Do I have anxiety or worry: What’s the difference?

Have you ever thought about starting a new job or school, and found your heart pounding and your mind racing with a series of “what ifs”? If so, you may wonder “do I have anxiety?”

Anxiety is your body’s natural threat response system. When your brain believes you are in danger, it sends out a series of signals to your body, resulting in the fight-or-flight response.

Worry is a component of anxiety symptoms

Anxiety has three main components: emotional, physiological, and cognitive.

Imagine you have a presentation coming up at work. You might notice feelings of fear and dread, two examples of the emotional component. You may also notice bodily sensations, such as heart palpitations, sweating, or a tightness in your stomach, which represent the physiological component. Finally, you might be thinking, “I can’t do it,” or “I’m going to embarrass myself.” Worries and negative thoughts like these about what might happen in the future are the cognitive component. So, while worry is an important part of anxiety, it is only one of the three main building blocks.

The anxiety disorder spectrum

Anxiety in itself is not bad. Normal levels of anxiety lie on one end of a spectrum and may present as low levels of fear or apprehension, mild sensations of muscle tightness and sweating, or doubts about your ability to complete a task. Importantly, symptoms of normal anxiety do not negatively interfere with daily functioning. They may actually improve your attention and problem-solving, motivate you to work harder toward a goal, or warn you about a potential threat. For example, anxiety about an upcoming exam will likely drive you to prepare fully, and the anxiety a hiker might experience when encountering a bear allows the hiker to run away to safety. These examples demonstrate how normal levels of anxiety can be adaptive and helpful to your everyday life.

Clinical levels of anxiety fall toward the other end of the spectrum. Diagnosable anxiety disorders occur when anxiety levels rise enough to rapidly decrease performance and cause impairment.

How would you know if you have crossed over into the zone of a full-blown anxiety disorder? Anxiety disorders are characterized by severe, persistent worry that is excessive for the situation, and extreme avoidance of anxiety-provoking situations. These symptoms cause distress, impair daily functioning, and occur for a significant period. For instance, a person who needs to stay home from work several days in a row due to panic attacks is likely suffering from an anxiety disorder.

Different evidence-based treatments are most effective for different anxiety disorders. For example, a man suffering from panic disorder would likely benefit from exposure therapy, while a woman suffering from social phobia might be best treated with cognitive behavioral therapy (CBT). If you believe you may have an anxiety disorder, seek help as soon as possible.

What Is “almost anxious” and how can you handle it?

As anxiety moves along the spectrum from normal to clinical, a gray area in the middle may still have a negative impact on your life: the “almost anxious” region. When the level of anxiety you experience is no longer adaptive or helpful to your performance and becomes a barrier to your enjoyment of life, but does not yet meet the diagnostic threshold for an anxiety disorder, you are “almost anxious.” You might find yourself struggling to focus your attention on tasks, distracted by negative thoughts, fear, or unpleasant body sensations. For example, someone who is “almost anxious” may sit at their desk all day, making minimal progress on an assignment due to constant worries and tightness in the stomach. While anxiety did not make it impossible to come to work, the level of anxiety experienced is making it hard to function. Using this concept of “almost anxious” can help you catch anxiety before it becomes too extreme, and target it using evidence-based strategies that help move anxiety back along the spectrum to an adaptive level.

When you find yourself feeling too anxious, try evidence-based techniques highlighted in the book Almost Anxious to bring your anxiety levels back to normal. Here are a few tools to try:

  • If you find yourself thinking, “I can’t do this,” “I’ll never get this assignment done,” or a similar negative thought, challenge this by asking if it is valid or helpful. You will likely find that these thoughts are merely fueled by your anxious brain, so stopping them in their tracks is important.
  • If your thoughts seem to be spiraling out of control, take a few minutes to practice mindfulness. Focusing on the present moment takes your thoughts away from the past and future, helping you re-center yourself.
  • Identify situations that make you anxious, and approach them instead of avoiding them. For example, if you are afraid of public speaking, talk in front of others as often as possible. Over time, you will find the discomfort fades away as you face the very things that used to cause you anxiety!

Comments:

  1. Gail Robinson

    I had severe anxiety and depression for six years. I was treated with transcranial magnetic stimulation (TMS) for this. All my symptoms are now gone! I have become an advocate for this treatment. It continues to be improved–one in two patients treated get better and one in three get complete remission!

    There is also a product called a “brain stimulator” by Fisher Wallace. It is FDA approved, and requires a prescription, AND there is a money-back guarantee!! It is also pretty inexpensive. It is marketed for anxiety disorders.
    All these are exciting developments for people with anxiety or depression!

