Stress vs. Anxiety: Compare causes, symptoms, treatments, & more

Causes | Prevalence | Symptoms | Diagnosis | Treatments | Prevention | When to see a doctor | FAQs | Resources

What is the difference between stress and anxiety? It seems like stress and anxiety are exactly the same—but they do have some similarities as well as differences. If you or a loved one is experiencing stress or anxiety, you will want to know more about each one. 

According to the American Psychological Association, stress and anxiety are both emotional responses. However, stress is usually due to an external trigger. These triggers can be short-term (for example, an important presentation, big test, or stressful argument). Or, the trigger can be long-term (for example, unemployment or a chronic illness). Stress can cause both mental and physical symptoms. Anxiety can cause the same mental and physical symptoms as stress. People with anxiety have “persistent, excessive worries that don’t go away even in the absence of a stressor.” Continue reading to learn more about stress and anxiety. 

Causes

Stress

Stress can be acute or chronic. Acute stress is short-term stress. It goes away quickly. You may feel acute stress when you are having an argument or starting a new job. Acute stress can also help you manage a dangerous situation—it can appear when you are trying something new or exciting, like skydiving. 

Chronic stress lasts for a more extended period of time than acute stress. Examples of causes of chronic stress are money struggles or marriage trouble. Chronic stress can last for weeks or even months. If stress is not managed, it can lead to health problems.  

In addition to situational factors that can cause stress, another risk factor is a lack of social and emotional support.

Anxiety

The exact cause of anxiety is unknown but is suspected to be caused by a combination of factors. These include:

• Chemical imbalance: Stress that is severe or lasts a long time can affect the chemical balance that controls your mood. A great deal of stress over a long time can lead to anxiety.
• Heredity: Anxiety tends to run in families. If one or both of your parents has anxiety, you may inherit anxiety. 
• Environment: The environment may play a role, too, especially if you have a higher risk due to heredity. For example, experiencing a traumatic event may cause anxiety, especially if you have inherited a higher risk. 

Risk factors for anxiety can vary based on what type of anxiety disorder is present. However, both genetics and environment play a role as risk factors. Other general risk factors for anxiety disorders include childhood shyness, exposure to stress or negative events at a young age, and a family history of anxiety or other mental conditions. Also, some medical conditions can cause or worsen anxiety symptoms, such as thyroid problems, irregular heartbeat, or caffeine. 

Prevalence

Stress

A study done by The Harris Poll for the American Psychological Association reported results in January 2021. The survey reported that the average stress level from the previous month was 5.6—on a scale from 1 (little to no stress) to 10 (a great deal of stress). The study found that 84% of adults reported feeling at least one emotion related to prolonged stress in the previous two weeks, such as anxiety, sadness, and anger. Most adults reported feeling stress about issues including the future of the country, the COVID-19 pandemic, and political unrest as “significant sources of stress in their lives.” 

Anxiety

According to the Anxiety & Depression Association of America, anxiety disorders are the most common mental condition in the US. Anxiety disorders affect 40 million adults in the US, which translates to 18.1% of the population every year. And although anxiety disorders are treatable, only about 37% of people with an anxiety disorder get treatment. Anxiety disorders often occur with depression—almost half of people with depression also have an anxiety disorder. 

Symptoms

Stress

Stress can cause both physical and mental symptoms:

• Stomach problems like upset stomach, diarrhea, or constipation
• Forgetfulness 
• Pain 
• Headaches 
• Low energy and lack of focus 
• Sexual problems
• Stiffness in the jaw or neck
• Fatigue 
• Sleeping too much or having trouble sleeping
• Weight changes
• Alcohol or drug use (in an attempt to relax)

Chronic stress can lead to other medical problems such as high blood pressure, heart disease, diabetes, obesity, depression, anxiety, acne, eczema, or menstrual problems. Stress can also worsen other health conditions.  

