There are countless things to worry about, from global warming to what's for dinner. Just about everyone stresses over some concern—large or small or somewhere in between—at one point or another.
And while those fraught moments can certainly come with feelings of anxiety, a diagnosable anxiety disorder—such as generalized anxiety disorder, panic disorder, or social anxiety disorder—isn't your run-of-the-mill stress.
About 18% of American adults have dealt with one (or more) of these illnesses in the last 12 months, according to the National Institute of Mental Health. They often live with "pervasive, uncontrollable worry, even when things aren't necessarily going poorly," says Todd Farchione, PhD, research assistant professor at Boston University's Center for Anxiety & Related Disorders. Anxiety disorders interfere with daily life, whether it's because the worry is so intense it makes it hard to, say, go to work, or because it's so frustrating to worry so much, he says. "Most people would say something like moving or an upcoming wedding are normal stressors, but when it starts to become very intense to the point where it's interfering in a person's life or she's very distressed by it, then it crosses into something you might want to talk to someone about."
Unfortunately, a diagnosis isn't always so clear-cut, even for the experts. Anxiety and stress are understandably similar, but there are some differences to watch out for. Here's how to tell if you've got more than stress on your hands:
Your worry is persistent.
It's normal to be stressed about sending your kid off to college the last couple months before graduation. Freshman orientation week will come and go, and likely, the stress of him leaving the nest will, too. But with an anxiety disorder, excessive worrying lingers; to warrant a diagnosis, a person will have been worrying for six months or longer. When evaluating anxiety, a clinician will look to see if you felt this way before the stressful scenario arose and whether or not you're likely to feel this way once it's resolved. If it's out of the ordinary and short-lasting, you probably do not have an anxiety disorder, Farchione says.
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You're worried about your worrying.
Feeling fed up with your stress is often a sign of an anxiety disorder, says Steven D. Tsao, PhD, clinic coordinator at the University of Pennsylvania's Center for the Treatment and Study of Anxiety. Anxiety can cause "a significant amount of distress in someone who is really bothered by it," he says, like a person with a fear of dogs who hates being so affected by them. Thinking "I just can't stand how I feel, I worry too much" may be a sign it's time to talk to someone, Farchione says.
You jump to negative conclusions.
Anxiety disorders can often make you imagine the worst possible outcome is the most likely outcome, Farchione says. Take a challenge at work, for instance: The stressed person can keep it in perspective, reminding herself it will pass and she can only do her best. The person with an anxiety disorder may feel like she's failing so much that she worries she's going to get fired and can't shake the looming disappointment and embarrassment she'll cause her family in the process, he says. Or maybe the person with an anxiety disorder finds a bump on her head and assumes it's a brain tumor, Tsao says. This pattern of negative thinking is called catastrophizing, a "distortion in thinking about the world in subtly inaccurate ways," he says.
You avoid the causes of your anxiety.
People with anxiety disorders might be more likely to pull away from their triggers, which is a passive way of responding, Farchione says, instead of facing those problems head on. "Breaking it down into smaller components and tackling it one step at a time would be a good way to approach a stressful situation," he says. "People with anxiety disorders may spend a lot of time worrying about what the outcome will be instead of engaging in effortful and meaningful problem-solving." Avoiding that presentation you're working on in the office will make you feel a whole lot better in the moment—but the work will catch up to you as the deadline approaches. "In the end, it really compounds the problem," Tsao says. "Try not to avoid the stressor, and instead find ways to take active steps toward addressing it."
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You overestimate threat.
"People with anxiety disorders often believe the chances of something being dangerous are much higher than they really are," Tsao says. That same person with a fear of dogs might believe her chances of being bitten are much higher than hard data on dog bites would predict. "The trap is that they will focus on the information that reinforces that threat-related belief," he says. She might remember all the details of every dog bite she's ever heard about, but forget all the times she's seen dogs and humans interact playfully and peacefully, because those don't fit the pattern of her anxious thoughts. "Anxiety is like a bad politician," Tsao says. "It's going to pound its fist on the podium for the information that supports its argument and leave out any information that goes against it."
You're irritable—and others are noticing.
Part of the difficulty in diagnosing anxiety disorders is that symptoms like restlessness, fatigue, irritability, and trouble sleeping or focusing are associated with a host of other health concerns, both mental and physical. But if any of these signs persists in a way that, once again, interferes with daily life—your coworkers have been noting you're difficult to work with or your spouse really has to prod you to get out of bed—it could be a good idea to seek out an expert's opinion.
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You know what makes you feel better—but you don't stick to the plan.
Many of the tips and tricks for busting everyday stress—like eating a healthy diet, exercising regularly, taking time for yourself, maintaining a consistent schedule—can also help people with anxiety disorders, Farchione says, but they don't always stick to the plan of self-care. "The anxious person having trouble at work will work 70 hours that week, and neglect all the things that are actually meaningful," he says. These healthy habits are crucial, though. "If you don't do the maintenance work on the machine that is your body, you're not going to be as finely tuned when you have to cope with stress," Tsao says. If you've tried these techniques and you're still struggling, it's probably time to speak with a professional. You'll want to find a cognitive behavioral therapist, he says, since CBT, which aims to teach new ways of thinking and reacting to taxing situations, is considered one of the best treatment options for anxiety disorders.
Sarah Klein is a Boston-based writer, editor, and personal trainer currently with LIVESTRONG.com, and previously of Health.com, Prevention magazine, and The Huffington Post. She’s the graduate of the Arthur L. Carter Journalism Institute at New York University.
