Stress vs Anxiety (How to Tell The Difference) | Ep. 397

There is a lot of talk about stress management and anxiety management. Today, we are going to address stress vs. anxiety and how you can tell the difference. 

My name is Kimberley Quinlan. I’m an anxiety specialist, and I help people overcome their anxiety while being the most kindest version of themselves. 

What we cover in this episode: 

• What is Stress? 

• What is  Anxiety? 

• How do we tell the difference? 

• Will stress and anxiety shorten my life? 

• How can I manage my anxiety when stress is really bad?

• Does anxiety cause stress? 

• Does stress cause anxiety? 

When I asked my friends over on Instagram whether they had any questions about stress vs. anxiety, of course, the most common question was, how do I tell the difference? But interestingly, a lot of people were asking, will stress kill me? How can I live with anxiety? Will it shorten my life? And the third question was talking about, how can I manage my anxiety when my stresses get really bad? Now, they notice that when stress is high in their lives, their OCD, their generalized stress, their panic disorder—any anxiety disorder seems to get worse. How can we manage that? I’m going to cover it all here today. Let’s talk first about what stress is, what anxiety is, and how we can tell the difference.

What Is Stress?

According to the National Institute of Mental Health, stress is a physical and mental response to an external cause. This is such as having a work stressor, having school stress, relational stress, or things outside of you happening in your life, creating a sensation of stress. A stressor may be a one-time stressor, or it may be something that happens over the course of time. What we want to understand here is—and I’m going to read this because it’s coming directly from the National Institute of Mental Health—it’s generally a response to an external cause. It goes away once the situation is resolved, and it can be both positive and negative. This is the part I loved: There is distress, which is of course negative stress—stress that creates a lot of angst in your life, and there is eustress, which is positive stress. It creates a sense of urgency. “Let’s go, I’m going to do this right now.” 

As I record this, the Olympics are on, and I’m assuming some of the Olympians have a lot of distress. Some of them have a lot of eustress where they feel that this is a thing happening in their lives and they are working towards it. When they have eustress, a lot of hormones get created from the brain and sent through the body, creating a lot of energy and preparation, getting them really beefed up, ready to go, and motivated. That’s the definition of eustress.

What is anxiety? 

Now we compare and contrast what is anxiety, and we want to look at it comparing to stress. Number one, generally, anxiety is internal. It’s usually a reaction to something. It’s commonly irrational. It’s commonly catastrophic, and it’s often disproportionate to the actual circumstance that is happening. It usually has a persistent feeling of dread and fear and, again, a lot of distress. It doesn’t go away. It usually interferes with your daily life. 

Often, people with anxiety get told like, “This doesn’t make any sense. Everything’s going to be fine.” For them, it feels really incongruent because, for them, they feel a lot of distress in their body, a lot of angst in their body, a lot of anxiety, and fear. This is constant, even if there is no immediate threat. Dissimilar to stress, often with anxiety, there isn’t an immediate circumstantial threat.

Symptoms of Stress

Now, let’s compare stress symptoms with anxiety symptoms. First, let’s look at stress symptoms. There are general emotional symptoms, like an increase in distress or sadness, an increase in fear, an increase in sense of overwhelm, being irritable, feeling grumpy, feeling annoyed, and feeling like everything is spinning around them. They might feel restless. They may feel like they’re having a difficult time concentrating, feeling like they’re unable to solve problems. They can’t see clearly. Everything just feels very unorganized. 

There are also physical stress symptoms. They may include headaches, clenching your teeth, dizziness, shoulder or neck pain, and muscle pain. It might be a shortness of breath or feeling exhausted all the time. It might be feeling nauseous, feeling sick more often, or getting sick more often. Maybe you may lose sexual desire and arousal, a common one. You might have sleep disturbances. These are common physical stress symptoms. I’m sure a lot of you have experienced these. Everybody has stress in their lives. I want to normalize stress. It is part of being a human being. We cannot attempt to reduce or eradicate it from our lives. Let’s just keep that in mind.

There are also cognitive stress symptoms. We touched on these a little bit, but let’s talk about them a little more in-depth. This is where the stress actually reduces our cognitive mental performance. It might be that you have trouble concentrating, keeping track, or remembering things. If you’re like, “Oh my gosh, where is that thing I’ve forgotten?” or “I completely forgot that that event happened”—common symptom of cognitive stress. You might have trouble getting things done, finishing and completing tasks, or being able to understand topics. Let’s say you’re studying for something, and usually you can grasp topics, but all of a sudden, you’re like, “I can’t seem to digest this into my brain.” You might have a lack of commitment and a lack of motivation. You might have a lot of negative thinking, and it might divert to negative thinking instead of maybe being more of a natural positive thinker, but all of a sudden, things start to feel pretty quickly negative. Again, all common cognitive stress symptoms.

