The terms are often used confused. It pays to know the difference and treat them accordingly say the experts.
Most of us have said we feel stressed or anxious at some point. One survey of more than 4,000 people by the Mental Foundation found that 74 per cent had been so stressed in the past year they felt overwhelmed or unable to cope. A separate survey of 6,000 people, also by the Mental Health Foundation, found that 60 per cent of those polled said they had experienced anxiety at such a level it had impacted their daily life in the past two weeks.
Sometimes we use the terms stress and anxiety interchangeably, but while the symptoms can be similar, they are separate conditions with different causes.
“Stress and some degree of anxiety are lifesaving,” says Chris Williams, professor emeritus of psychosocial psychology at the University of Glasgow and founder of the website Living Life to the Full, which provides free online courses based on the principles of cognitive behavioural therapy (CBT). “If we didn’t feel stress and some degree of alertness, we wouldn’t be aware of threats and would just walk out into the middle of traffic and not be bothered or pay any attention. If we didn’t feel anxiety, we’d often be poorly motivated to get tasks done and quite unsafe.”
What is stress?
According to the charity Anxiety UK, stress is usually a response to external causes such as a tight work deadline or an argument, and this usually disappears after a solution has been found.
“Stress is a response to a stressor or demand being made on you, such as making a speech or taking an exam, and has an acute onset,” explains Dr Tara Quinn-Cirillo, a psychologist and associate fellow of the British Psychological Society. It’s usually short term and doesn’t hang around, although sometimes it can become chronic if you are dealing with multiple stressors.
“The ‘good’ kind of short-term stress can motivate you to meet deadlines and get things done, but “bad” longer-term stress can impact your physical and mental health,” says Quinn-Cirillo.
Williams says: “Although feeling a degree of pressure can motivate you to meet challenges, if that pressure is seen as too big, too much, too demanding and in too short a time frame, that can push people into chronic stress or anxiety and they won’t perform as well.”
What is anxiety?
“Anxiety isn’t usually associated with a specific event or trigger, it’s more worrying about multiple things, not just a specific short-term event (as is the case of stress). It’s a set of feelings – usually worries, fears or apprehensions – but there’s not always an apparent threat,” says Quinn-Cirillo.
“Anxiety will also build up over time rather than start suddenly as stress can. You may start off being stressed, and then there’s another thing and another thing, and you get this cumulative effect. Anxiety hangs around.”
What do stress and anxiety feel like?
Symptoms of both stress and anxiety can include feeling overwhelmed, having worrying thoughts, irritability, sleep problems and difficulty concentrating.
“Stress and anxiety can affect your body, causing muscle tension in the neck, shoulders and temples,” says Quinn-Cirillo. “You may have other physical symptoms including problems sleeping, gastrointestinal issues, feeling sick and butterflies in your stomach. You may notice you are breathing faster or your heart is racing. Stress and anxiety can be draining too, so you could feel fatigued and worn out, but more so with anxiety as it goes on for longer.”
The differences between stress and anxiety
Although there is an overlap between stress and anxiety, the main differences are that anxiety symptoms tend to persist and be more severe, and generally don’t have an obvious trigger, whereas stress is usually in response to an identifiable demand or event and tends to be less severe and more short term, according to Quinn-Cirillo.
Williams says that people with anxiety typically tend to start avoiding things that seem scary. “Problematic, diagnosable anxiety disorders and anxiety states have a more significant effect on a person’s life than the lower level of worry or distress,” he says.
“Severe anxiety will stop someone doing the things they normally do. They may have social anxiety and avoid social gatherings or busy places such as public transport. They may experience worrying thoughts and feelings of panic, or start to lean on things like alcohol, food or smoking to get them through, or rely on other people to support them, which stores up trouble for the future,” he says. It can be a self-fulfilling cycle. “Anxiety leads to actions that reduce confidence still further so fears build up. It means your world will get smaller, you lose confidence and feel scared.”
Can stress turn into anxiety?
“Yes, absolutely. If you have multiple stressors, your stress levels aren’t dissipating and you notice there are no peaks and troughs in your stress, you could be developing anxiety,” says Quinn-Cirillo.
What causes stress and anxiety?
Stress tends to be triggered by identifiable pressures and demands made on you – everything from a work assignment, the school run, an exam, job loss or increased workload, to giving a speech or a presentation, getting the Christmas shopping done or a family member being ill.
A survey by the Mental Health Foundation found that 36 per cent of adults who reported stress in the previous year cited a health condition affecting themselves, friends or relatives as a source of stress. The figure rose to 44 per cent in the over-55s. In the survey, 22 per cent named debt as the cause of their stress.
Work is another source of stress. The Health and Safety Executive, Britain’s national regulator of workplace health and safety, estimated that 914,000 people were affected by work-related stress, anxiety and depression in 2021/22, resulting in 17 million working days lost across the country.
Anxiety is caused by stress snowballing into multiple worries, so the brain begins to see everything as a potential threat. You find yourself worrying about things that have happened in the past and things that might happen in the future over several months.
