I asked Dr. Natalie Arnette to help me understand the difference between anxiety and stress because this time of year can be very hectic for my students. Her answer was so helpful that I asked Dr. Arnette to write a blog featuring our discussion.
As a psychologist, I field many questions from friends, neighbors, and acquaintances. I welcome these, and feel that elevator conversations or “coffee talks” about topics related to my work are one small contribution I can make toward de-stigmatizing mental illness. Over the years I have repeatedly found myself discussing horrific events (“Why did that person DO that?”) and attention problems (“Why can’t she sit STILL?”) in equal measure. Recently, however, the questions have changed. I have noticed a pattern in my conversations at cocktail parties and neighborhood cookouts: everyone is stressed! Elementary students have over-booked schedules, middle school students have more homework than can possibly be finished, high school students worry that every quiz grade will keep them from the college-job-life that they dream of, and college students fear they will never actually get a job. Their parents, by the way, worry about all of that, and more! When you live in such a pressure-filled environment, it is difficult to know when stress crosses a threshold into something more! The primary question I get today is “Is this anxiety, or just stress?”
Good question, right? How do we know? By definition, stress is a normal response to a threatening situation. In this case, “threatening” just means aversive, not scary! Big-city traffic is a threat that leads to stress for most people in my area. Anxiety is a response to that stress, and for many people, can lead to significant impairment in functioning. Imagine a sense of overwhelming dread or panic at the thought of your morning commute in traffic, rather than mere annoyance. Perhaps that dread or panic is so extreme that you can’t bring yourself to get behind the wheel, so you miss school or work. That’s “impairment in functioning,” and that’s anxiety.
To be fair, anxiety at some level can be a normal response to challenges, and in certain circumstances, can even help us cope with intense situations or improve performance. Most people have had experiences in which they have used anxiety in such a way, whether it is getting “pumped up” for a big game or honing concentration on a difficult task or test. But, when anxiety becomes an excessive, irrational dread of everyday situations, it can become a very disabling condition.
Of the 40 million adults in the United States who suffer from anxiety disorders, 75% report that their symptoms were present before age 22. About 8 percent of adolescents ages 13-18 meet the criteria for an anxiety disorder, with many reporting that symptoms emerged during elementary school. Anxiety disorders are one of the most commonly occurring mental health concerns on college campuses; about 13% of US college students have been diagnosed with a mental health disorder such as anxiety or depression. Stress-levels are at an all-time high among student populations of all ages, which has a negative impact on anxiety, depression, or related conditions. Given that anxiety disorders often co-occur with other conditions, including substance abuse issues or disordered eating, it is clear that anxiety should be on the radar of all parents, educators, and students. Anxiety is very, very common!
So what can we do? The good news is that anxiety is also very, very treatable! If you recognize that your stress or anxiety has started making it hard for you to do your best at work or school, or are concerned about someone in your life who seems to be struggling with anxiety, help is available. Depending on the level of impairment, help might come in the form of a friendly listening ear or a new commitment to self-care. Many people find that they are better able to manage their stress when they carve out time to focus on things like consistent exercise, healthy diet, and adequate sleep. Involvement in yoga, meditation, or moderate physical exercise (brisk walks on a cool fall day for stress management? Just what the doctor ordered!) are great ways to improve your response to stressors. Using a self-help app, or engaging a friend or family member as an ally in your efforts to manage stress are also excellent strategies.
What if it isn’t “just stress”? When dealing with clinical levels of anxiety, these techniques can be an important foundation for treatment, as well. I often speak with anxious clients about sleep issues, for example, before we move on to addressing the core fears. If a person doesn’t receive adequate rest, it is very difficult to “work” in therapy (or any other context)! However, many individuals with anxiety disorders need to change their thoughts about the stressors in their lives, as well as make behavioral changes, in order to bring about improvement in symptoms. Cognitive Behavioral Therapy is a therapeutic intervention that has been well-studied, can be used with or without medication, and is the gold-standard treatment for anxiety disorders. A therapist using this approach can help an anxious individual address distorted patterns of thinking that perpetuate anxiety, as well as guide behavioral changes that can help the person truly find symptom relief. Helping a child, adolescent, or adult with anxiety is the highlight of my day, because I so often get to SEE the light bulb go off as the person recognizes the patterns of thinking and behaving that keep them stuck in anxiety, and witness the smile as it returns!
Natalie C. Arnette, Ph.D., LLC Licensed Psychologist Roswell, GA www.drarnette.com
Online Resources Anxiety Disorders Association of America – www.adaa.org National Institute of Mental Health – www.nimh.nih.gov American Psychological Association – www.apa.org Child Anxiety Network – www.childanxiety.net