The Wrong Therapy


There is no shortage of words or phrases to describe anxiety. Maybe we call it, ‘the jitters’ or, ‘the heebie-jeebies.’ We may opt for the more formal, ‘apprehension’ or ‘concern.’ There are many more to choose from. I am quite fond of, ‘botheration.’

Perhaps this array of synonyms is down to anxiety being a common yet individual experience.

What makes anxiety different to stress though? And is ‘worry’ just another in the catalogue of words for anxiety?

Anxiety, Stress and Worry are different and recognising their distinctions enables better understanding and management.

Stress is essentially a thing. An experience that creates a negative reaction. Some stressors are individual. I have a friend who hates small talk. The experience of small talk creates negative feelings. My friend manages this stressor by avoiding typical small talk situations. He gets his hair cut by a barber who does not speak English. My father in law, on the other hand, will talk endlessly about ‘A’ roads and the weather. He will small-talk to anyone who will listen. For my Father in Law, this is not at all stressful. In fact, a haircut by a non-English speaking barber would be stressful for my father in Law.

There are events likely to cause stress whoever we are, whatever our personal quirks; moving house, death of a loved one and so on. So universal are these stressors that in 1967 Holmes and Rahe compiled a top 43 stressful life events.

In essence then, stress is a negative event or experience within the world, or accumulation of events. This can be individual (like small talk), or it can be universal (like the death of a spouse).

Anxiety is the reactions to stress but can exist without an external stressor. Anxiety is feeling, experienced both physically and emotionally. Anxiety is a prevailing sense of doom and tension, a racing heart, nervous shivering, inability to settle and feel calm. Anxiety can be a mild feeling or it can be entirely debilitating. Anxiety can seemingly spurt out of nowhere or bubble away beneath the surface. Many people will say it is worse in the morning and it eases through the day. Many people will try to work out why they are anxious.

Worry is the cognitive material. The mental conversation we have with ourselves when feeling anxious. Worry is the ‘what-ifs’ and the played out scenarios. Worry is the self-reassurance (“I’m being silly!”) and analysis and mental planning. Worrying is something that the over 65's regret doing most!

In summary, stress is the cause, anxiety is the reaction and worry is the cognitive engagement.

Stress, anxiety and worry interact with each other but they are different. Being clear about these differences is one step towards responding to them.