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Worry, Anxiety, Stress, Panic, Phobia, and Fear:  What’s the Difference?

Worry, Anxiety, Stress, Panic, Phobia, and Fear:  What’s the Difference?

 

These terms get used a lot to described mental and emotional states.  Is it an “Anxiety Attack” or a “Panic Attack?” Isn’t Phobia another word for Fear?  Does worrying mean being fearful?

 

Confusing right? 

 

While there is overlap and similarities between all of these terms, they are also distinct and separate from each other. They have their differences.

 

 

Worry

 

The definition of worrying is to cause anxiety by dwelling on difficulties. Worry may not always produce anxiety, however, especially if successful problem-solving occurs as a result of the worry.

 

When we worry, we repetitively think about the negative aspects of a problem.

 

We may do this because we are already feeling anxious. Then the worrying makes us feel more anxious. Then we feel anxious about feeling anxious. It’s a vicious circle that could lead to more symptoms of anxiety and possibly progress to symptoms of a panic attack.

 

Worrying is a normal part of life. It’s a signal that something could be wrong.  It helps us solve problems. It prepares us for potential future problems.

 

Worrying can also be a sign of an anxiety disorder if the worries are excessive and the resulting anxiety interferes with your life.

 

Symptoms of Worry:

 

  • Repetitive or uncontrollable negative thoughts or images

 

  • Restlessness or feeling on edge

 

  • Fatigue

 

  • Difficulty concentrating or mind going blank

 

  • Muscle tension or muscle soreness

 

  • Poor sleep

 

 

Anxiety

 

Anxiety is the physiological feelings of tension, nervousness, racing heart, sweating, and feelings of dread that can be triggered by worried thoughts and/or fear. 

 

Anxiety can be a feeling of apprehension about something in the future and anxiety can be experienced in the moment during stressful events.

 

All anxiety related disorders fall under the umbrellas of Anxiety Disorders, Obsessive-Compulsive Disorders, and Trauma Related Disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM 5, APA 2003). In the United States mental health professionals use the DSM as a universal authority for psychiatric diagnoses.

 

The DSM does not contain the term “Anxiety Attack.” It’s just referred to as “Anxiety”, and it is not the same as a Panic Attack.

 

Symptoms of Anxiety:

 

  • Having difficulty controlling worry

 

  • Sense of impending danger or doom

 

  • Restlessness or feeling on edge

 

  • Trembling, twitching

 

  • Fatigue

 

  • Difficulty concentrating or mind going blank

 

  • Breathing rapidly (hyperventilation)

 

  • Increased heart rate

 

  • Muscle tension or muscle soreness

 

  • Poor sleep

 

  • Frequent urination and/or diarrhea

 

  • Sweating

 

  • Nausea

 

 

Stress

 

Stress is often caused by a stressor. Stress is emotional or mental strain and is experienced when the demands of something (the stressor) outweigh our ability or our perceived ability to meet those demands. 

 

Stressors include physical and emotional demands or conditions that we must endure such as continuous noise, extreme heat and cold, long work hours, financial obligations, family, and toxic relationships. 

 

Symptoms of Stress:

 

  • Worry, negative thoughts or images

 

  • Stomach upset Nausea

 

  • Difficulty concentrating or mind going blank

 

  • Restlessness or feeling on edge

 

  • Poor sleep

 

  • Fatigue

 

  • Muscle tension

 

  • Chest pain or discomfort

 

 

Panic

 

Panic is a sudden and uncontrollable feeling of fear and anxiety.

The Diagnostic and Statistical Manual of Mental Disorders (DSM 5, APA 2003) defines a Panic Attack as an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes and during which time four (or more) emotional and physical symptoms are experienced.

 

Note that the abrupt surge can occur from a calm state or an anxious state.

 

Panic attacks can happen during specific feared situations and they can happen randomly during periods of non-threatening, normal activities such as sitting and watching TV.

 

Panic attacks are the body’s evolutionary response to a perceived external threat. The fight, flight, or freeze response is helpful if we encounter a wild animal poised to eat us. The adrenaline that begins flowing through our bodies aids in our escape and survival. When the external threat is defeated or evaded, the symptoms disappear. 

 

For most people today, however, there is no wild animal. It’s a false alarm that signals an internal threat or danger. It’s a misperception of danger.

 

After experiencing a first panic attack, the fear becomes about experiencing another one. 

 

Fear of experiencing a panic attack may actually bring on a panic attack and accelerate the symptoms of one already in progress, also known as, Fear of Fear.

