October 11, 2016

Are you anxious - or just stressed? Here's the difference...

Hey, guys! I'm about to talk about some sensitive mental health issues with y'all.

If you're in crisis, please don't turn to this post for advice! 

Call the national suicide hotline at 1-800-273-8255. 

And always remember: YOU ARE NOT ALONE!

Some degree of stress - whether it's because of school, work, or events in your personal life - is normal, which is why whenever I've talked to counselors on campus about my anxiety, they tend to rule it off as part of the "adjustment period" that all freshmen go through.

But experiencing anxiety isn't the same as feeling stressed out, no matter what anyone might say. It's more than worrying the night before a midterm, or fighting with your significant other during a challenging life transition.

So what is anxiety, then? And what makes it different from stress? While the following post aims to answer as many of your questions as possible, here's my simplified answer:

Anxiety is a serious mental health condition. It's not "normal," and it's not "something everyone goes through." So, don't let anyone belittle your experience by telling you otherwise. If you're having panic attacks, if you're afraid to leave your dorm, if you sweat and shake and want to vomit every time a stranger says hi to you in the halls - don't let anyone tell you that they know exactly how you feel just because they know what it's like to survive finals week. Because while stress might share some of the same symptoms as anxiety, anxiety hangs around long after the final is over. Stress doesn't.

And that's just one of the many differences between normal, manageable stress and a more serious mental health condition, such as anxiety or depression. In reality, you can't distinguish between stress and anxiety by asking yourself one simple question. The nuances are more complicated than that.

For that reason, I urge you - if you identify with any of the statements in this post, reach out to a mental health resource on campus! Many colleges offer free short-term therapy, counseling, mental health coaching, or at the very least academic advisers who might be able to help you make sense of what you're going through and direct you to more helpful outside resources. Thanks to the steady rise of mental health awareness on college campuses, many universities understand the common challenges facing college students and are able to offer greater help than ever before.

Oh, and one other important takeaway: Anxiety is not normal - but it is common. Particularly on college campuses, mental illness continues to appear at higher and higher rates.

Mental illness does not discriminate - nobody is immune to anxiety or depression. Even if somebody seems bubbly on the outside, you never know how much they are struggling on the inside. So, even if you're saying to yourself "There's no way that's me - I can't be anxious/depressed/mentally ill," don't forget that mental illness can literally happen to everyone. And many times, mental illness begins as stress - stress that wasn't adequately handled or even confronted at all.

Thus, don't hesitate to reach out to a counselor even if you know that what you're dealing with isn't as serious as anxiety, depression, or another clinical mental health problem. Yes, therapy is stigmatized - but it really isn't just for the so-called "crazy" people. In actuality, therapy is a coping tool that helps us better understand ourselves and how we react, emotionally, to difficult situations that confront us.

In other words, only YOU know your mind and body best, and if what you're feeling isn't normal for you, then reaching out to a therapist might help you learn some strategies you can use in your everyday life to cope better with even a little bit of healthy, normal stress. Hell, even perfectly well-adjusted people can still benefit from a little soul-searching in therapy! You don't need to have a mental illness to give your mental health a little TLC <3

You're more scared than worried.

While anxiety often manifests itself through worry, too, a sense of impending doom is a hallmark symptom of anxiety - not stress. When you're stressed, you might say you're going to die if you fail the chem final, but chances are that your rational brain knows that's not really the case. 

For an anxious person, however, the threat of dying if you fail a test feels real. The worst part is, you probably realize how crazy and irrational you're being - you just can't help it. Your brain knows that the world isn't going to collapse if you don't get an A, but your body doesn't, and your thoughts are powerless against the overwhelming feeling of panic and doom.

That's anxiety - not stress. So, if you're relating to any of those feelings, and they don't subside after the stressful situation has passed, then you'll probably want to seek a doctor, counselor, or therapist for a mental health check-up.

You don't know why you're stressed.

Typically, stress comes with an identifiable cause. If you're stressed, you know that you're stressed because something probably just happened to you - whether it's that your cat just died, your finals are coming up, you have homework due at midnight and it's 11:05, or whatever your reasoning may be.