The Difference between Stress vs Anxiety

If we compare and contrast those two anxiety symptoms, if we were to say, “What are the stress versus anxiety symptoms,” you probably have already acknowledged or you’re thinking as you listen to this, that sounds a lot like anxiety, and you’re right. The symptoms are majority the same. However, the most common anxiety symptoms would be feeling restless, nervous, having racing, intrusive thoughts, racing thoughts in general, increased heart rate, and rapid breathing. We call it hyperventilation. You might be someone who sweats. You might have trembles. You might feel weak or dizzy. You might do a lot of rumination. You might, again, have a very difficult time concentrating and being able to listen to someone. Your brain is over here, thinking about other things. You may have a massive degree of sleep disturbance, and you might also have a massive degree of GI struggles. These are all very common anxiety symptoms. I know it’s getting a little confusing here because, again, they do look a lot like stress symptoms. 

Now let’s get to the good part. How would we tell the difference then if they’re so similar? Well, let’s compare and contrast. With stress, it usually occurs as a response to something external. Anxiety usually is a response to something internal. How you’ve perceived something to be. Not always. Again, you’re naturally going to have anxiety if there’s a bus coming for you or if there was an earthquake. We actually had a big one here in California a couple of days ago. Yes, you’re going to have a natural degree of anxiety, but usually that’s an internal thing. Even if the earthquake has completely gone, you might start to have like, “What if we have another one? What if something bad happens? What happens if we die next time? What if our house falls in on us?” You start to create a narrative about the event, and that is often when anxiety really starts to impact your daily life and your daily functioning. Whereas with stress, it happens. And then once the stressor has gone, you return back to baseline. 

The next piece is, it’s usually a bodily response in response to the threat. Whereas with anxiety, it’s usually a feeling that again directly respond to how you’ve interpreted the event. It’s not always true for specifically those who have intrusive thoughts. Again, it can get a little confusing. But if you’re definitely noticing a lot of what-if and it’s coming from a place of what-if and bad things might happen, again, that’s usually an anxiety response. With stress, again, once the event has passed, it usually goes away. Whereas with anxiety, it usually continues even when the stressor has gone away from our life or the original event that created the anxiety.

Similar to stress, and again, if we were to contrast, stress can be positive. It can increase or decrease motivation, depending on the stressor and how you’re managing it. Whereas anxiety usually only has negative outcomes. It usually takes a lot away from your daily functioning. It can then progress into an actual disorder where, again, it’s impacting your functioning and so forth. 

Now, here is the thing to remember as we compare and contrast: If you can take one major thing away from today, do not spend any time or very little time trying to figure out which is which. You’ll probably only end up in more rumination, more anxiety, and more stress, trying to figure out whether it’s anxiety and stress. I know that sounds ironic, but we are not here to say you have to figure it out. What we are here to say is, what are the skills, and how can I be effective once I’ve identified what is what?

Can I have Stress and Anxiety? 

A common question is, can I have stress and anxiety? Yes, simply put. You can have both. In fact, we know based on those symptoms, stress can create anxiety. Some people can have so much stress in their lives that they start to have panic attacks. That’s usually a combination of the two. You have stresses, maybe financial work, your education, whatever it might be, your kids, your relationships. You have stress in your life, and then you start to have an irrational and really catastrophic thought process about those stressful events, which means now you’ve got both. 

Can Stress Cause Anxiety? 

Can stress cause anxiety? 100%. Can anxiety cause stress? 100%. Again, having an anxiety disorder is a stressor in your life. It’s a stressor on your family. It’s a stressor on your calendar. It’s a stressor on your daily activities. Having to do daily functioning while bringing anxiety along, that’s stressful. I want you to be as gentle as you can as you address this. 

If you’re feeling overwhelmed and discouraged, stay with me because this is where it gets really, really interesting.

Can I Die from Stress and Anxiety? 

I was super shocked at how many people wanted to know, can you die from stress? I was not expecting that question. I was thinking here I was doing a very easy episode about comparing and contrasting the two. But this was overwhelmingly the most common question about stress and anxiety in general. 

If you haven’t already, I want you to go over to the internet and Google “Stress TED Talk.” There is an amazing health psychologist named Kelly McGonigal, and she did the most amazing TED Talk about how to make stress your friend. She started this with the most important update in research we have about stress. Because I think the reason that we all ask this question of “Will I die from stress?” comes from the fact that we’ve been told that stress is bad, anxiety is bad, you should get rid of it, it’s got to go away, you’re going to shorten your life, bad things are going to happen. We’ve heard that so much. She came on and shared research that I think blew the internet’s mind. 

