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Stress or anxiety? Here's how to recognize the difference

Last week, SZA announced on Twitter that she would no longer do any photo shoots, video shoots, or interviews, shortly after Rolling Stone revealed the cover of its March “Women Shaping the Future” issue, which features her alongside Normani and Megan thee Stallion. She then tweeted about her anxiety and how she “could care less” about others’ opinions on it. Twitter had opinions, though, some seemingly dismissive of the singer’s mental health issues. “All the new celebs got anxiety out the ass, what’s going on?” wondered one user, while another responded that “everyone [has anxiety] low key.”

Here’s the thing, though: Not everyone experiences anxiety. Sure, everyone experiences stress — but stress is not the same as an anxiety disorder. As someone who manages an anxiety disorder, I know. Understanding the difference is crucial to avoid perpetuating stigma and misconceptions around anxiety disorders, which can make it even harder for people who struggle with them to get the help they need.

The symptoms of stress and anxiety are similar, says Inger Burnett-Zeigler, associate professor of psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine. They can include irritability, as well as physical symptoms, such as muscle tension and difficulty sleeping, The key difference between stress and anxiety is that the symptoms of stress are acute, whereas those of anxiety — that is, an anxiety disorder — can last weeks or longer.

“Stress is typically something that comes on from some sort of environmental trigger,” like a presentation or a sick family member, Burnett-Zeigler explains. When the trigger goes away — once you give the presentation, or your family member gets better — the stress subsides.

On the other hand, an anxiety disorder, specifically generalized anxiety disorder (GAD), which I live with, “is more of a global experience,” Burnett-Zeigler says. “People who are anxious don’t necessarily attribute it to one specific circumstance. They’re overwhelmed with this feeling in multiple different settings in their lives.” They ruminate and fear negative outcomes and judgments from others, constantly. I’ve described GAD as having a high baseline level of anxiety, no matter what, whether I’m at work or on vacation. Unlike with stress, there isn’t a specific thing I can resolve to make my anxiety disappear.

Anxiety can also manifest as panic disorder or social anxiety disorder. People with panic disorder have sudden, repeated panic attacks, whose symptoms can include shortness of breath, heart palpitations, and nausea, and can emerge seemingly out of nowhere, with no apparent trigger, per the National Institute of Mental Health. Those affected often fear future panic attacks, itself a panic-inducing experience, creating a vicious cycle, Burnett-Zeigler explains.

Social anxiety disorder can vary in its specificity, she says. For some people, it emerges only in certain settings, such as performing, and for others, in any situation involving speaking, even conversations.

The bottom line is, if you’re lying awake at night, thinking about a deadline you have the next morning, or your heart races before asking someone out — and you stop experiencing these symptoms afterward — you’re stressed. You don’t have anxiety.

And while both stress and anxiety can interfere with your day-to-day functioning, the risk is greater with anxiety, which can spur people to avoid certain situations, change how they do their job, or even render them incapable of doing their job, Burnett-Zeigler says. Indeed, SZA’s anxiety disorder has driven her to avoid photoshoots, video shoots, or interviews for the rest of her life — which could hurt her music career, “but that’s her way of coping in that particular moment.” When we conflate stress with anxiety, we minimize the serious and potentially debilitating effects of the latter, and the suffering of those who live with it.

Comments like “everybody has anxiety,” are especially tricky, since anxiety disorders are indeed common, with 31.1% of adults in the US experiencing one at some point, per the NIMH, and research suggests they’re becoming even more common, especially among young people. But it’s worth noting that such comments ring with a dismissiveness not normally seen when we talk about, say, heart disease, type 2 diabetes, or other common physical conditions.

This dismissiveness perpetuates stigma against mental illness and the misconception that we should be able to just muscle through it, making it harder for people to seek help, since they may also hold stigmatizing beliefs related to their own anxiety, Burnett-Zeigler says. They might think it’s not really a problem, that it’ll get better on its own, or that it doesn’t require professional treatment. Mental health stigma is particularly heavy in communities of color. “This can lead to delays in treatment seeking or people not receiving treatment at all,” Burnett-Zeigler says.

Not using "anxiety" when we really mean “stress” may seem nitpicky, but language is important; it shapes how we see ourselves and others, and ensures we get the mental health care we deserve.