Anxiety and Stress, Part I: What’s the Difference Between Anxiety and Stress?

For the average American, a day full of stress and frustration is the norm. From the buzz of the alarm clock to the jingle of the evening news, with all the screaming children, demanding bosses, jarring advertisements, and incessant Facebook updates in between, it seems like there is never a minute to rest.

But what does all this noise and activity really mean? Is the never-ending rush of things to do really helping you lead a rich and fulfilling life? Or is it piling more worry on you than any human being should have to cope with? If this scenario sounds familiar, anxiety and stress could be taking its toll on your body and your brain in ways you never even imagined. Let’s discuss the difference between anxiety and stress by first learning about the different types.

Types of Anxiety

Anxiety disorders are among the most common types of mental illnesses in the U.S. About 18 percent of the population is affected, although 30 percent or more of people suffering from an anxiety disorder will wait ten years or more to get help. Anxiety disorders in general take a high toll on the healthcare system, costing billions of dollars in expenses; a significant portion of this cost comes from the fact that anxiety disorder patients often experience symptoms that feel like a physical illness and seek treatment for those symptoms, rather than getting treatment for their anxiety.(1)

There are six major types of anxiety disorders, although some experts break these down even further. Social anxiety disorder, or SAD, is one of the most common, affecting as much as 6.8 percent of the population. SAD is characterized by a feeling of anxiety during social situations, and in extreme cases, can prevent sufferers from enjoying even simple social excursions such as going shopping or eating out at a restaurant. Generalized anxiety disorder affects about 3.1 percent of the population. It is likely one of the most underdiagnosed anxiety disorders, as patients often have a hard time distinguishing between normal day-to-day stress and generalized anxiety.

Obsessive-compulsive disorder, post-traumatic stress disorder and specific phobias are also types of anxiety disorders that can occur. While each type has its own set of causes and complications, many of the physical, mental and emotional symptoms that they create are similar. Some of these can include:

• Stomach aches, headaches and nausea
• Sweating and shaking
• Extreme fatigue and/or inability to sleep
• Rapid heartbeat coupled with a shortness of breath
• Irritability
• Irrational fear
• Paranoia
• Always expecting the worst

Some people can experience a level of anxiety that isn’t linked to an anxiety disorder. This is usually aggravated by a tendency to linger on the mistakes of the past, worry about the unknowns of the future and forget to live in the present moment. This is one of the main factors that differentiates anxiety from stress; while anxious people experience fear about the past and the future, people experiencing stress are largely concerned only with the worries of the present and the immediate future, and irrational fear is usually absent.

Over time, high levels of fear-riddled anxiety can lead to an anxiety disorder, and for some, the sudden onset of a panic attack can mark the beginning of an anxiety spiral.(2)

Panic Attacks

Just about everyone has felt a sudden sense of fear for no reason at some point in their lives. A panic attack, however, is different from the ESP-like feeling of trepidation that can strike the average person. The attacks can occur seemingly out of the blue, with an intense and overpowering feeling that everything is out of your control, or that something disastrous is going to occur and there is nothing you can do about it, along with a feeling of what many sufferers describe simply as terror. There are also physical symptoms that happen alongside the terror, and over time repeated occurrences of these symptoms can lead to serious health problems.(3)

A panic attack starts in your brain. The chemical messengers norepinephrine and serotonin are believed to play a significant role, both in the development of panic attacks and in anxiety in general. These neurotransmitters send signals to the amygdala and hypothalamus, key brain structures for regulating your emotions as well as your more primitive instincts, which causes a release of adrenaline into your bloodstream.(4) This leads to the classic fight-or-flight response that can occur in anyone during an emergency, as well as the physical symptoms that happen during a panic attack:

• Increased heart rate and blood pressure
• Sweating, especially sweaty palms
• Difficulty breathing or hyperventilation
• Dizziness
• Muscle weakness
• Stomach ache
• Chest pain

In addition, the fear of when the next panic attack will occur can greatly add to the stress of a panic disorder. This can even become a self-fulfilling prophecy as the fear of another attack actually brings on another attack.

Brain Chemistry and Anxiety

Both the physical and mental symptoms of anxiety exist within human beings for a good reason. In the days when cavemen had to fight off giant predators, gladiators wrestled with lions, or hunters took down mammoth animals for their own survival, fear and anxiety served a very useful evolutionary purpose. A heightened sense of awareness of the environment around you during the fight-or-flight response has helped humans remain alert during potentially dangerous situations for millennia.

The stomach cramps associated with anxiety are related to the slowing of the digestive system, which is necessary to divert more energy to the heart and brain during an emergency situation. Fast, shallow breathing allows you to take in more oxygen during a shorter period of time, which can help your body respond more quickly to an attacking bear but won’t do you any good when the only threat is a social interaction. Even today, the physical symptoms of panic can be useful, for instance, when your child is running into the street and you need to be able to respond quickly.

So why do people still experience the fight-or-flight response of anxiety, even when there is no real danger nearby? Over-activity within the amygdala, the part of your brain that is known to play a role in fear response, is one likely answer. There is another area of the brain, known as the periaqueductal gray, that regulates defense mechanisms in dangerous situations. If you perceive a situation as potentially dangerous, the periaqueductal gray may overreact to minor threats—not life-threatening—and aid the process that sends your body into fight-or-flight mode.(5)

Scientists still don’t know the exact causes, but one thing is certain: your response to a stressful situation plays a key role in your body’s likelihood of experiencing panic or anxiety. Your mindset, in fact, may be an even more important factor in keeping fear and anxiety away when stress occurs than the whole arsenal of psychiatric medications available today.

References:

1. Facts and statistics. (2016, August). Retrieved from http://www.adaa.org/about-adaa/press-room/facts-statistics
2. Anxiety disorders. (n.d.). Retrieved from http://www.nami.org/Learn-More/Mental-Health-Conditions/Anxiety-Disorders
3. Panic disorder: When fear overwhelms. (2013). Retrieved from http://www.nimh.nih.gov/health/publications/panic-disorder-when-fear-overwhelms/index.shtml
4. Cuncic, A. (2016, January 25). What Happens to Your Body During a Panic Attack? Retrieved from https://www.verywell.com/what-happens-to-your-body-during-a-panic-attack-3024889
5. Ericson, J. (2014, March 19). What Happens In Your Brain When You Have A Panic Attack? How The Brain’s Fear And Threat Centers Backfire. Retrieved from http://www.medicaldaily.com