  2. Gail Robinson

    I had severe anxiety and depression for six years. I was treated with transcranial magnetic stimulation (TMS) and all these symptoms are now gone. I am quite an advocate for this treatment. One in two people improve, one in three with depression get complete remission from depression.
    There are also some new products available for sale –the Fisher Wallace “brain stimulator” is the one I am familiar with. It is FDA approved, comes with a money back guarantee. Since one has to have a prescription for it, I am impressed. It is inexpensive, relatively speaking. I am writing all this in hopes it helps someone else!

  3. Arleen Schinke

    Only those who have experienced depression/anxiety can relate to and really treat it properly. The ability to empathize, which is so critical, only comes with the actual experience. I call it “God’s gift” for going through this particular Hell because it can’t be acquired any other way.

  4. Hope beyond Hope

    I have struggled with anxiety and depression all my life. I was diagnosed and treated for my condition when I was 14 years old. I began taking Prozac in 1992 and I continued to take it until my anxiety became so bad I had to try something else. I have a patern of coming off my meds when things are going good and it never ends well. I have finally come to the conclusion that I will never be completely free of this disorder, but I work daily to exercise what control I do have over my situation. I have found that a combination of faith, exercise, good rest, a healthy diet and for now Lexapro have helped me get through my daily life without complete panic attacks. One of the most frustrating things about this disorder is the fact that it feels like their is no way to control the way I respond to my environment and what life throws at me some days. What I do find comfort in is knowing that with God’s help , my network of friends and community I can face the future one day at the time. I have tried to commit suicide several times in my life , because I have felt so overwhelmed with my circumstances. I feel very misunderstood even by my own family. I feel like I am a burden on my family and wish more than anything I could function like a “normal “ person. I am thankful for publications like this that make readers aware of this disorder and for the helpful tools you have provided. However, sometimes you simply can’t avoid the anxiety.

  5. Kelly Corrigan

    I don’t think you have ever had anxiety. It is life altering and haunting. There is no escape. You can’t stop your mind for excessive thoughts. You are not nor can you be mindful of the situation. You have dug your yourself into an endless pattern of fear.

    With worry you are present . You know what you are experiencing and have the ability to recognize an event is about to occur or is occurring.
    Good or bad. You may be able to cope, or adjust the situation.

    I do not believe physicians are taught or want to deal with worry or anxiety. They both require time with the patient and extreme empathy.

  6. Mary

    I’m afraid this article is too anodyne to help the anxious. I deal with anxious students frequently and 1) their situations and psychological/biological conditions are much more complex than these elementary (and very middle-class) examples and 2) they sound like the kind of advice from the non-anxious that makes my anxious students feel misunderstood and dismissed (and thus, alas, more anxious). They can’t just “ask themselves if their anxiety is useful”–never mind “valid”! They haven’t got “a few minutes to practice mindfulness.” Could you come back to us on this important topic with a slightly franker, meatier article? I suspect it’s written this way to keep anxious people from getting anxious reading it, which is a kindness, but in my experience people feel better if the truth of their situation or condition is seen and addressed. Sub-clinical anxiety is an awful way to live, so all power to you in trying to reach out.

  7. Darin M Flynn

    Thanks for the great article. It is very helpful to remind ourselves that some anxiety is normal. Unfortunately, when a patient feels anxious, it is too common to label and diagnose it as a disorder. As with other life-altering diseases, this dilutes the diagnosis much like someone “has cancer” who had a small basal cell carcinoma removed from an extremity who is grouped with a glioblastoma patient who also “has cancer”. Thanks again.

  8. azure

    ” challenge this by asking if it is valid or helpful.” Um, one of the problems that comes w/anxiety is that the negative thoughts seem realistic and valid. So asking oneself if they’re valid is going to get (for some people anyway), YES. What then?

    Trying to learn to see thoughts as just thoughts, not necessarily defining reality for her/himself. What reality is, since people seem to have significantly different ideas about what constitutes “reality”–for example Reuters has an article re: how few MDs know/realize that cancer patients are way too often faced with what the article calls “financial toxicity” or that their treatments to deal with the cancer may put them into substantial debt (i.e., they may need to file for bankruptcy) they may lose their home, they may have cut back on food (according to the article, true for 1 in 5 of white or Asian women, for 50% of black and Latino women–that’s in the US, allegedly the ‘wealthiest nation” in the world–the one that refuses to provide affordable health care to its residents).

    Seems that the typical oncologist’s reality is that: (1) oh is that happening? Who knew? and (2) not my problem, couldn’t possibly affect the success of treatment, now could it?

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