There is a real difference between anxiety and stress, although one may cause the other. There are also important differences in how they are treated. Anxiety is a “fear” response. When you’re in danger (for example, a bear is chasing you), your nervous system revs up to increase your odds of survival. You become hypervigilant (acutely aware and sensitive to changes in the environment), you have an increase in adrenalin to help you run faster, your heart rate speeds up… All of these things happen instantaneously when you’re in danger so you have the physical resources to fight or flee. That is a “fear response”. Anxiety (“Panic” if it’s severe) is a “fear response” in the absence of danger. In other words, there is no “bear”, but it feels as if there is one, and you’re worried that there might be a “bear”. The only way to treat anxiety is to turn around and see that “there is no bear”. In other words, the treatment for anxiety involves facing your fears, not running away from them by avoidance, trying not to think about it, or trying to “just relax”. The more we avoid things that make us anxious, the bigger and more powerful that anxiety becomes. Sometimes it’s unrealistic thoughts that provoke anxiety. In that case, the thoughts have to be examined logically. To get rid of anxiety, you have to sit with it long enough for it to fade on it’s own. This might sound scary; that’s okay. An experienced Cognitive Behavioral Therapist will help you through it, and support you as you face down your fears, and cut them down to size.
“Stress” is the result of being alive. Working long hours, coping with the demands of a job, spouse, children, and family, illness, etc. all cause stress, even if you are not particularly anxious. Stress can make you feel tense, irritable, or overwhelmed. Muscle tension increases with stress. If you have any physical ailments or pain, muscle tension can make it worse. Stress can increase levels of cortisol in your blood, making it difficult to sleep or lose weight; stress can have negative effects on your immune system, leaving you more vulnerable to illness. Stress can cause changes in your hair and skin, and leave you feeling “run-down”. Lifestyle changes, relaxation training, and meditation can be extremely helpful in reducing stress. You might need extra support and assistance making healthy changes, and here again, an experienced Cognitive Behavioral Therapist can help. Much of the time, when people are stressed they turn to their physician first, and may be offered medications like an SSRI (Prozac, Paxil, Zoloft, Celexa, Lexapro etc.) or a mild tranquilizer such as Ativan or Xanax. If you have a long-standing history of depression or anxiety, medication can be a helpful adjunct to treatment. If you are stressed because of your situation, medication is seldom the treatment of choice. The situation needs to be addressed; changes made where possible, and new skills learned to cope in a healthy way with whatever stressors remain. That’s what “Stress Management” really is.
Stress and anxiety often go hand-in-hand. It may take several sessions with a therapist to “tease-out” or untangle the symptoms, the causes, and appropriate solutions. Whether it’s stress, anxiety or both, you do not have to face it alone.
(Key Words: Anxiety, Stress, Stress Management, Meditation, Cognitive Behavioral Therapy, SSRI, Prozac, Paxil, Zoloft, Celexa, Lexapro, Xanax, Ativan, Panic).