disorders because the level of fear they cause tends to be disproportionate to the actual danger.

Specific phobia is the most common kind of anxiety disorder. Based on NIMH data, about 12.5% of Americans experience at least one phobia throughout their lives. Roughly half of phobia cases are mild, but the rest are either moderate or severe.

Virtually anything can qualify as a phobia, so the exact number of phobias isn’t concrete. However, The Phobia List—a website that’s been listing known phobias since 1995—has around 530 as of this writing. Among the most common include:

• Acrophobia: Fear of heights
• Aquaphobia: Fear of water (doesn’t involve any disease)
• Aviophobia: Fear of air travel (sometimes called aerophobia)
• Claustrophobia: Fear of closed or confined spaces
• Hydrophobia: Fear of water induced by late-stage rabies
• Phobophobia: Fear of developing a fear or phobia
• Social phobia: Fear of social interactions, an older term for SAD
• Zoophobia: Fear of animals

The last one, zoophobia, is more of an umbrella term because it rarely manifests as a fear of all animals. Instead, people feel afraid of at least one type of animal. Examples include dogs (cynophobia), snakes (ophidiophobia), and spiders (arachnophobia). In fact, the term itself is part of a more encompassing phobia called “biophobia,” the fear of living things.

For the record, anyone would be stressed at the sight of an unfriendly pooch or a snake in the house. However, a phobia involves thinking about worst-case scenarios even after the danger has passed or when a scenario is improbable to happen. Maintaining such a dangerous level of fear for too long can lead to panic attacks.

Stress, Anxiety, and Something Much Worse

So far, it’s established that stress is how the body responds to a certain situation. Anxiety is how the body responds to stress, primarily characterized by an intense feeling of dread. But when all that boils over, this chain can lead to something worse—even fatal.

First is depression, which, contrary to popular belief, isn’t the opposite of anxiety. Studies over the past decades have linked them, with half of the people struggling with depression also struggling with an anxiety disorder. If you think about it, having intense fears can ruin one’s day enough to send them into a slump.

Mental health experts say that anxiety disorders tend to occur before depression. Anxiety often begins before and during adolescence, whereas depression emerges upon entering late adolescence or adulthood. One study even found that SAD (ironically) could multiply the risk of developing a major depressive disorder by more than fivefold.

Anxiety is also linked to substance abuse, as most cases drink alcohol and smoke tobacco as their coping mechanisms. Although the exact science behind these has yet to be fully understood, it’s believed that alcohol urges the body to release dopamine to help people feel good, even if temporarily. The same can be said for the nicotine in tobacco.

That said, these substances are basically hijacking the brain’s reward system. By releasing dopamine and other “feel-good” chemicals, they motivate people to consume more to the point of addiction. The World Health Organization, alongside other bodies, have reiterated that no amount of alcohol or tobacco consumption is safe.

Then, there’s perhaps the most grim of all: suicide.

When researchers in Sweden looked at roughly 1,000 cases of deaths by suicide in 2015, they discovered that half of these were suffering from anxiety symptoms a week prior to their suicide. Adjusting for mood disorders, they also found that the risk of death doubles among people with said symptoms.

Even the act of entertaining suicidal thoughts is an emergency in its own right. In another study conducted in the U.S., it’s reported that 70% of suicide attempts meet at least one requirement to be diagnosed with an anxiety disorder like GAD or SAD.

Anyone whose anxiety has reached or is on the verge of reaching this point shouldn’t delay seeking help. Their emotional burdens are, at this point, too much to bear alone, hence the need for support from family, friends, and professionals.

Conclusion

Common English may treat stress and anxiety as synonyms, but they’re worlds apart when used in mental health. Knowing what it is and what it isn’t can be a matter of life and death, not just for you but also for your loved ones. Don’t hesitate to treat the warning signs of a brewing anxiety-related disorder as an emergency; seek a licensed therapist right away