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Is it Stress or Anxiety?

Chronic stress and anxiety disorders are not identical. Learn why and when to seek help.

Ronesh Sinha, M.D.

Contributor

Ronesh Sinha, M.D.

Palo Alto Medical Foundation

Any busy person knows how it feels to wake up in the middle of the night, fretting over the to-do list roaring through the brain. But how do you distinguish between a constant feeling of stress and an anxiety disorder? And when should you seek help?

Woman stressed sitting at desk

Good and Bad Stress

Some stress is a normal part of daily life. Good stress, called “eustress,” can help you achieve difficult goals and to stretch your limits in beneficial ways—for example, to finish a big work project or complete a homework assignment. You feel pressure to achieve your objective, but it isn’t debilitating. It doesn’t make you ill. And it feels good when your reach your goal.

Negative stress, or “distress,” on the other hand, can make you ill, especially when it is intense, multifaceted or prolonged—or all three. 

“Think of the stress you feel when you are trapped in your car for a long commute, day after day,” says Ronesh Sinha, M.D., an internal medicine specialist at Palo Alto Medical Foundation. “It all adds up. More than 70 percent of doctor visits are said to be attributable to the effects of negative stress.”

Common physical symptoms related to negative stress include:

  • Fatigue
  • Gastrointestinal Problems
  • Skin Problems
  • Nausea
  • Headaches and Muscle Aches
  • Rapid Heart Rate
  • Increased Blood Pressure

Emotional and psychological effects can include:

  • Irritability and Anger
  • Frustration
  • Depression
  • Anxiety
  • Insomnia
  • Loss of Appetite or Overeating
  • Poor Concentration and Memory

How to Assess Chronic Stress

You may have learned to cope with your chronic stress so effectively it feels like normal life. Take a minute to assess how you’re really feeling right now:

  • Are your muscles tense, especially in the head, eyes, neck, shoulders and upper or lower back?
  • Is your pulse rate (particularly your resting heart rate) elevated or irregular, even when you are not moving?
  • Is your breathing shallow? Is it difficult to take in a really full breath?

In addition, your behavior and emotions may signal that you are over-stressed. Be honest about whether you are unduly irritable, depressed, anxious, antisocial, lacking enjoyment in pleasurable activities, eating or sleeping too much or too little, abusing alcohol or drugs, demonstrating anger such as road rage or temper flare-ups with family or coworkers, or having memory problems and trouble focusing or organizing.

What is an Anxiety Disorder?

Occasionally feeling anxious is also a natural part of life. For example, it’s not unusual to worry about a loved one or to feel fearful about an upcoming event, such as giving a speech.

However, when those worries and fears become highly intense and so unrelenting that they interfere with your ability to function in daily life, your normal anxiety may have tipped into an anxiety disorder. 

Anxiety disorders come in many shades, including:

  • Generalized Anxiety
  • Panic Disorder
  • Obsessive-Compulsive Disorder (OCD)
  • Social Anxiety
  • Post-traumatic Stress Disorder (PTSD)
  • Phobias

All of these anxiety types can range from mild to extreme, and symptoms can be continuous or episodic.

If you are experiencing unrelenting or extreme stress or anxiety, talk with your doctor about solutions. You may want to meet with a therapist who specializes in these issues, and your doctor may suggest medication as well.

Also consider taking a stress management course, such as Mindfulness-Based Stress Reduction; years of research supports its effectiveness in reducing the negative effects of stress. Finally, learn some easy techniques that can help you lower your stress level.

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  • Help for Clinical Depression
  • Addiction Treatment Options
  • Is it Sadness or Depression?
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