Anxiety

Anxiety can also cause physical and mental symptoms. Symptoms may vary based on the type of anxiety. Some general symptoms may include nightmares, feeling panic, having anxious thoughts that are hard to control and can worsen over time, and behavior changes, such as avoiding activities of daily life. Physical symptoms can include a fast heart rate or pounding heartbeat, muscle tension/aches/pains, dizziness, dry mouth, cold or sweaty hands, nausea, numbness and tingling, and shortness of breath. 

Diagnosis

Stress

Stress is generally not measurable by tests. You can talk with your healthcare provider about your symptoms and their severity. By talking and also sometimes through a questionnaire, your healthcare provider can understand the impact of stress on your life. If your stress is chronic, your healthcare provider may also talk to you about other symptoms. For example, if chronic stress causes high blood pressure, your healthcare provider will want to address both the stress and the high blood pressure. 

Anxiety

If you have symptoms of anxiety, your healthcare provider can take a history and perform a physical examination. Although there are no lab tests to diagnose anxiety, your healthcare provider may order some lab tests to rule out other conditions. If there are no signs of physical illness, your doctor may be able to treat your symptoms or may refer you to a mental health professional, such as a social worker, psychologist, or psychiatrist. The diagnosis is based on your symptoms and how they interfere with your life, as well as the doctor’s observation of your behavior. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, is a reference manual used to diagnose mental conditions such as anxiety. 

There are different kinds of anxiety. 

• Generalized anxiety disorder (GAD): People with GAD have a lot of worry about various issues, such as family, work, and school. The worry can feel extreme and persistent. GAD can cause restlessness and trouble with concentrating and sleep.
• Panic disorder: Panic disorder causes sudden and very intense panic attacks. A panic attack can feel like a heart attack, with symptoms such as sweating, palpitations, chest pain, and feeling like choking. People with symptoms that feel like a heart attack should go to the emergency room right away. 
• Phobias: Phobias are an intense fear of a certain object or situation that may lead one to avoid everyday situations. Phobias may include animals, heights, flying, or injections, for example.
• Social anxiety disorder (SAD): People with SAD feel overwhelming worry about—  and may avoid—social situations. 
• Agoraphobia: People with agoraphobia have an intense fear of certain environments, such as tight spaces, crowds, public transportation, or places outside the home. In severe situations, people with agoraphobia may not be able to leave the house at all. 
• Separation anxiety disorder: This usually affects children or teenagers who worry about being away from their parents. They worry that their parents will be hurt or not return home. 

Post-traumatic stress disorder and obsessive-compulsive disorder are other mental health conditions that share some of the same features of anxiety disorders.

Treatments

Stress

Talk to your healthcare provider about ways to manage stress, to help determine which strategies will work for you. Meditation and mindfulness-based stress reduction help reduce stress and worry, as well as provide other benefits such as improved memory and focus, fewer emotional ups and downs, and better relationships. Cognitive-behavioral therapy (CBT) is a type of therapy that can help mental health symptoms. Some people also find exercise, acupuncture, and/or massage to be helpful for stress management. 

Anxiety

CBT is often used in people with anxiety. CBT can help you cope with things that cause fear and feelings of anxiety, and helps you to confront your fears so you do not feel like you have to avoid things. Your healthcare provider may also suggest a prescription medication to help manage anxiety. There are many options available, including antidepressants and anti-anxiety medications, and it may take a bit of trial and error to find the appropriate medication for you. 
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Prevention

Stress and anxiety

While stress and anxiety can’t always be prevented, you can take some steps to help reduce symptoms. Talk to your healthcare provider if you have questions about which steps may work for you:

• Cognitive-behavioral therapy
• Try relaxation activities such as meditation, yoga, and breathing exercises. There are also many apps available if you prefer to try these at home.
• Take some time for yourself every day, doing something you enjoy, such as taking a walk or reading a book. 
• Eat a healthy diet, exercise, and get enough sleep. Try to establish a routine by going to sleep and waking up around the same time each day. Limit caffeine intake, and avoid drugs and alcohol.
• Keep a journal, making note of the positive aspects of your life. Try to challenge your negative thoughts.
• Say “no” to taking on too much when you are feeling overwhelmed.
• Connect with family and friends who support you.
• Take breaks at work or school.
• Take opportunities to volunteer, if you have the time and energy.
• Ask your doctor or pharmacist if any of the medications you take (including prescription, OTC, vitamins, or supplements) could be contributing to your symptoms. 
• Do not hesitate to seek help from your healthcare provider/mental health professional. 

