Being anxious vs. Anxiety Disorder

When my doctor first told me that several of my symptoms could be explained by anxiety, I was both confused and furious. I debated for years that even if I admitted that I was anxious most of the time (note the even if: once a lawyer, always a lawyer), it only related to my mind and could not explain my physical symptoms – until I met my current doctor who patiently explained to me that these symptoms were because of an anxiety disorder, not just being anxious.

This is a statement that puzzles most people when confronted with it for the first time. A lot of my friends have asked me if there is really a difference. Some have even been “kind” enough to tell me that I should just stop being anxious and then everything will be fine.

What is the difference between being anxious and having an anxiety disorder?

Anxiety disorder is a mental condition characterized by significant levels of anxious feelings about the future or fear of the present, leading to physical symptoms. It is different from regular feelings of being anxious.

Scenario A : Imagine you have an exam tomorrow. You are a bit stressed about your performance, you get a bit nervous, get anxious and have an unpleasant feeling.  You start mugging up as much as you can in the last minute. You write your exam the next day. You feel you could have done a bit better but you know you can’t do anything about it. You leave the exam and go out for a movie with your friends.

Scenario B: Imagine you have an exam in six weeks. You are nervous, scared and anxious. You obsessively prepare for it and keep thinking of ways in which it can go wrong for you. You worry about what will happen if you don’t write that exam well – that you will not get your degree, you will not be able to get a job, you will end up being unemployed or you are going to be a failure. You have heart palpitations, nausea or diarrhea or you sweat a lot, have breathing problems, have a feeling of lump in your throat most of the time.  You rush to the exam, write it as well as you can. You come out of the room. You go over the answers again and again. You do the same over-thinking and worrying all over again until you get the exam results – and perhaps even after.

That is, broadly speaking, the main difference between being anxious and having an anxiety disorder.

Being anxious is normal and may even be beneficial. It can fire up the fight or flight response in your autonomous nervous system and help you make decisions that are good for you. This is probably why most students are able to grasp a lot in a short time before exams (even though they may forget it the minute they leave the exam hall), as their anxiety finally makes them move their ass (or keep it put in one place actually) and study!

Having an anxiety disorder, on the other hand, can be debilitating. It can slowly creep up on you and leave you with physical symptoms which make day to day life very difficult. It can cause heart palpitations,

You can do a simple test to know the difference between being anxious and an anxiety disorder. This is based mostly on my experience and general reading.

1. Stressors – Is there an ongoing or upcoming stressful event or new experience? Like an exam, or a wedding or a first date.

A person with an anxiety disorder feels anxious even with no stressors or reasons. Going to the grocery store can make them anxious – ranging from thoughts about whether they will get everything they want or whether their bank card will work when they swipe it at the counter.

I cannot tell you the number of times I have had palpitations while swiping my bank card at the supermarket, fearing what will happen if the card is declined and how humiliating it will be. All because it happened once (seven years ago) when I forgot to transfer enough money from my professional to personal account.

2. Duration – Do your anxious feelings slowly wane away after the stressor is gone?

For a person with an anxiety disorder, feelings of anxiety are basically endless and there is no limitation period (again, lawyer speak, I know).

For about a year from mid-2018 until early 2019, every night before I went to bed, I used to be anxious about all the ways in which a burglar could enter our home, or a fire could break out or how I was going to miss all my deadlines and lose my cases. I did not get cured in 2019. I nearly died and then started recovering.

3. Intensity and Expression – Feeling anxious is not always an intense feeling. It is a feeling that can co-exist with other feelings and can be distracted. It does not make your physically sick to a point where you cannot take it (not always at least). A more detailed post on the physical symptoms of anxiety will follow soon.

An anxious person has various physical symptoms including heart palpitations or pounding, sweating, breathing difficulties, digestion problems (your gut is your second brain, after all), nausea, trembling. These could get very intense and morph into panic attacks (but not always).

Two nights ago, I had a disagreement with my husband. It was not about anything life-changing (for the moment), nor was it trivial. I could not sleep for hours after, feeling anxious about how the consequences of the disagreement were going to play out – ranging from divorce to running away. Neither is going to happen – I am too tired to do either honestly – but I couldn’t stop the anxiety. I had to do yoga, listen to hypnosis and read a book before I could finally stop the cycle and sleep.

How do I implement this test?

If you suspect you may have issues with anxiety, here is a top tip for you. Buy a notebook, divide each page into four columns – A: Date, time B. Physical Symptoms C. Feelings D. Thoughts – and write it in it every day or whenever you feel “off”/anxious. Maintain it for at least three months and take it to your doctor. Discuss it with your doctor and/or your psychologist. Of course, go to your doctor as early as you can if your physical symptoms escalate.

There are many forms of anxiety disorders (six recognized by the American Association of Psychiatry). The description I have given in this post relates mostly to Generalized Anxiety Disorder, which is what I have been blessed with. I will be writing more about GAD, symptoms, diagnosis and how to handle it. The how to handle it part will mostly be a work in progress. ?

Photo by Finn on Unsplash