How to distinguish anxiety from an anxiety disorder

Most people have felt anxious at one time or another. Situational anxiety is unpleasant enough (though it serves a purpose) in limited doses, but when it becomes incessant and crippling, we need help.

What is anxiety?

Anxiety is a physiological alarm response which prepares us for fight or flight in the face of a threat. However, we need to distinguish between reasonable anxiety and unreasonable or pathological anxiety (anxiety disorders).

The intensity of reasonable anxiety is proportional to the situation (an objective danger), and it ends when the threat ceases; in this case, anxiety is useful, helping us to protect ourselves against an objective threat. For example: A lion is an objectively dangerous stimulus, and our resulting anxiety helps us by making us run away.

In the case of unreasonable or pathological anxiety, by contrast, we interpret situations, symptoms, or thoughts as dangerous when in fact they are not, and the intensity of our anxiety is not proportional to the objective situation. Typically, a pathological anxiety reaction is very intense and lasting, continuing even after the situation is past. For example: We are entrusted with a new task, and we think—without good reason—that we are not up to the challenge, so our physiological alarm response goes off, and we experience anxiety much longer than we should.

In the case of simple stress (as opposed to pathological anxiety), the intensity of our reaction is proportional to the importance of the challenge facing us, and is always less than that of unreasonable anxiety. For example: I am entrusted with the task of preparing a project, and I conclude that I have insufficient time to complete it. Faced with this situation, my stress reaction is activated, and thanks to that, I get in gear to try to finish on time; as soon as I’m done the project, my stress disappears.

Normal or healthy stress ends when the external challenge is past, and we return to our habitual emotional state; the physiological activation decreases to our base line.

However, when the perceived threat is very great, and we believe that our life is in danger, the intensity of our anxiety reaches an even higher level, possibly even causing a panic attack.

What is an anxiety disorder?

In summary, anxiety disorders are the most common psychiatric disorders (Kessler, McGanable, Zhao, Nelson, Hughes, Eshelman, Wittchen and Kendler, 1994); however, their prevalence can vary among different countries and cultures (Krisanaprakornkit, Krisanaprakornkit, Piyavhatkul and Laopaiboon, 2007). International diagnostic classifications recognize various kinds of disorders within the group denominated as anxiety disorders. Specifically, in the DSM-V-TR (American Psychiatric Association), we find the following:

– Panic disorder with and without agoraphobia

– Social anxiety disorder (also known as social phobia)

– Specific phobia

– Obsessive-compulsive disorder (OCD)

– Posttraumatic stress disorder (PTSD)

– Acute stress disorder (ASD)

– Generalized anxiety disorder (GAD)

– Anxiety secondary to medical condition

– Substance-induced anxiety disorder

– Non-specific anxiety disorder

The best measures to take

When constant, intense sensations of anxiety are experienced several times a week for several months, the most recommendable solution is to go to a specialist to receive effective help with managing this kind of disorder. The National Institute for Health and Clinical Excellence recommends two kinds of treatment for anxiety disorders: pharmaceuticals and psychotherapy.

The important thing is not to fall into the error of thinking that normal moments of stress or anxiety are symptoms of a serious illness or disorder. Most of these emotional situations can be overcome if we act with foresight and responsibility, learning to manage our own emotions and granting ourselves more space to analyze the situations we face as individuals.