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Am I Anxious or Am I Just Stressed Out?

Am I Anxious or Am I Just Stressed Out?

 You've noticed a pattern. You lie awake at night, your brain defying your will to sleep. Worried thoughts parade through your mind instead of sheep. You wake up tired and wishing you could just stay home. You love your friends but keep ending up alone. During your morning drive, you think about what could go wrong that day and say, "I knew it!" when things don't go your way.


You read articles on the internet. You look up your symptoms and cringe. You finally experience some relief when one diagnosis matches your symptoms better than anything else: anxiety. But what does it mean to have anxiety? Does it mean you have a disorder? Does it mean you need medication?


You might, but you also might just be having a natural reaction to stressful circumstances. Anxiety is a normal human experience, and we're living in anxious and uncertain times. Just because you're feeling anxious doesn't mean you have a disorder or need medication. But if you do, finding out is good news. It is possible to fully recover from anxiety with the right care.


How can you tell when you need treatment for anxiety? We're here to help. Read on to learn more about the difference between everyday anxiety and clinical anxiety.


Normal Anxiety Versus Anxiety Disorders


The most important way to distinguish passing anxiety symptoms from a disorder is how long you have them and how intense they are. Ask yourself these questions: 

  • How often do I feel anxious?
  • How intense is the anxiety I feel?
  • How much does my anxiety affect my life?
  • Has anxiety ever caused me serious problems at work or home?
  • How long have I been experiencing symptoms of anxiety and stress?


Another term for "normal anxiety" or everyday anxiety is situational anxiety. It's normal to experience anxiety when you're in a stressful situation. One way you can tell whether your symptoms indicate an anxiety disorder is if the symptoms go away when the situation is over.


When you have an anxiety disorder, your symptoms are frequent and chronic. In other words, your anxiety doesn't go away even when nothing stressful is happening. Your anxiety is also out of proportion to the circumstances. You feel just as bad, or even worse, when you're worrying about something as you do during or after the worst-case scenario you worried about.


One of the most important differences between situational anxiety and an anxiety disorder is how it affects your functioning. People with everyday anxiety are able to cope with and bounce back from anxiety. Their anxiety goes away when stressful circumstances pass, and any effect it has on their work or home life is minor and temporary. On the other hand, anxiety disorders are chronic and interfere with a person's ability to complete daily tasks. Severe anxiety can cause people to become socially withdrawn and have serious problems at work or school.


To learn more about the differences between clinical anxiety and everyday stress, let's meet Margaret and Pauline. Margaret has an anxiety disorder, while Pauline does not.


Margaret vs. Pauline


Margaret and Pauline are both stressed about work. They're having to work overtime. Each has to give a presentation in a few weeks. They're both experiencing classic symptoms of everyday stress and anxiety. They feel tired and irritable. They worry. Their muscles are tense.


Both Margaret and Pauline play their favorite music on the way home from work. However, Pauline is able to let more of her stress go during the ride. She goes straight from work to the gym, where she's able to work out even more of her stress. Margaret, on the other hand, is so stressed out that she's stopped going to the gym. And while Pauline spends Fridays venting to friends, Margaret has become withdrawn and hasn't spoken to anyone in weeks.


Margaret never fully releases her stress. Desperate for relief, she's been drinking more than she wants to drink. But as soon as the alcohol wears off, her mind is flooded with worried thoughts again. Margaret tosses and turns and wakes up in the middle of the night. Pauline falls asleep easily. Pauline is healthy while Margaret is often sick. Chronic, relentless stress has weakened Margaret's immune system. Because while it's been worse lately, she's been anxious for years.


In the days leading up to the presentation, Pauline's stress increases. Like Margaret, she starts drinking a little too much and loses some sleep. She misses a workout. But she makes sure she goes to the gym the next day. She decides not to drink while she's feeling this way because she knows it makes things worse. She works hard and nails her presentation. She gets a promotion.


Margaret is just as smart as Pauline, but she can't envision a situation in which she doesn't fail her presentation. Anxiety won't let her imagine anything other than disaster. The stress is so overwhelming that she quits her job without notice a week before she's due to give her presentation. It's the third job she's quit in the past year.


What Do I Do If I Have an Anxiety Disorder?


If you feel more like Margaret than Pauline, you might have an anxiety disorder. One of the first things you should do if you notice that anxiety has been interfering with your everyday life and getting in the way of your goals is to seek a professional opinion and get assessed for anxiety.