She basically told us about a new research study of 30,000 people. They were all adults over the course of eight years, and they were all asked, how much stress did you experience in the last year? Now, a lot of them reported that they did because, as you know, all adults have stresses in their life. Then they asked them, do you think stress is harmful for your health? And then they followed them and used public death records, and they found that—and I’m going to read this—the people who reported a very stressful event in their life had a 43% increased chance of dying. That’s scary. But stay with me. This only occurred in those who believed that stress was harmful to their health and that the people who had the lowest risk of dying were not those who didn’t have stress, but it was those who didn’t believe that the stress was harmful to their health. 

Really let that sink in. The ones who seemed to be impacted the most by stress weren’t the ones who had the most stress. They were the ones who believed that stress impacted their health. What? This is blowing my mind. What she talks about here and what that research study really showed is how you think about stress really matters. The trick is to think of stress as helpful or as neutral. But what we want to look at here is that when we are stressed, understand the mechanics of our brain. When we’re stressed, our brain sends out a message, sends out all of these stress hormones, whether it’s for eustress or distress, and that prepares us to manage this event. 

If any of you have listened to me before, this is exactly what happens with anxiety. When your brain interprets danger, it sends out a message to say, “Run, get away. Try and solve the problem.” It tries to help you solve this problem. Very similar. The only difference, which we’ve already discussed, is that anxiety is often catastrophic and irrational, and with stress, it’s usually proportional to what’s going on. Not always. Sometimes there’s a combo. The physical symptoms, if we view them this way, could be exactly what we need to prepare us to manage this stressor in our lives. 

Here is an example. This is me today. I need to record a podcast. I’m starting to feel tightness in my chest. I’m starting to feel like this is such a huge topic, and I have to cover it in a short period of time. I’m starting to notice that my body feels more agitated and hyper-aroused. Okay. I can say, “This is bad. This is going to ruin it. This stress is terrible. It’s going to kill me. It’s going to shorten my life.” Or I could say, “This is exactly what I need to propel me into doing this really well. That this added energy, I can actually use it to really come across to you right now on what’s beneficial,” or “I can use this energy to sustain me while I record this podcast for as long as it’s going to take.” If it might be that you need to get through a long period of time, you can go, “Okay, I’m going to use this to energize me or to help me recognize that I am in the midst of a stressor and I’m going to use these physical symptoms to benefit me.”

Stress and Anxiety Remedies

How you think about stress really, really matters. That being said, we’ve already got the most important stress and anxiety remedy that we need, which is to really adjust how we think about it. We know this with anxiety. I’ve been saying it for years on this podcast. When you have anxiety, it’s not a problem. The only reason it becomes a problem is how you respond to your anxiety. You having a 10 out of 10 panic attack is technically not a problem. It is not dangerous. It will not hurt you. How you respond to it determines how much suffering and distressing that panic attack is. For me, when I have a panic attack, and I still have them every now and then, it’s not a problem. I’m just like, “Oh, here it is. It’s coming back. I’m going to let it do its thing. I’m going to let it race my heart. I’m going to let it tighten my chest. I’m going to let it make me need to go to the bathroom.” None of this is a problem. Whatever I need to do, I’ll just get through it. I’ll bring the anxiety and the panic with me that this is not a catastrophe anymore and this is not going to hurt me. It’s really no different from me getting a headache or whatever physical ailment I might be having. How you think about it really, really matters. 

There are other stress and anxiety remedies. We’re not just using that strategy because that in and of itself might not be fixing the actual mechanics of why we’re getting into trouble. Number one, a way to work on stress and anxiety is to keep a journal and to really start to track. When am I getting stressed? What were the triggers? When does the anxiety show up? What am I thinking when I have it? And really get to know what’s getting in the way. 

Treatment for Stress and Anxiety

Another really important thing is to ask for help, whether that be physical, going to therapy, or getting professional help with whatever’s going on. Maybe you need support. That may be really, really important. There is a really great treatment for stress. It’s called mindfulness-based stress reduction. It’s like a program that you can go through with steps and activities of mindfulness, meditation, and cognitions, looking at some of these concepts we’ve talked about. Again, if you’re having anxiety, we know cognitive behavioral therapy and exposure and response prevention are going to be your two go-to practices. They are there for you as well. 

We actually also have research to see that actual physical contact with people and asking loved ones for help increase the release of oxytocin, which naturally soothes your body when you’re stressed. Ask for help. Ask people to support you. Reach out to a support group, friends, or someone you know who might be going, go to podcasts. Feel like you’re part of a community. That can help with the experience of stress that you’re having by making you feel less alone. 

Can you use ERP Exposure & Response Prevention to treat anxiety and stress? 

