If you google ‘stress’ you will find thousands of resources; books, websites, podcasts, courses and more. Same for anxiety. But is stress the same thing as anxiety? What are the symptoms of anxiety and stress? How do you know whether it’s stress or anxiety that is bothering you, and does it make a difference anyway?

What is stress?
One clinical definition of stress, from the British Psychological Society, is that ‘stress is the feeling of being under a level of mental or emotional pressure beyond your ability to cope. The root causes of stress will differ from person to person, and a stressful situation for one individual may not produce the same level of stress in another.’

Reactions to stress can be both psychological and physical, impacting your thoughts, feelings, and behaviour. Common signs of stress include headaches, muscle tension, neck/jaw/back pain, problems sleeping, loss of appetite, and difficultly concentrating. You may also experience feelings of anxiety, increased irritability, low self-esteem, and/or a constant sense of worry.

Dr Funke Baffour, writing on ‘the good, the bad, and the ugly’ of stress makes the valuable distinction between different types of stress, noting that some stress can be positive, for example adjusting to a promotion or all of the preparations involved in getting married. The types of stress that boost our mood and energy, motivating us to put in extra effort to achieve specific things are short term, and this is a key point. Stress that is prolonged over a long period of time is the bad stress, and that’s what we generally mean when we talk about feeling stressed or being ‘stressed out!’

What is anxiety?
Anxiety is feeling stress, concerns or other negative emotions in anticipation of some future event (which may or may not be real, and which may or may not be likely to occur). Anxiety is when you worry even when there is nothing objectively wrong in the present moment, and/or you’re worrying to an extent that is out of proportion to the actual threat. Anxiety can include dwelling on something, or seeking continual reassurances (for example from friends, family, Dr Google). The symptoms of anxiety include catastrophising, and lots of ‘what if?’ leading to your mind racing ahead, or feelings of dread, feeling restless, unable to concentrate, detachment, the urge to get away from the situation, or the place, sometimes feeling the need to flee from a situation.

In addition to all the things going around in your thoughts, there can be physical anxiety symptoms, or sensations, including muscle tension, feeling dizzy or lightheaded, feeling hot and/or sweaty, or clammy, shaking or trembling, sleep disruption, tiredness, and digestive issues. 

How do I tell the difference between stress and anxiety?
It can be quite hard to tell the difference, as anxiety and stress share many of the above physical symptoms.

One key distinction is duration; stress is usually short-term, in reaction to a specific event or situation. And stress, as noted above, can be a positive force, motivating you to action. Anxiety is more pervasive; it will be present across different events or situations, and can be very debilitating, preventing you from taking action or from feeling like you’re achieving things. And these feelings will likely be generalised, across several aspects of your life, rather than relating only to the specific task, event or situation (the ‘stressor’). Also, stress is more rooted in the here and now; it’s a reaction to a current or not too distant situation or event. Anxiety is more of a heightened reaction to current stressors or worrying about something that is far off in the future, or that may never actually happen.

I think my issue is stress – what helps relieve stress?
While different things work for different people, there are a few strategies that are widely found to be helpful to reduce stress. Try a few and see what works best for you.

• For many people the single most effective strategy is deep breathing; practice when you’re not particularly stressed, so you can draw on calm when you need to.

Belly big - breathe in - belly small - breathe out

• Take a slow breath in through your nose for a count of 4, breathing into your lower belly so it inflates

• Hold it for a second or two

• Breathe out slowly through your mouth for the count of 5, and feel your belly deflate

• Wait a few seconds then take another deep breath and find a breath pattern that suits you.

• Mindfulness can help to keep your mind where your body is and is very helpful to relieve stress (and to calm anxiety and relieve depression as well). While you can be mindful through focusing during everyday activities, most people find it best to try an App to get started. There are lots of apps available (e.g. Calm, Plum Village, Mindfulness) and it generally comes down to finding a voice that appeals to you. I’d suggest trying 15-20 minutes daily. Many of my clients have been concerned that they need to ‘clear the mind’ to be mindful, so it’s really important to know that there is no expectation that you will clear your mind; rather it’s about acknowledging that thoughts pop up, and then refocusing.

