Worry vs. Stress vs. Anxiety: What’s the Difference?
By Peggy Loo, PhD
People tend to use terms like worry, stress, and anxiety interchangeably. I’m a big believer in promoting mental health literacy through clarifying terms and definitions. (If only so your therapist has an accurate understanding of what you’re experiencing so they can best help you!)
While there are definitely similarities across all three, it’s incredibly helpful to know the key differences. My patients have said that it’s also super helpful and relieving to realize that stress, anxiety, and worry can be a completely healthy and understandable responses to a life situation. Meaning that it’s not automatically a sign there’s a problem or something that needs to be “fixed”.
While it may not feel great to be stressed, worried, or anxious, each response has a purpose and can help us adapt effectively to a situation. What it comes down to is if stress, anxiety, and worry become persistent and disruptive in your life.
So let’s start with definitions of each from a psychologist’s point of view.
What is the difference between stress, anxiety, and worry?
What is stress?
Stress is a response to an external pressure or situation. Stress is caused by something outside of yourself, like an important deadline or the subway unexpectedly running late. For example, I would say “I’m stressed because my boss pushed up my deadline” or “That traffic was stressful because I got a late start to my morning”.
Since stress is externally triggered and situational, we can often point to the cause of our reaction. More importantly, we can expect that our stress is alleviated when the situation passes. Stress works by telling us there’s an increased or unexpected demand on our energy or resources - which moves us towards managing both more thoughtfully or effectively.
What is anxiety?
Anxiety is a broad spectrum of physical, mental, or emotional symptoms that can occur in response to an unknown, future occurring scenario.
There is an important difference between fear and anxiety. We feel fear in response to a specific, present-tense threat. Fear is designed to enable survival in the moment to something immediately dangerous. For example, if I unexpectedly encountered a bear while hiking with friends, fear would be an appropriate, survival-oriented response. It would alert me to existing danger so I could run or protect myself from harm.
We feel anxiety in response to a future scenario or perceived threat. While anxiety might motivate me to protect myself in some ways, I am focused on a threat that hasn’t yet occurred (and may not)! To use my previous example, I might feel anxious about encountering bears while packing for my hiking trip.
What is worry?
Worry is one of the most common symptoms of anxiety. Worry is a persistent, repetitive, and often uncontrollable chain of thoughts. Worry has more to do with the internal experience of “being in your head”. Worry might be very specific, or it may be quite general and you find yourself hopping from concern to concern in your head.
If worry is time limited and specific, sometimes it can work by inspiring us to problem solve or focus on an aspect of the situation we do have control over. However, worry can also easily “spiral” or become overwhelming to the point where we feel like we make no progress or waste time worrying. Worry may be triggered by external events or it may be triggered internally (e.g., by your own thoughts, memories).
Now that you know some of the major differences between stress, anxiety, and worry, let’s return to anxiety.
Is anxiety bad?
I make sure my patients know that some anxiety can be helpful. Anxiety is an arousing, or activating experience.
If you are familiar with the Yerkes-Dodson law, which illustrates the relationship between arousal and performance, you know that arousal isn’t a bad thing. Think of the first half of a bell curve shape or upside down letter “U”. Research has shown that increasing arousal positively corresponds with improved performance. A moderate level of arousal causes us to become more alert, attentive, and motivated.
For example, let’s say I have a work presentation next week. Not knowing how I will do or what my boss may say may increase my stress and anxiety - however it will also encourage me to prep in advance and pay attention to details that would help me create a great presentation. As is the case with all of our emotions (yes, all of them) - each has a built-in function that is meant to serve us in a helpful way.
Where it gets tricky is when the emotion overrides its helpful function. When this happens, we end up being hindered rather than helped by our feelings. This is often the case for anxiety.
Think of the second half of the bell curve. When there is too much arousal, performance goes down or is impaired, often because we are physiologically flooded (with adrenaline or cortisol), emotionally dysregulated, and mentally scattered. This negative type of experience is more often what we think of when talking about anxiety, which is when it presents in its more distressing, extreme forms.
Again, while some anxiety can be helpful, experiencing overwhelming anxiety erodes our emotional and physical health over time. Remember that anxiety is future-oriented, so an unfortunate side effect of anxiety is not only that there’s always something we could be anxious about, but we are also distracted and rarely living in the present.
What are the signs of anxiety disorder?