Now, can you use both ERP exposure and response prevention to treat both anxiety and stress? The answer is yes and no here. This is what I have told my clients in the past. If you have anxiety—something that you are avoiding, that you’re ruminating about, that you’re seeking reassurance—you’re really having a high level of anxiety. Definitely, of course, use ERP. If you’re having stress, similarly, you want to fix how you’re framing it, how you’re managing it, are you avoiding anything—absolutely. We want to make sure we are cutting out any ineffective behaviors in how you are coping because there’s healthy coping and unhealthy coping. But what we wouldn’t do with stress, and this is the differentiating factor, we wouldn’t expose you and purpose to more stress. Only if you’re having a major OCD around avoiding anything stressful. But generally, no. 

If you’re going through a stressful time, this does not mean you need to expose yourself to more of it. It just means we need to use healthy strategies to cope because stresses come and they go. It’s a part of life. That doesn’t mean you’re failing; it’s just life is hard. We wouldn’t expose someone to having more stress. If someone was having a health issue, we wouldn’t purposely give them more health issues. If someone was having financial issues, I wouldn’t expose them to spending more money and putting themselves in more financial distress. No. But with anxiety, if it’s irrational and catastrophic, we may. But that would be up to you and your clinician to make that decision. They’re like the nuance of the work that we’re doing. We don’t want to make things super hard for you in life. We want to be as effective as we can. 

How do I do ERP if I am stressed out? 

Another person has asked that I really struggle to do my exposures for my anxiety disorder or for my OCD when I’m stressed. In that case, we have a combo, and we want to manage both. We may use a lot of mindfulness-based stress reduction. We may use a lot of cognitive therapy. We may increase exercise. We may increase self-care. We may increase eating healthy foods. We may improve your sleep hygiene. We may reduce your caffeine. We may increase your support. We will do those things to help alleviate you so that you can go on to do more exposures. But a lot of times, if you’re someone who is going through a very stressful time and you’re having to do exposure, we want to do a lot of balance. 

Very recently, we did an episode called the Rest to Productivity Ratio. You’re going to want to go back and listen to that, and that’s going to help you balance this idea of using your skills, taking care of yourself, and learning how to push yourself. Still, we’re not going to wait till the stressor passes because that might take months in some cases and learning how to balance and go back and forth and teeter-totter between productivity and rest with your homework for your therapy. There’s no perfect answer for that. We never want to wait for stresses to go before we do exposure, but we also don’t want to overwhelm you to the point where you can’t get any progress anyway.

Now, we also know—another piece of research—that caring for others is a massive stress reducer. If you’re doing it in the most gentle and genuine way of being in connection with and helping others, that actually also releases a lot of oxytocin in our body—a hormone that does soothe and calm us. That can be very, very beneficial. 

Home Remedies for Stress and Anxiety 

With that being said, I’m going to quickly review just home remedies for stress and anxiety. I’ve already mentioned them, but I want to make sure they’re made very important. 

Number one, make sure you’re getting enough sleep. If you’re stressed and anxious, you’re probably going to need a little extra sleep. That has been my experience. Not that I’m encouraging you to sleep all day or have bad sleep hygiene, but gift yourself with a little 30 minute extra each night. Try to get to bed 30 to 45 minutes earlier than you usually do so you can get some quality sleep. 

Number two, do not use substances to manage stress and anxiety. That usually makes it worse. It usually impacts your sleep. It usually increases anxiety. We’ve done episodes on substance use for anxiety before. Do not rely, if you can, on any substance or even food to nurture you through those. Now, we all emotional eat—myself included—there’s nothing wrong with that. But don’t use that as your only way of coping. It usually creates more problems. 

Again, do not hesitate to reach out to a doctor if you feel like you need medication. There’s nothing wrong with asking for medication if you have stress and/or anxiety, just to get you through this time of difficulty. 

The other thing is meditation. Stress and anxiety can be greatly benefited by a meditation practice. We have a whole meditation vault called The Meditation Vault of prerecorded meditations. You can use them anytime you want. You have lifetime access to them. If you’re interested in that, you can go to CBTSchool.com. They are there to help you. There’s meditations for depression, stress, sleep, motivation, OCD, health anxiety, social anxiety, general anxiety, panic attacks, all of the things, even meditations for times where you don’t want to meditate. They’re all there for you. You can head up to CBT School if you’re interested. 

There you have it. We have: What is stress? What is anxiety? How do we tell the difference? How can you reframe your thinking about stress? What are some strategies and treatments that you can use for stress and anxiety? The beauty is, the strategies are very similar. Hopefully, that means that you have the thumbs up to get going and move forward. Don’t spend any time trying to figure out which is which, and go and try your best. Remember, it is a beautiful day to do hard things. When it comes to stress and anxiety, that’s the work. 

Have a great day, everybody. I’ll see you next week.