People with anxiety may also benefit from prescription medication such as antidepressants and/or anti-anxiety drugs. 

When to see a doctor for stress or anxiety

If you feel overwhelmed by stress or anxiety, if it is taking a toll on your health, if you are using drugs or alcohol to cope with your symptoms, or if you have new or unusual symptoms, it is a good time to get professional help. Your primary healthcare provider can examine you, and refer you to a mental health professional if necessary. There is nothing to feel embarrassed or hesitant about. Stress and anxiety are very common, and your doctor will be glad you came to them for help. 

Sometimes, symptoms of anxiety can feel like a heart attack. Even if you think you are having an anxiety attack, it is best to go to the emergency room to rule out life-threatening conditions. If you are unsure or hesitant, it is safer to go to the emergency room so you can be quickly evaluated by a healthcare professional. 

If you are having thoughts of suicide, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) immediately or go to the emergency room. 

Frequently asked questions about stress vs. anxiety

What’s the difference between stress and anxiety? 

It can be confusing to determine the differences between stress and anxiety. Usually, stress is in response to an external cause, such as a big presentation or an argument, and the stress goes away after the situation is over. On the other hand, anxiety is your internal reaction to stress. Although there are different types of anxiety disorders, anxiety usually involves a constant feeling of worry that interferes with everyday life activities. Both stress and anxiety can cause physical and mental symptoms, such as pain, insomnia, and high blood pressure. Your healthcare provider can help determine if you are experiencing stress or anxiety, and provide medical guidance on how to cope with either one, and/or refer you to a mental health professional if needed.

What are common anxiety triggers?

In general, stress that does not go away can trigger anxiety, especially if left unaddressed. Anxiety can also be triggered by a lack of sleep. Specific triggers can vary. What causes anxiety in someone may not cause anxiety in another person. Being aware of anxiety triggers and thoughts helps you learn to manage them. For example, if you know that public speaking makes you feel anxious, you can try some deep breathing techniques to help you relax before you speak in front of a group. 

How do I know if I am anxious or stressed?

It can be difficult to know if you are anxious or stressed. If you are worried about a specific event, such as moving to a new house or starting a new job, that is usually due to stress. If,  on the other hand, you constantly worry, even if there is no immediate threat, that is more likely anxiety. If you are feeling symptoms of stress or anxiety, your healthcare provider can evaluate you and help you feel better. 

Can stress cause anxiety?

Sometimes stress can be positive, for example, if it pushes you to meet a deadline, and then the stress goes away after the work is done. However, stress that persists and does not go away can trigger anxiety, especially if left ignored. If you are feeling symptoms of stress or anxiety, it’s always helpful to check in with your healthcare provider.

Resources

• 7 tips to avoid stress, NYC Health + Hospitals 
• Anxiety, MedlinePlus U.S. National Library of Medicine
• Anxiety disorders, Cleveland Clinic
• Anxiety disorders, National Institute of Mental Health (NIMH)
• APA: U.S. adults report highest stress level since early days of the COVID-19 pandemic, American Psychological Association
• Anxiety facts & statistics, Anxiety and Depression Association of America
• I’m so stressed out fact sheet, National Institute of Mental Health (NIMH)
• Manage stress: Strengthen your support network, American Psychological Association
• Stress, Cleveland Clinic
• Stress and your health, MedlinePlus, United States National Library of Medicine
• Stress busters: 4 integrative treatments, Johns Hopkins Health
• Stress effects on the body, American Psychological Association
• What is anxiety?, Anxiety.org
• What’s the difference between stress and anxiety?, American Psychological Association