Most new or unexpected situations require adjustment, which can understandably cause some mild anxiety or stress. However, these emotions are usually proportionate to the context, shorter-term, and eventually resolve themselves as you adapt externally and internally. Even if it is uncomfortable at times to worry or stress, people are often able to creatively problem solve, reach out for support or resources, and manage without significant negative consequences.
However, if you are experiencing ongoing symptoms of anxiety or notice that your anxiety is starting to affect your physical health, work, or personal life - or if it starts to last months (versus days or weeks) - it may mean that you have what is called an anxiety disorder and benefit from counseling with a mental health professional.
Some examples of more significant anxiety symptoms are:
Persistent feeling of apprehension or dread
Ruminative thinking or racing thoughts that feels out of control
Imagining the worst-case scenario
Poor concentration or high distractibility
Increased heart rate or chest tightness
Shortness of breath
Feeling “keyed up”, jittery, or on edge
Difficulty falling asleep or staying asleep
Muscle tension or soreness
Upset stomach or knots in your stomach, intestinal or stomach problems not explained by a health condition
Increased or decreased appetite, weight gain or loss
Anxiety affects people differently
Sometimes serious anxiety manifests for one person in somatic, or physical ways; for others, they describe “spiraling” and racing thoughts. For most, anxiety is often a combination of both physical and cognitive symptoms. Since the experience of anxiety can be such a broad one, it’s not surprising that anxiety is the most common mental health concern reported by adults in the United States, affecting one in five adults, or nearly 20% of individuals over 18 years of age.
Don’t panic: anxiety disorders are very treatable
Generalized anxiety disorder, social anxiety disorder, panic disorder, various phobias, and obsessive-compulsive disorder are all types of anxiety disorders that present differently or affect various parts of your life. Each can feel debilitating but they are highly treatable and respond positively to psychotherapy and at times, medication.
Types of therapy that help with anxiety
Cognitive Behavioral Therapy (CBT), Mindfulness Based Cognitive Therapy (MBCT), Emotion Regulation Therapy (ERT) are examples of specific therapies that are proven effective in treating anxiety. Each of these approaches help you address the mental, emotional, and physical aspects of anxiety with targeted skills and strategies. Despite research that clearly illustrates how treatable anxiety disorders can be, only about 35% of adults seek professional support.
Can therapy help with anxiety?
Yes! Therapy for anxiety can be tremendously beneficial. First of all, experiencing strong anxiety often makes us feel out of control, incompetent, exhausted, or sabotaged by our own bodies and minds - which is an awful way to feel. Working with a therapist helps you remember that you are not alone, and that things can get better. Therapy can demystify what anxiety is and act as a stabilizing source of support while you learn to make changes that lessen the unwanted effects of anxiety in your life.
Therapy for anxiety can help you:
recognize and replace unhelpful ways of thinking
learn skills that counteract anxiety and encourage groundedness
create personalized strategies that replace unproductive ones
increase self-awareness about your symptoms or triggers
build confidence that you can manage your anxiety successfully
One of the toughest things about anxiety is that we often unknowingly reinforce or exacerbate anxiety in our efforts to manage it. Remember that anxiety is an activating experience, and can even feel like a protective instinct (e.g., if I’m panicking, there’s probably good reason, so I’ll keep it up) However, much of anxiety treatment is meant to slow you down and decelerate your mind and body, which can feel unnatural or counterintuitive.
Other ways of treating anxiety
In therapy you may also discover additional resources or ways of reducing your anxiety, such as support groups, psychotropic medication, or lifestyle changes like regular exercise or self-compassion. These resources can further re-instill a sense of hope and agency that chronic anxiety threatens to extinguish. While seeking therapy for anxiety can and often provides immediate and significant relief, the ultimate goal of therapy is to develop the resiliency to cope with life’s stressors without sacrificing the ability to experience joy, gratitude, or calm.
Sometimes anxiety can feel like a regular part of your daily life or even your identity - but that does not need to be the case! It’s never too late to seek support for your anxiety and feel better. If you are interested in professional support for your anxiety, book a free 15-minute consultation to learn more.
About the Author: Peggy Loo, PhD is the founding director of Manhattan Therapy Collective and has extensive experience treating anxiety disorders such as generalized anxiety disorder, panic disorder, and social anxiety. Some of her favorite solo strategies for anxiety involve grounding by laying on the floor, deep breathing, and non-cheesy self-compassion exercises.