Understanding Anxiety and Stress: A Comprehensive Guide for Adults
With nearly a decade of experience as a psychotherapist, I've witnessed the widespread use of terms like "anxiety" and "stress" in everyday discourse, pop culture, and social media. These concepts, often thrown around casually, actually have a significant impact in clinical settings.
This guide is your bridge to understanding the clinical aspects of anxiety and stress without diving into overly technical language. Our mission is to empower you with the knowledge required to distinguish between the common experiences of anxiety and stress and their clinical implications.
The objective of this comprehensive guide is to empower you with knowledge about anxiety and stress, their consequences, identification, and management. If you're seeking practical, research-based strategies that can be applied immediately, you've come to the right place.
Section 1: What Is Anxiety and Stress?
Everyday Anxiety
Anxiety is a natural experience that we all feel from time to time. It may happen right before a job interview or presentation, when checking our bank account and realizing we're short on funds, or while walking back to our cars at night in an unfamiliar part of town.
Anxiety has multiple symptoms including physical sensations like sweating and nail biting, mental challenges like worry and racing thoughts, behavioral reactions such as pacing and shaky feet, and emotional signs like fear and guilt. Anxiety is a necessary experience that helps us stay safe and alive.
TIP: Our brains are wired to protect us based on past negative experiences and anticipation of future ones.
Common Stress
Stress is similar to anxiety in that it's a natural experience that shows up in uncomfortable ways. Often, it can feel like a weight on our shoulders, resulting in headaches or tension, lead to a lack of mental capacity, or trigger bursts of energy that are difficult to control.
We can experience stress due to positive things such as preparing a meal for a first date, studying for a national exam, or completing tasks for a job certification. We can also experience stress due to negative circumstances, like driving in rush hour traffic or hearing our neighbors fighting. Stress can easily influence us and move our attention away from practicing self-care.
TIP: Because stress is inevitable, learning how to manage it can significantly enhance our quality of life.
How Common Anxiety and Stress Relate
Stress is produced by life stressors, such as your partner being diagnosed with a chronic medical issue, having to work extra shifts to cover for a coworker on medical leave, or experiencing the death of a family member. We all experience life stressors differently but leaving them unaddressed can potentially lead to anxiety among other mental health problems.
TIP: You can read more about life stressors and their relationship to anxiety here.
Under normal levels of stress, we can still focus on our daily tasks, although with discomfort. However, higher levels of stress can escalate into more prolonged and excessive anxiety, persisting for several months and varying across different life situations.
A clinical level of anxiety can lead to loss of work productivity, relationship issues, forgetfulness, and fatigue. It is estimated that 40 million adults, or 19.1% of the U.S. population, suffer from an anxiety disorder. [1]
Section 2: Recognizing Anxiety and Stress: Common Signs and Symptoms
Common Signs of Stress
These are some of the ways that stress show up in our lives:
Irritability, frustration, and impatience
Your mind goes blank or races with endless or repetitive thoughts
Overwhelm, dread, physical tension, or exhaustion
Life issues start to worsen along with other mental health problems
Sadness, lack of energy, low motivation, and negative thinking
TIP: Read more about stress here.
Signs of Clinical Anxiety
Here are a few descriptions of how high levels of anxiety may appear:
Uncontrollable fear or worry that persists even with distractions
Digestive issues such as bloating, stomach pain, or feeling like vomiting
Negative thoughts about oneself, anticipation of danger, and minimizing one's abilities
Chest or heart pain, difficulty breathing, and sensation of choking or passing out
Difficulty with sleep, eating, relationships, and other important areas of life
Trembling, shaking, avoidance of certain situations or people, and a mind that goes blank
When we feel that anxiety is getting out of hand, it's highly likely that we're experiencing a clinical level of anxiety. Meeting with a medical health professional or mental health professional is highly recommended.
