Worry and alertness are completely normal physiological events, not only in humans, but also in other living organisms.
Sporadic stress sharpens our senses and allows us to respond more effectively to environmental impositions and, therefore, can save our lives in a dangerous situation. In an extreme scenario, the difference of two seconds in response capacity can mean the difference between life and death.
The problem arises when, in a society full of stimuli and responsibilities, the stress response sets in to stay. The World Health Organization (WHO) establishes that depression is a condition of global concern, since more than 300 million people suffer from it. In any case, anxiety symptoms are not far behind: 260 million people see their quality of life reduced by long-term anxiety symptoms.
Establishing a limit between the normal and the pathological is a real challenge, since as individuals we do not have enough psychological tools to differentiate a clinical entity from something expected within our personality or condition as humans. For these reasons and many more, below we will a review of the differences between anxiety and pathological anxiety.
The physiological mechanisms of anxiety
Anxiety is a natural defense mechanism of organisms against external and internal stimuli that are perceived as potentially harmful and that reduce individual survival. Some anxiety is beneficial in the natural world since it makes animals sharpen their senses in moments of danger, try to access food sources more insistently and, in short, “give everything” to remain in the environment for another day.
When humans perceive a harmful stimulus, the adrenal glands begin to release adrenaline. This is a hormone that increases heart rate, constricts blood vessels, dilates airways and participates in the fight or flight response, mediated by the mechanisms of the sympathetic nervous system (CNS). The plasma half-life of adrenaline is 2-3 minutes, so it generates very short but intense emotions in humans.
On the other hand, Cortisol is the stress and anxiety hormone par excellence. Although its half-life is about 60-90 minutes, its secretion can continue over time in anxiety disorders once the causal agent has disappeared. Cortisol suppresses the action of the immune system, promotes the metabolization of compounds stored in the body, increases blood glucose levels and allows body homeostasis. In summary, cortisol mobilizes resources to do what is most important in times of stress, which is to obtain energy and maintain muscle tone to respond to dangers.
The 3 differences between anxiety and pathological anxiety
As we have seen, adrenaline promotes an immediate response to danger, while cortisol is responsible for a more modulated and sustained reaction over time.
The big problem with cortisol secretion, at a pathological level, is that can have harmful effects on the body’s immune system and many other organs. Let’s look at the difference between normal and pathological anxiety.
1. Anxiety is not a pathology, but generalized anxiety disorder (GAD) is
As we have said, anxiety is a natural adaptive response, but if it continues over time, it becomes a diagnosable disease. Generalized anxiety disorder (GAD) is included in the group of anxiety disorders, which also include panic disorder and various groups of phobias.
According to the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychological Association (APA) in 2013, GAD can be diagnosed based on a series of parameters. These are the following:
All of these diagnostic criteria are standardized in clinical practice. For this reason, a generalized anxiety disorder is considered a pathology, while sporadic anxiety is not.
2. Pathological anxiety is sustained over time
This is the most important differential factor when distinguishing between disease and normality. As we have said, feeling anxious occasionally is normal (and even positive), but if it extends once the original stressor has disappeared, it is time to suspect a slightly more complex condition.
For a patient to be considered within this pathological spectrum, anxiety symptoms must remain continuously for at least 6 months.
It is possible that a person with pathological anxiety always feels that their fears are justified. Therefore, he perceives that he worries with reason and does not believe that his condition is outside of normality. Nothing could be further from the truth: finding reasons to worry cyclically is also a sign of an emotional disorder, even if these are more or less valid.
If you doubt these statements, chronologically place on a timeline what your most intense worries have been in recent times , and you will see that almost none of them last more than half a year. If you chain one worry to another and feel like you haven’t felt well for a long time, it’s possible that anxiety has taken more control of your life than you think.
3. Pathological anxiety has a series of associated symptoms
As we have said previously, for a GAD to be considered such, it must meet a series of criteria, among them that the patient manifests at least 3 of the 6 symptoms that we present to you: lack of rest (pigeonholing), ease of feeling fatigue, difficulty in time to concentrate, irritability, muscle tension and/or problems sleeping.
Furthermore, these signs must be present for more than half of the days of the week during the aforementioned 6 months. This sustained clinical condition causes the patient to feel continually unhappy. have digestive problems, headaches, memory impairment and other additional physiological disorders.
On the other hand, some studies indicate that up to 20% of professionals in certain fields, in moments of generalized anxiety, tend to somatize their problem. This means that, without any organic justification, they feel localized pain or discomfort that seems to be the result of an illness. One of the most famous physical pains is that of the stomach and intestines, since the gastric muscles contract due to the action of stressful nerve pathways without apparent meaning.
In other words, Generalized anxiety can cause pain that should not otherwise be there. Although this does not directly affect the “real” health of the individual, it can be an important trigger of social and work difficulties, in addition to generating even more worries and feeding back the circle of anxiety.
Summary
As you can see, the key difference between anxiety and pathological anxiety is the time interval in which the sensations, feelings and psychological processes occur. If the duration of the worries is more than 6 months and cannot be explained by other underlying diseases, it is time to suspect this psychological disorder.
In any case, it is worth noting that generalized anxiety disorder can be treated , either with a pharmacological approach (long-term antidepressants and benzodiazepines in the worst moments) combined with psychological therapy or with psychological therapy alone, depending on the intensity of the condition and the patient’s wishes. If you feel that your condition is beyond physiological normality, do not hesitate to ask professionals for help.