Scientists still don’t understand why some people develop anxiety disorders, but various risk factors have been identified, including being female, having a close relative with an anxiety disorder, experience of stressful life events such as domestic violence or abuse, drug or alcohol problems, or physical health conditions such as chronic pain.
How to manage stress and anxiety
“Once you understand what is happening, that’s the biggest intervention you can make,” says Quinn-Cirillo. “It’s about recognising that stress and anxiety are natural responses and understanding why your mind and body are reacting in this way,” she goes on. “Some people are naturally more stressed and anxious than others. It may be that they have had more adverse life experiences – our brain is really good at storing these up as it needs to know what to do if those threats arise again. What can happen is that your brain can go into overdrive and regard everything as a potential stressor.”
The American Psychological Association says that mild stress and mild anxiety respond well to similar coping mechanisms, including taking exercise, sticking to a consistent sleep routine and eating a nutritious, colourful and varied diet.
Other self-help coping mechanisms recommended by the American Psychological Association include eliminating or trying to reduce the source of your stress where possible, getting support from family and friends, warm baths, massages and stretches to reduce muscle tension, getting outside into green spaces, doing activities you enjoy, and reframing your negative thoughts with techniques such as mindfulness, where you teach yourself to focus on the present moment while calmly accepting your thoughts, feelings and bodily sensations.
A review of 209 studies into mindfulness techniques found that mindfulness behavioural therapies were an effective treatment for a variety of psychological problems and were especially effective for reducing stress, anxiety and depression. The NHS recommends breathing techniques for stress, as well as “working smarter not harder” by prioritising important tasks and managing your time better, looking for the positives in life, helping others by volunteering, and setting yourself challenges such as a 5K run or learning a language, which can help build confidence and may help you manage your stress.
Practising relaxation techniques such as visualisation and guided muscle relaxation can also reduce stress.
When to seek treatment for stress or anxiety
David Smithson, operations director at the charity Anxiety UK, says if you are feeling stressed or anxious and it’s affecting your daily life and physical or mental health, it’s important you get help.
“If it’s workplace stress, you could talk to your line manager about taking time off or reducing your workload to lift some of the pressure,” says Smithson. “People still hold back because of the stigma – they worry about being judged and considered weak or a failure, but it’s okay not to be okay and reach out.”
Williams says that for lower levels of anxiety, he would point people towards asking themselves “Are anxious thoughts and fears getting worse so they are dominating more and more of my life?” and “Is the degree of anxious avoidance preventing me from going to places, meeting people or doing activities I want to do?”
“When anxious thoughts dominate and you are more anxious most of the time, you need to seek an assessment and do something about it,” he says.
He adds that it’s helpful to see a doctor if you’re experiencing severe anxiety symptoms such as panic attacks, in which sufferers experience a surge of adrenaline and feel something terrible is going to happen then and there. “If you have experienced one or more episodes of panic, you should see a doctor to get a clear diagnosis – and also to rule out possible physical causes of panic attacks, such as unidentified heart issues or diabetes. You shouldn’t attempt to self-diagnose.”
Treatment for stress and anxiety
Treatments include psychological therapies and medication, depending on the severity of your symptoms.
Cognitive behavioural therapy (CBT), a technique where you are taught to understand that our thoughts influence our emotions and actions, is recommended for the treatment of generalised anxiety disorder (GAD) in guidelines from the National Institute for Health and Care Excellence (Nice).
GAD is characterised by a number of different and excessive worries that are difficult to control, and it affects 1 in 25 people in the UK. Nice guidelines describe GAD as having excessive worries more days than not, over six months.
Williams says: “CBT is very effective for severe anxiety and phobic anxieties generally. It helps people balance their thoughts, look at things differently, and face their fears in a planned, step-by-step way to build confidence. It’s a whole-person approach.”
He adds: “CBT helps people tackle things they have been slowly avoiding, as well as unhelpful behaviours such as drinking too much alcohol or reassurance seeking, where the person looks for the opinion or support of health workers, family or friends. These so-called safety behaviours help the person feel better in the short term, but this improvement doesn’t last and the anxiety comes back. What the person needs is an alternative explanation to help them understand that the symptoms are all part of panic.”
CBT tends to work best for people who are seeking an active solution. Griffiths says: “Other approaches might be more appropriate if someone prefers a talking-based or reflective treatment such as applied relaxation or psychoeducational groups.”
CBT isn’t always effective for people with more complex mental health problems, and your doctor may prescribe an antidepressant such as a selective serotonin reuptake inhibitor (SSRI), some of which have an additional indication for GAD or panic disorder.
Five ways to address the root cause of your anxiety
- Cut down on caffeine
- Cut out ultra-processed foods, which can cause an imbalance in the gut flora
- Cook with turmeric, as it can have an anti-inflammatory effect
- Get more sleep, as sleep deprivation can make your body more prone to a stress response
- Be strict with your boundaries around work and social media use