• If you feel stress building, this 5 – 4 – 3 – 2 – 1 mindfulness exercise is good to use when you just have a few moments and want to ground yourself. What are:

  • 5 things you can see - aim to notice things you hadn’t seen before, like a pattern, or a flash of colour in your surroundings

  • 4 things that you can feel - your feet on the floor, the breeze, warmth of the sun if you’re outdoors, the texture of a fabric, etc.

  • 3 things you can hear - birds, a clock, music from a passing car

  • 2 things you can smell - coffee, plants, spices, and

  • 1 thing you can taste - notice how your mouth tastes, maybe a lingering flavour from recent food or drink, or take a sip of tea, and really taste it.

• I talk to my clients about having a good ‘foundation’ and that includes exercise, sleep and diet. While sleep can be disturbed during periods of stress, keeping to a good sleep routine can help to alleviate this, and act as a bit of a buffer. Same goes for exercise; when you’ve got a lot going on its really easy to skip exercise, but even simply getting outside for a walk can get your focus off the stressor, release feel-good chemicals in your brain, and help you relax.

• Find your flow – find those activities that you can just lose yourself in, whether that’s listening to music, knitting, doing a jigsaw, cooking, or whatever. Think of a time when you were doing something and became so engrossed that you lost track of time. That’s flow; and often it comes when you’re doing something creative – when you’re focused on what you’re doing your mind is not busy stressing, and has a chance to relax.

• If you enjoy writing, keeping a journal can also help with stress. Write down key things from your day, both good and bad; this can help both by unloading your thoughts, and by enabling you to see and focus on the things that went right, and to spot any patterns.

Counselling can help with stress, particularly with things like spotting patterns in thoughts and behaviours, and may be helpful if you find stress is becoming more frequent or unmanageable.  Stress is a common trigger for anxiety, so it’s best to catch it early if possible.

So I have anxiety, not stress. How do I deal with anxiety?

When I’m counselling clients with anxiety, we cover many of the same strategies that help with stress. In particular, I’m a big fan of mindfulness as a tool to calm both stress and anxiety. In addition, we work through other tools you can practice and use yourself to calm anxiety, including challenging your self talk, and practising small acts of bravery.

CHALLENGING YOUR SELF TALK
This involves noticing negative thoughts like ‘this always goes wrong’, or ‘I can’t do this’ and questioning those thoughts. Think of different ways to interpret the situation, think of times you have done something similar and done it well, break big scary things down into chunks, and look for facts. Words like ‘never, always, can’t’ are actually quite easy to challenge, as you just need to find one thing that has gone ok, one time a bad thing didn’t happen, one element of a fear or situation that you know you can conquer. If you can’t imagine talking to a friend or family member the way you talk to yourself, then think what advice or support you would offer friends and family and give yourself the same support.

SMALL ACTS OF BRAVERY
If you continually avoid something that makes you anxious (for example, dentists or blood tests) this can make it seem bigger and scarier and leave you more anxious in the long term. If you break something that feels big and scary down into chunks, you can then take small steps to deal with that anxiety. For example, arrange a dental check up and agree beforehand that it will only be a check up and no treatment will be done. Or, breaking it down further into smaller steps, visit the dentist surgery in person to make the appointment, rather than doing it online or by phone, ask if you can simply look at the room, and perhaps sit in the chair, accompany someone else to their appointment etc. This way, you learn that what you fear isn’t likely to happen, and you work out ways to cope with fears or setbacks by doing it one step at a time.

COGNITIVE BEHAVIOURAL THERAPY (CBT)
One key therapy for anxiety is Cognitive Behavioural Therapy (CBT). CBT can help across all types of anxiety, including general anxiety, social anxiety, health anxiety (also known as illness anxiety disorder), phobias, situational anxiety, and more. CBT looks at your thoughts and looks for patterns or persistent thoughts that contribute to your anxiety, and then supports you to challenge and change those thoughts and replace them with new ones that serve you better. It’s a bit like the process of challenging your self talk, but with the support of a counsellor to help you question whether thoughts are true or false, the likelihood of things happening, and what alternatives are there.

I hope that this information has helped you work through what’s happening for you and given some inspiration on strategies to help. As ever, I’m happy to have a chat and answer any questions you may have.

Thanks, Louise (Principal Counsellor)

Photo by Christian Erfurt on Unsplash