You may be able to get diagnosed and treated for anxiety by your primary care physician (PCP). Many people with mild anxiety can recover with the help of an anxiety medication prescribed by their PCP. However, your general care doctor probably does not specialize in mental health and may not be able to diagnose or treat more complicated or severe anxiety. For best results, we recommend setting up an appointment with a mental health professional. You can use our therapist search tool to find an affordable therapist near you.


Most therapists can't prescribe medication, but we think it's best to start with one. First, it's usually easier to get an appointment with a therapist than a psychiatrist. It's also possible to successfully treat even severe anxiety disorders without medication, and therapy is frequently recommended as part of the treatment plan for anxiety. If you do need medication, it can be easier to get an appointment with a psychiatrist if you're referred by your therapist.


The kind of treatment you'll receive will depend on your diagnosis and the severity of your anxiety. Anxiety disorders you might be diagnosed with include generalized anxiety disorder, social anxiety disorder, and panic disorder. We'll talk more about how those are diagnosed in the next section.


For more information on getting started with a therapist, you can read our article on "How to Choose a Therapist." For more information on treatment options for anxiety, you can read our article on therapy versus medication, which includes a section on therapy versus medication for anxiety.


How Do Doctors Diagnose Anxiety?


Some people who get diagnosed with anxiety by their doctors had no idea they were anxious. They thought they were having problems with their heart, stomach, or immune system. Stress and anxiety have physical effects that are easy to mistake for symptoms of medical conditions. (The reverse can happen, too, which is why it's important to get annual wellness exams from a doctor.)


Many of the physical symptoms of anxiety are caused by an overactive sympathetic nervous system. This network of brain, nerve, and body responses is often called the "fight or flight response." Signs your sympathetic nervous system is active include: 

  • Sweating
  • Restlessness
  • Muscle tension
  • Rapid breathing
  • Shortness of breath
  • Increased heart rate
  • Heart palpitations
  • Trembling or shaking
  • Slowed or blocked digestion


In cases of extreme or heightened anxiety, you might experience a full-blown sympathetic nervous system response. These effects are part of what cause people who are having panic attacks to feel like they are having a heart attack or dying. Symptoms of a panic attack can include any or all of the symptoms listed above.


Most of the time, however, anxiety is subtler. You don't always sweat when you're stressed out, and your heart rate doesn't always speed up. But you might physically tense up. You might lose your appetite, feel tired, or have trouble sleeping.


The symptoms of everyday stress and symptoms of anxiety disorders aren't that different. Symptoms of generalized anxiety disorder listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM), the primary reference guide for psychiatric diagnosis, include: 

  • Having trouble controlling worried thoughts
  • Feeling restless, keyed up, or on edge
  • Having difficulty concentrating
  • Feeling tired a lot of the time
  • Experiencing muscle tension
  • Having trouble sleeping
  • Feeling irritable


These and many other anxiety disorder symptoms are also symptoms of everyday stress and anxiety. You've probably had at least one time in your life where school, work, a relationship, or something else stressed you out so much that you couldn't sleep and worried a lot about it. So how can you or your doctor tell if you have one of these disorders or are just experiencing the effects of everyday anxiety?


One of the criteria listed for almost every DSM disorder (anxiety disorder or otherwise) is that the condition must "cause clinically significant distress or impairment in social, occupational, or other important areas of functioning." In other words, if you're struggling to maintain work and relationships like Margaret, your anxiety is more intense, and more likely to indicate a disorder, than if you have anxiety symptoms, but do the thing anyway, like Pauline. Another important sign of an anxiety disorder is just how heavy and relentless it is. It's not just something you experience for a day or a week.


We recommend consulting with your doctor or setting up an appointment with a therapist if your symptoms of anxiety make you feel terrible most of the time or have a serious impact on your daily life. While anxiety can derail your life, it's also highly treatable. You can recover fully with the right treatment. So, reach out—the help you need may be only a call or click away.

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Stephanie Hairston, MSW
Posted on 07/30/2020 by Stephanie Hairston, MSW

Stephanie Hairston is a freelance mental health writer who spent several years in the field of adult mental health before transitioning to professional writing and editing. As a masters-level clinical social worker, she provided group and individual therapy, crisis intervention services, and psychological assessments. She has also worked as a technical writer for a medical software company and as an editor for a company that appeals denials of insurance coverage for behavioral health treatment. As a writer, she is motivated by the same desire to help others that brought her into the field of social work and believes that knowledge is one of the most essential recovery tools. She strongly believes in the mission of OpenCounseling and in making therapy accessible for everyone.