Section 3: Types of Anxiety Disorders
Types of Clinical Anxiety
As of 2016, there are 11 types of clinical anxiety recognized by the medical and mental health professions in the U.S. I've listed the most common types for adults along with a brief description and their prevalence in today's society:
Generalized Anxiety Disorder is characterized by excessive worry and anxiety that persists about numerous activities, situations, or events. People may worry about getting sick, fear sickness leading to death, feel uncomfortable around people, worry about burdening others or making them feel bad, and worry about worrying too much. It affects approximately 6.8 million adults (3.1%) in the U.S. [2]
Social Anxiety Disorder involves high levels of fear or nervousness in social situations where individuals worry about being judged or criticized by others. This often leads to avoidance of social interactions or sharing one's opinion. People also worry they'll do something to embarrass themselves and can experience intense anxiety. It affects approximately 15 million adults (7.1%) in the U.S. [2]
Panic Disorder is experienced as ongoing, unexpected panic attacks (described below) that reach a peak within minutes but are draining and terrifying in nature, often making it feel like hours have passed by. Panic attacks include at least four of these symptoms:
Palpitations, pounding heart, or accelerated heart rate
Sweating
Trembling or shaking
Sensations of shortness of breath or smothering
Feelings of choking
Chest pain or discomfort
Nausea or abdominal distress
Feeling dizzy, unsteady, light-headed, or faint
Chills or heat sensations
Numbness or tingling sensations
Feelings of unreality or being detached from oneself
Fear of losing control or “going crazy”
Fear of dying
The fear of having more panic attacks is part of Panic Disorder. It affects approximately 6 million adults (2.7%) in the U.S. [2]
Specific Phobia includes an intense fear or anxiety to a particular object or situation prior to being exposed to it (anticipatory). There are 5 categories: animals (spiders, bugs), natural environment (heights, storms), blood-injection-injury (needles, medical procedures), situational (elevators, airplanes), and others (situations that can lead to vomiting, clowns). It affects approximately 19.3 million adults (9.1%) in the U.S. [2], although some studies find the percentage can range from 8-12%.
Other types of anxiety disorders include Separation Anxiety Disorder (0.9-1.9% of adults in the U.S.), Selective Mutism, Agoraphobia, Anxiety Disorder Due to Another Medical Condition, Substance/Medication-Induced Anxiety Disorder, Other Specified Anxiety Disorder, and Unspecified Anxiety Disorder.
Section 4: The Impact of Anxiety on Daily Life
It's no secret that experiencing anxiety can affect various aspects of life including work, relationships, and overall well-being. From feeling mentally and physically drained to frequent trips to the bathroom or medical professionals, anxiety can consume valuable time and energy. Here are some additional ways clinical anxiety affects our lives:
Missed opportunities to hangout with friends or initiate new friendships
Irritability, mood swings, and procrastinating
Gastrointestinal issues such as heartburn, diarrhea, and a sensation of nausea
Being caught up in one's internal experience and not fully present with work tasks
Impact on Romantic Relationships
There are ways in which clinical anxiety can affect our romantic relationships. Some of these include:
Avoiding asking someone out on a date and becoming frustrated when seeing others in relationships.
Not attending social events that could enhance your relationship and increase your social support.
Trying to read your partner's mind and expecting them to know your needs without expressing them.
A lack of clear communication about your desires and requirements.
Problems with sexual performance and enjoyment of romantic interactions.
Demanding that your partner spends most of their free time with you.
TIP: You can read more about healthy relationship expectations in my blog here.
Real-Life Scenarios
In my practice, I've seen many individuals who avoid sharing their true feelings with their partners or coworkers because they fear upsetting them. Instead, they go through the motions, suffer in silence, and ultimately experience a lower quality of life.
I've also seen couples who avoid important conversations due to the fear of their partner's reaction. This avoidance leads to increased stress, unrealistic assumptions, emotional disconnection, and other unintended consequences. Learning how to manage our anxiety can open the door towards addressing discomfort in our romantic relationships.
TIP: The way we express our feelings is just as important as how we listen to our partner's. Learn more here.
Section 5: Managing Anxiety and Stress
Each type of clinical anxiety requires specific coping skills to address its unique symptoms. However, anxiety disorders have common symptoms that the following coping skills can help manage.
