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Stress, Anxiety and Depression: What's The Difference?
Stress and Anxiety are often understood interchangeably but they are distinct in their symptomatic presentations, their treatment and their definitions.
Stress and anxiety are, despite their mixed use, distinct in their symptomatic presentations. Depression has a different presentation altogether and ranks highest in terms of mental health disturbance. It is important to not use these terms in place of each other or assume they all are covered by the larger aegis of issues in mental well-being — so that individuals suffering from the diagnoses get the correct help they need, as the method of treating each can be as distinct as their presentation.
To understand the difference between these, let us start with some simple definitions.
Stress is a state of activation to an event that requires resources beyond our capacity to cope. In other words, it is the physiological, psychological, and emotional response to that event.
Anxiety is a state of arousal, of heightened emotional activity of fear or dread of what may happen. Once again, the symptoms are both physical and mental.
Depression is, instead, the opposite of arousal. It is quite literally a state of 'depressing.' That's when the system shuts down and we end up going into a shell, replete of energy and mood, incapable of feeling the regular breath of emotions we feel in the regular course of events. As a rule of thumb, going from stress to anxiety to depression involves a journey from activation to arousal to shutting down.
The Symptoms of Stress, Anxiety and Depression
The Symptoms of Stress
Stress as a reaction appears in many ways, including:
- Inability to sit still
- Desire to be in control
- Inability to sleep or rest
- Poor cognitive skills
- Distorted sense of self and reality
- Incapacity to be in the present moment
- Body ache, back ache, headache
- Lack of concentration
"The greatest weapon against stress is our ability to choose one thought over another."– William James
The Symptoms of Anxiety
Anxiety can usually be identified by some of the following symptoms:
- Agitation and restlessness
- Increased heart rate
- Sweating and trembling
- Rapid breathing
- Fear and dread of the future
- Imagining the worst
- Living in the imagined future
- Churning in the stomach or gut
- Headaches or other somatic symptoms
- Magnification of events
The Symptoms of Depression
Depression, on the other hand, tends to be identified by the following symptoms:
- Helplessness and hopelessness
- Negative attribution style
- Cognitive disturbance
- No hope for the future
- Disconnection from present
- Disassociation and numbness
"Depression is being constantly colour-blind, and constantly being told how colourful the world is."– Atticus
The Difference in Symptoms
The fundamental difference between stress, anxiety and depression in terms of the symptoms is the degree of dysfunction they cause and the lack of perceived control that is felt by the individual. It is important to note that while there is an overlap, they are by no means the same. Each of these conditions may signal poor mental health.
For example, stress can be managed without help or medication. Conversely, if stress is left unabated it can be a silent and slow decimator of both mental and physical well-being. Similarly, if anxiety is managed well with a good toolbox of skills and techniques, it can slowly recede into a phenomenon the individual feels some agency over.
Depression needs to more seriously be addressed in a professional setting. The same goes for chronic anxiety, as treatment over time can prove extremely beneficial in restoring well-being, reducing symptoms, and alleviating long-term health risks.
How Stress and Anxiety Are Linked
Stress and anxiety are considered a natural part of the body's reaction to perceived threats or danger. The evolutionary reason for stress and anxiety was to ensure that we are ready to deal with what is coming our way. We are meant to be able to 'release' this activation once the threat has passed or, more importantly, only have this activation when there is a real threat.
In the modern world, we are not always able to de-escalate, and we are also not experts at threat identification and understanding or teaching our bodies if there is a real reason to prepare ourselves for threat or experience a 'stress response' (Hans Selye, 1956) — also known as the fight or flight response.
Simply put, stress can be something more short-term. Anxiety may or may not have a clear, identifiable trigger. Stress begins a generic feeling of unhappiness while anxiety brings forth nerves or nervousness. Stress puts us into a state of being overwhelmed while anxiety puts us into worry about what may happen and a state of dread. They influence each other most deeply by co-existing to the degree that we cannot distinguish one from another.
The Main Differences Between Anxiety and Depression
Depression is identified as feelings of sadness, helplessness and despair. It performs as a chronic unhappiness with life's situations and the inability to see any hope.
Anxiety is a feeling of apprehension, impending dread and doom. It is a chronic worry about what may happen and the helplessness of not being able to do anything about it. In this sense, anxiety is a state of being constantly 'on' in imagining and catastrophising about the future.
Simply put, depression involves the feeling of internal scrutiny of the self, worthlessness, and even guilt. Anxiety involves dread, worry, and a feeling of panic at not being able to deal with them but not necessarily self-deprecation.
It is important to remember the main difference is in the states of arousal: depression slows the system down while anxiety revs it up.
How to Overcome Stress, Anxiety and Depression
Building a coping repertoire is an essential part of counselling and therapy. Coping has broadly been categorised as one of four types:
- Problem-focused — which addresses the problem causing the distress
- Emotion-focused — which is about reducing the negative emotions associated with the problem
- Meaning-focused — where we try to use mental or cognitive strategies to derive meaning from the situation
- Social and support-seeking — where an individual reduces stress by seeking succour from others
The tension of chronic stress states, unsettled anxious thoughts, overthinking, and deep worry can be worked through well in therapy. Counselling also provides a deep holding place for depressive ideas and feelings of helplessness.
The starting point of how therapy and counselling work is to provide the first listening ear for issues that have felt intensely personal and debilitating, as anxiety and depression often do. It is a way to take the first steps of coming out of being alone with these thoughts of dread and worry.
In Gestalt therapy, the idea is to first listen and then start clearing the path together. A path that may be strewn with old experiences that are clogged and difficult to make sense of. In this clearing, clarity emerges and we are able to become more aware and better resourced to deal with our own inner mental demons.