On the other hand, the causes of anxiety tend to be more elusive and vague. If you suffer from Generalized Anxiety Disorder (GAD), you might wake up feeling stressed, scared, and jittery on what otherwise might have been a completely normal Tuesday, and have no idea why. Your finals might have just ended, and by all other accounts, you should be feeling happy and relieved - but you don't. You just feel impending DOOM instead.

By their very nature, stress symptoms like racing mind, rapidly beating heart, or sweaty palms constitute our body's response to threatening situations. That means if there's no situation causing you stress, then it's not normal to experience anxiety for no reason at all. Thus, if you've been stressed for an extended period of time and just can't figure out why, it might be worth looking into your mental health more closely. Anxiety could be causing your symptoms, and you might not even know it! 

You can't remember the last time you weren't stressed.

Another hallmark of stress is that it tends to pass with the said stressful situation - meaning, if you're stressed about catching an airplane, you shouldn't still feel anxious once you're strapped into your seat and ready to take off.

Anxiety can persist hours, days, weeks, even months after a stressful situation passes (which explains why I am still nervous about that dumb thing I said when I was twelve, I hope). Anxiety doesn't follow a logical timeline by any means, whereas stress is built into our body's biological clock to accompany stressful times in our lives.

So, yes - while it's normal to feel stressed sometimes, it's never normal to feel stressed all the time. Yet even if you've felt off for an extended period of time, it still might not be anxiety. It could be prolonged stress due to a long-lasting situation (such as a job or relationship) that you didn't realize was causing you stress - or even a completely different mental health disorder. Alternatively, it might be anxiety if it's long-lasting and has no clear cause, not even one that you don't want to admit.

Either way, I would recommend seeking outside help for this problem if it gets to the point where stress has become a fixture in your everyday life. If you can't think of a single day in the past few weeks where you have found even moderate repose from stress, please - visit a therapist or another mental health professional! A counselor will be able to help you identify the true cause of your emotional distress.

You're having trouble concentrating, eating, or sleeping.

Severe stress can definitely interfere with our sleep, appetite, and concentration - but it's not okay if that becomes your norm. Not sleeping well the night before a big exam is one thing; having trouble working up an appetite for weeks on end is a totally different animal. See what I'm saying?

When you know what's bothering you, it's more likely that your distraction is just stress talking, and not anxiety. However, if you're not sure what the problem is, and you're having these symptoms, it might be worth consulting a mental health professional. 

Oh, and if you're having these symptoms but no other symptoms of anxiety or depression, consider seeing your primary care doctor first! Sometimes, what we think is a mental health issue may actually be caused by a physical problem, especially when stress begins to interfere with our bodies themselves. As a medical professional, your doc can definitely give you a better idea of whether it's physical or mental than I can.

You have these aches and pains all the time.

...and you know they aren't caused by a physical health problem. You've seen your doctor; you've explained what you're going through; and still, they can't find anything wrong with you. What's up with that?

This symptom actually happened to me last fall, and still happens to me now: I visited my doctor for chronic neck pain that was interfering with my concentration in school, my sleep, and even my dancing. But when she examined me, she said that it was most likely that the cause of my neck pain was simply stress. Today, my neck pain only flares up during periods of intense stress and anxiety - which is how I know she was completely right!

Physical symptoms are definitely interconnected with mental ones, especially when it comes to anxiety. A lot of our stress response is physical as well as mental, from a racing heartbeat and chest palpitations to neck pain and tension headaches. Because anxiety has the same symptoms as stress, experiencing these problems for prolonged periods of time with no medical explanation could be a symptom of anxiety.

In some cases, physical illnesses like common colds can even be triggered by anxiety. So, if you have an unexplained ache, pain, or other health problem and know that nothing else is wrong, try a mental health check-up instead of a physical one. You just might find the answers you're looking for in this new approach :)

You feel disconnected - you're not sure what's real.