 

Symptoms of Panic:

 

  • Palpitations, pounding heart, or accelerated heart rate.

 

  • Sweating.

 

  • Trembling or shaking.

 

  • Sensations of shortness of breath or smothering.

 

  • Feelings of choking.

 

  • Chest pain or discomfort.

 

  • Nausea or abdominal distress.

 

  • Feeling dizzy, unsteady, light-headed, or faint.

 

  • Chills or heat sensations.

 

  • Numbness or tingling sensations.

 

  • Derealization (feelings of unreality) or depersonalization (being detached from oneself).

 

  • Fear of losing control or “going crazy.”

 

  • Fear of dying.

 

 

Phobia

 

A phobia refers more to the specific object or situation that is feared. Phobia means a “Fear of” something such as a fear of white kittens. It’s the thing that causes the fear.

 

A phobia is a label for an intense, irrational fear. It doesn’t seem reasonable to be fearful of white kittens.    

      

Symptoms of a Phobia:

 

  • Specific Irrational Fear

 

  • Panic

 

  • Pounding heart

 

  • Sweating

 

  • Trembling

 

  • Shortness of breath

 

  • Feeling of choking

 

  • Chest pain

 

  • Nausea

 

  • Feeling dizzy faintness

 

  • Numbness or tingling

 

  • Chills or hot flashes 

 

 

Fear

 

The Merriam-Webster Dictionary defines fear as “an unpleasant often strong emotion caused by anticipation or awareness of danger.”

 

The Cambridge Dictionary defines fear as “an unpleasant emotion or thought that you have when you are frightened or worried by something dangerous, painful, or bad that is happening or might happen.”          

 

Fear is the thinking or intellectual labeling of something as dangerous and the resulting feeling of extreme dread.                                                                                                  

So fear is both an emotion (or feeling) and a thought. 

 

You and I can feel fear in the moment as in “I was frozen in fear when the plane hit turbulence.”        

 

Fear becomes a thought when we label something as fearful as in “I fear something bad ever happening to my family.”  

  

Fear can be rational whereas a phobia is irrational.

 

Fear is an evolutionary biological mechanism that helps in our survival.

 

Symptoms of Fear:

 

  • Rational anticipation or awareness of danger

 

  • Trembling, shaking

 

  • Sweating      

 

  • Increased heart rate

 

 

 

Summary

 

Worry and stress tend to go together when the cause is identifiable and rational such as having financial difficulties and conflict with relationships. 

 

When we are stressed, we usually know what is worrying us. With anxiety, however, we may not know what the cause is or our emotional and physical reaction is often irrational and out of proportion to what is actually going on.  With anxiety there often is no actual danger.

 

Worry can progress to anxiety when the worrying seems uncontrollable and the worry is not rational such as worrying if you actually locked the door even though you checked it 3 times. 

 

Anxiety can progress to panic attacks. We can become anxious about feeling anxious, and then have fear of feeling fearful.

 

Phobias can result from associating symptoms of anxiety and panic attacks with specific situations such as flying in an airplane. 

 

Fear can be present in worry, stress, anxiety, panic, and phobias. 

 

Fear is a rational anticipation and labeling of danger whereas a phobia is an irrational anticipation and labeling of danger. Fear aids in our survival.

 

 

Source:

 

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (Fifth edition). Washington, D.C.: American Psychiatric Association; 2013.

 

For more information:

 

Please purchase my book “Attacking Panic:  The Power to Be Calm” for more in depth information on how to stop panic attacks quickly and how to treat the root cause (Amygdala/Sympathetic Nervous System). 

 

The book shows you how to go beyond just giving up control and allowing yourself to experience a panic attack.  

 

The book has more powerful strategies that will short-circuit your fight or flight system, stop a panic attack very quickly, and even prevent a panic attack from occurring. 

 

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Russell Hunter, Psy.D.
Licensed Clinical Psychologist

I want to help you. Please feel free to contact me confidentially by email below with any questions or if you need some advice about the content posted on The Fear Blog.

Attacking Panic: The Power To Be Calm. Copyright © 2017 Russell A. Hunter, Psy.D. All rights reserved. Attacking Panic is available in paperback and Kindle edition at Amazon and in paperback at Barnes & Noble and other online retailers.

How to Stop A Panic Attack Quickly.

Russell A. Hunter, Psy.D. Psychology Today Profile

National Register of Health Service Psychologists

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