Are you unsure whether your anxiety is normal or if it has escalated to unhealthy levels? Knowing the difference between healthy anxiety and a clinical anxiety disorder can help you sort out what kind of professional help you might need and which coping strategies are most likely to bring relief.
What Does It Mean to Be Anxious?
Although anxiety is often an unpleasant feeling, it’s actually a healthy response to certain triggers.
“There are many situations that come up in everyday life when it is appropriate and reasonable to react with some anxiety,” says Edmund Bourne, PhD, a former director of the Anxiety Treatment Center in San Jose and Santa Rosa, California, and the author of The Anxiety & Phobia Workbook.
That’s because anxiety — as in day-to-day worrying about say, crossing a busy street or about a persistent toothache — helps keep us safe. It’s also a natural response to stressors. As Dr. Bourne explains, “If you didn’t feel anxiety in response to everyday challenges involving personal loss or failure, something would be wrong.”
“Normal” anxiety is proportionally related to a specific situation or problem and lasts only as long as the situation or problem does, says Sarah Gundle, PsyD, a clinical psychologist in private practice in New York City and a teacher at St. Luke's-Roosevelt Hospital Center at Mount Sinai Hospital. For example, it’s completely normal to feel anxious about speaking in front of a large group of people or meeting an important deadline at work.
What Does Anxiety Feel Like?
According to Bourne, while people may experience anxiety in different ways, in many cases it affects a person's entire being — psychologically, physically, and behaviorally — and it crosses over into something truly distressing.
Psychologically, anxiety involves subjective feelings of uneasiness or apprehension, he says. Physically, anxiety might include bodily sensations such as rapid heartbeat, muscle tension, dry mouth, or sweating. And behaviorally, it could lead a person to avoid ordinary situations, stop communicating about feelings, or fail to make decisions.
In its most extreme form, anxiety can cause you to feel detached from yourself or even fearful of dying, going crazy, or thinking irrationally, Bourne adds.
What Does It Mean to Have an Anxiety Disorder?
Anxiety disorders are diagnosed by a mental health professional on the basis of specific criteria. These criteria have been established by the American Psychiatric Association (APA) — in general, to qualify as disordered, a person's anxiety or fear must be age inappropriate, out of proportion to the situation, and interfere with the ability to go about daily life.
“The other key difference is that the anxiety lasts for a long time, even when the situation or problem has been resolved,” Dr. Gundle explains.
For someone with an anxiety disorder, the worrying may feel impossible to control or manage and may lead the person to avoid other people, situations, or things that they believe will trigger anxiety symptoms, Gundle says.
For instance, a person may have an anxiety disorder if they experience significant distress or fear about an unrealistic scenario that likely will never happen, Gundle explains. Or a person who has a fear of heights and feels anxious driving over bridges may have an anxiety disorder if they are no longer able to cross bridges at all.
Anxiety among people with a disorder can come up unexpectedly and seemingly without reason. “People with an anxiety disorder feel worry and fear constantly. The feelings of distress can be crippling,” Gundle says.
According to the APA, specific types of anxiety disorders include:
- Agoraphobia, or a fear of situations that are difficult or embarrassing to escape from
- Generalized anxiety disorder, ongoing and excessive worry that interferes with daily life
- Panic disorder, a condition involving repeated panic attacks
- Separation anxiety disorder, a condition in which someone is overly fearful of being separated from another person to whom they feel attached
- Specific phobias: excessive fears of objects, activities, or situations that are typically not harmful
- Social anxiety disorder, a condition in which someone has excessive fears of embarrassment, humiliation, or rejection in social situations
RELATED: Panic Disorder: Symptoms, Causes, Diagnosis, and Treatment
How to Tell the Difference Between an Anxious Feeling and an Anxiety Disorder
How can you tell if your anxiety has surpassed normal levels and crossed into anxiety disorder territory? According to Bourne, you may have a disorder if your anxiety is intense, long lasting, and leads to phobias or severe fear that disrupts your life.
The National Institute of Mental Health (NIMH) reports that, in addition to a feeling of distress, symptoms of the most common anxiety disorder, generalized anxiety disorder (GAD), may include:
- Feeling restless, on edge, or wound-up
- Becoming fatigued very easily
- Difficulty concentrating
- Muscle tension
- Sleep problems, such as trouble falling asleep, staying asleep, feeling restless, or having unsatisfying sleep
Seek professional help if your anxiety is interfering with your relationships, work, or school life, or if it is causing you significant distress, Bourne advises. That said, you don’t have to have a disorder to seek professional help for anxiety. If you’d like to be able to better manage everyday anxieties, a mental health professional could be very helpful.
Also, consider speaking with your primary care doctor to rule out underlying conditions that may be contributing to or even triggering anxiety symptoms.
According to the Mayo Clinic, medical problems that can be linked to anxiety include:
- Chronic pain or irritable bowel syndrome
- Drug or alcohol misuse or withdrawal
- Heart disease
- Respiratory disorders, such as chronic obstructive pulmonary disease (COPD) and asthma
- Thyroid problems, such as hyperthyroidism
Coping Strategies That Can Help You Manage ‘Normal’ Anxiety or a Disorder
Whether your anxiety is situational or stems from a disorder, a few healthy coping strategies may help restore your sense of calm, says Bourne.
One oft-recommended technique is deep breathing, in which you slowly inhale through your nose so that your chest and belly expand and then slowly exhale through your mouth, according to Harvard Health. Repeat for a period of two to three minutes or longer.
Deep breathing helps relieve anxiety by activating your parasympathetic nervous system, which reduces the overall stress and anxiety you may be experiencing, explain Mayo Clinic experts. This, in turn, typically slows your heartbeat and stabilizes blood pressure. A focus on your breathing can help you let go of distracting thoughts or feelings, Harvard Health says.
Another common technique for reducing anxiety, notes Bourne, is to identify and replace fearful self-talk.
First, Bourne says, identify any fearful thoughts going through your head. Many of these thoughts are “What if?” statements, with examples including, “What if I stutter?” or “What if they see me sweating?”
Try replacing the fearful self-talk with calming and constructive statements, such as, “I’ve handled this before and can handle it again,” or “I can be anxious and still deal with this situation,” he suggests.
Foundational strategies such as a healthy diet, avoiding stimulants like caffeine that are known to worsen anxiety, regular exercise, and creative projects that divert your mind from anxious thoughts and help you build a sense of purpose also help, Bourne says.
According to the Anxiety and Depression Association of America, other ways to manage anxiety are:
- Identify your personal triggers.
- Get enough sleep.
- Limit alcohol consumption, which can trigger anxiety or panic attacks.
- Volunteer or become more active in your community to take a break from personal everyday stress.