Even serious stress shouldn't interfere with your ability to connect with the people around you. Granted, you might feel a little distracted around your friends and family if something big has just happened to you, such as a death in the family or a major work problem. But you shouldn't feel out-of-body, as if you are floating, or begin to question reality. 

That's called dissociation, and it's a major symptom of chronic anxiety. Dissociation can be broken into groups of symptoms, too - for example, an out-of-body experience is known as depersonalization, while the uncertainty of what's real and what isn't is known as derealization. Or, it can even be as simple as feeling numb toward or disconnected from an important event (i.e. having no feelings about an experience that should have otherwise been important to you). This kind of dissociation is often seen in patients with PTSD after a traumatic experience. 

Dissociation can occur in people with anxiety or PTSD when facing a stressor or talking about the past - but it can be a hallmark of other mental illnesses as well. For example, someone who suffers from depression might experience a constant state of numbness and inability to connect with others. Dissociation on its own also characterizes several independent disorders - so, if you're experiencing dissociation but no other symptoms of anxiety, you should still seek help from a mental health professional who can tell you more about what you're going through!

You're starting to avoid places, people, or situations out of fear.

While stress might tempt us to skip our finals, deep inside we know we could never do that. Our grade fundamentally matters to us more than paying attention to some silly stress response.

Yet for someone with anxiety, that stress might simply be too much for them, and they might start skipping classes or tests because their physical and mental distress is too great. Or, they might avoid social situations because the fear of embarrassing themselves is simply too high. Or, they might have a phobia of some other thing that they can't stand to be around because it leads to obsessive thoughts or feelings of terror.

Whatever your fears are, if they are so great that they're leading you to avoid certain places, people, or situations, chances are that your problem isn't simple stress. If you're stressed about a number of things, it might be generalized anxiety, whereas if you're stressed about social situations in particular, you might have social anxiety in particular. There are also a number of phobias that pertain to specific situations and things, varying from public speaking to spiders. And even still, there are other disorders - like Obsessive-Compulsive Disorder - that cause intense fear of certain unpleasant situations or thoughts. While they're very diverse in their symptoms and causes, all of these mental health issues are much more serious than plain old stress, and definitely deserve a trip to a therapist or other professional for deeper exploration.

Your problem is solved - yet you're still worrying about it.

As I mentioned earlier, normal stress is, by its very nature, a response to certain troubling situations or events. So, if you're experiencing stress for no reason at all, it might be less normal than you originally thought.

The same is true for periods of prolonged stress, as we also talked about before. However, it can be difficult to tell how long is too long to worry, even when your stress does have an identifiable cause. So here's what I'll tell you, as a general guideline: if your problem still causes you distress long after it's solved, then it's not just stress. It's probably more severe than that.

Here's an example from my own life to help you out: at Boston University, I write for the student newspaper, and I was recently assigned an article that caused me a lot of trouble. Even after I submitted this challenging article to my editor - meaning that I should have been done worrying about it for good - I was still preoccupied by sentences I'd written and interviews I'd conducted that I wasn't 100% certain about. 

And that is not normal for someone who's experiencing normal stress about a situation. For me as an anxiety sufferer, however, it's a classic hallmark of my mental health disorder, and didn't come as a great surprise to me - I'm constantly dwelling on my problems, even after they should have been "solved" by all other accounts. If that sounds like you, then it could definitely be more than stress, and it's probably worth looking into.

You're having panic attacks, chest pain, or palpitations.

Everybody has a panic attack once or twice in their life, probably - but having them much more often than that isn't normal at all. In fact, it's a surefire symptom of a deeper anxiety disorder. And chest pain and heart palpitations are never normal; whether your problem is physical or mental, chances are that these symptoms signal an underlying issue there.

Now, don't get me wrong: chest pain and heart palpitations - two symptoms of a panic attack - can definitely be symptoms of physical ailments, so don't rule out seeing a doctor before you jump to the conclusion that your problem is mental. However, if you're having other symptoms of anxiety and know that your problem isn't physical, it could be anxiety or panic disorder, an anxiety disorder that isn't accompanied by other symptoms.  