Self-Care
The following skills help reduce everyday stress and manage anxiety:
Regular exercise can help us release the energy anxiety sends our way while introducing positive, stimulating experiences
Creating a consistent bedtime routine that helps our mind know exactly what to expect
Avoiding the overuse of stimulants such as caffeine found in coffee and tea
Journaling our experiences for increased insight and notice our personal anxiety cycle
Grounding Techniques
It's normal to want to avoid pain and instead have pleasurable experiences. In the case of anxiety disorders, avoiding our experiences leads to making our symptoms stronger. The following coping skills will help us "be" with our experience and reduce its negative effects:
Practice activities that help you concentrate on your body sensations such as mindfulness, yoga, or a bath
Pay attention to your five senses: What am I seeing, hearing, touching, smelling, and tasting?
Be curious about your symptoms and experiences: Where does this thought come from? Where in my body do I feel this emotion? Is this a new or familiar experience?
Try the “famous” deep breathing technique. Watch a video here.
The key is to observe our experience to further understand our thoughts and emotions. Often, they are sending us important messages that we need to live a life of purpose.
Section 6: Seeking Professional Help and Medical Management
For manageable levels of anxiety and stress, seek support from friends, family members, a coach, or a religious leader. People in the community can normalize your experience, share their own helpful strategies, and check on you. You can also look into self-help books or an anxiety group online.
Seek A Medical Consultation
When you start noticing that anxiety is increasing, lasting longer, and interfering with one or multiple areas of your life, schedule an appointment with your primary care physician (PCP). Your PCP can help you identify if there are physical health issues, medication side effects, or other life factors contributing to anxiety.
It is possible that your PCP may recommend psychiatric medication. They will often provide you information on how the medication works, its side effects, and what to expect. Many medical professionals will also recommend seeking help from a mental health practitioner if you require additional support or if you prefer not to start with medication.
TIP: Learn more about what to expect from your physician here.
Consult With A Mental Health Practitioner
Another important step is seeking a consultation with a mental health practitioner such as a psychiatrist, psychologist, licensed marriage and family therapist, licensed professional counselor, licensed master social worker, or a psychiatric nurse practitioner.
Research has shown that a combination of mental health counseling and medical interventions can be effective in managing anxiety. Note: Any recommendations should come from the medical and mental health practitioners you consult with, not from this article. The mental health specialist you choose should be skilled in using Cognitive Behavioral Therapy (CBT) as part of their treatment approach.
While other forms of therapy can be beneficial to varying degrees, CBT has the most research-based results. There are also newer variations of CBT that have been found effective in treating different types of anxiety disorders, including Dialectical Behavior Therapy (DBT), Mindfulness, and Acceptance and Commitment Therapy (ACT).
What To Expect In A Consultation
A typical first session with a mental health professional:
They introduce themselves, address your questions, and explain the therapy process.
They gather information on your symptoms, stressors, and therapy goals.
They explore work, education, social connections, and family to better understand you.
Treatment recommendations may occur near the session's end, but 2-3 sessions are often needed for in-depth feedback and goal setting.
If you wish to continue, a second appointment will be scheduled. Homework is optional, and you can always decline.
TIP: You can schedule a free, no obligation 15-minute consultation with me, here.
Section 7: Conclusion and Encouragement
Summary
In this comprehensive guide on anxiety and stress, we distinguished between common experiences of anxiety and stress and their clinical implications. We covered various aspects, including the nature of anxiety and stress, their common signs and symptoms, different types of anxiety disorders, and their impact on daily life and relationships.
This guide also provided practical tips for managing anxiety and stress through self-care and grounding techniques. We emphasized the importance of seeking professional help when necessary, including consultations with medical and mental health practitioners, and explained what to expect in such consultations.
In Closing
I'm thankful that you took the time to read this comprehensive guide on anxiety and stress. I hope that you found valuable information from the information presented along with insights from my experience as a Licensed Marriage and Family Therapist.
Stay tuned for upcoming blog posts on Generalized Anxiety Disorder, Social Anxiety Disorder, and Panic Disorder. It's possible to manage anxiety and stress; don't lose hope. Begin with the recommendations on this guide and you will gradually make progress in your mental health journey.
References & Additional Reading:
National Alliance on Mental Illness: website link
Anxiety & Depression Association of America: website link
Mayo Clinic on Anxiety Disorders: website link
PsychCentral on Anxiety Disorder and Phobias in the DSM-5: website link
Photo by Joice Kelly