No matter what, however, panic attacks definitely don't equal normal stress. Normal stress won't cause chest pain or the feeling that your heart has "skipped a beat." If you're having these symptoms, be sure to take them seriously and see a medical professional who can help you determine the underlying cause.

Your worries are uncontrollable - nothing helps anymore.

It's important to remember that normal stress can and should be managed. Dealing with stress in a healthy, productive way is what allows a healthy mind to remain healthy. On the other hand, unhealthy stress responses, when left unchecked for long periods of time, can deteriorate into more serious mental health problems, such as an anxiety or mood disorder.

To some extent, worrying is a normal part of life. You might worry about what dress to wear on your date tonight, or running late for your 8 AM class when you wake up late - and that doesn't mean you have anxiety. 

However, it's never normal for anxiety to interfere with your everyday life to the point where you have difficulty functioning. You shouldn't be worrying incessantly about every little thing you do, or worrying relentlessly about one thing until you feel sick to your stomach and just wish you could go back to bed. So, when worrying interferes with your life to that extent, and you feel powerless to do anything about it, don't rule it off as the stress experienced by an average person - it's probably not, and it's at least worth looking into! 

You're having thoughts of death, suicide, or hurting yourself or others.

If this sounds like you right now, please CALL THE NATIONAL SUICIDE HOTLINE AT 1-800-273-8255 or seek help URGENTLY from another source. No matter how you might be feeling, your life is still beautiful and still worth living! This feeling is just your mental health disorder talking, and says nothing about who you are as a person or what you're truly worth. Try not to listen to that ugly, horrible voice in your head - it's simply not true!

It might seem obvious that feeling like you don't want to live or like your life isn't worth living isn't normal. In fact, people who feel this way are often aware that their feelings are outside of the norm of regular stress. But unfortunately, it's a sad truth that prolonged, chronic stress can push people to the point of suicide. 

As I said before, many mental health disorders begin as perfectly normal, healthy stress, but morph into something more sinister and dangerous because the original stress wasn't coped with properly. If this sounds like you, PLEASE SEEK HELP IMMEDIATELY! Even if you're having these thoughts intermittently or "casually," your mental health could deteriorate quickly if you're faced with even the slightest stressor. 

And if this doesn't sound like you, but maybe you know someone who's said concerning things like this in the past, be sure to take what they say 100% seriously - every cry for help deserves to be heard, and you can simply never predict what someone in severe emotional pain might be capable of. Never assume that a threat of suicide is just a threat! 

Something just feels off, but you don't know what. 

Finally, sometimes stress leaves us feeling a little off our game, but we don't know how or why. Maybe there's no one specific "symptom" concerning us, but instead it's an amalgamation of things. Perhaps our feelings have become so muddled and confused surrounding the stressful situation that we can't identify one clear reason why it's become a problem; we just know that we don't feel right. And that's okay.

Knowing that something is off, but not knowing why, does not necessarily mean that you have a mental health disorder - but it doesn't necessarily mean that you don't, either. Sometimes, it's difficult to describe how we feel, or put a specific word or phrase to an experience. That doesn't make our symptoms any less real to us than they are to someone who can eloquently explain exactly how they feel to a therapist, nor does it discount the possibility of anxiety, depression, or another mental health issue.

Chances are, just feeling "off" for a little while probably isn't a sign of a deep emotional problem. Feeling a little off-balance from time to time is a natural part of life, especially when confronted with enormous amounts of stress. However, if it feels like it's been going on forever, and you still can't shake the idea that something unidentifiable is wrong, then don't just ignore it! 

I've said this a thousand times in this post so far, but it still couldn't be more true: only YOU know your mind and body better than anyone else. If you think something is off, then you are probably right! And in your search for answers, don't discount the possibility that the problem could be mental, not physical. Not all illnesses are ones we can see...

Disclaimer: I am not a medical professional or mental health counselor.
This post should not be construed as medical advice in any way.
Please consult with your doctor if you identify with any of the symptoms in this post or are in need of mental health treatment for any other reason.

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