As a Therapist at the Counseling and Wellness Center of Pittsburgh, I frequently encounter a prevalent concern among clients – the pervasive presence of stress and anxiety in their daily experiences. Without a doubt, stress and anxiety can be unsettling, and they can feel particularly intense when they appear to pose a threat to one’s well-being. However, in instances where immediate safety isn’t at risk, feelings of unease are often linked to triggers that threaten emotional or psychological equilibrium.

Anxiety itself can fall into one of three categories, namely: worry, stress and anxiety. You might be interested to know that 40 million Americans suffer from an anxiety condition and if you are one of them, you are not alone. Let’s dive into each category and identify the components of each.

Worry: Cognitive Component of Anxiety

The first category is the most common and that is the form of anxiety caused by worry. Worry is what happens when your mind dwells on negative thoughts, uncertain outcomes or things that could go wrong. It’s the cognitive component of anxiety, and occurs basically in your mind, not your body. When we think about an uncertain or unpleasant situation — such as paying the bills, being on time for an appointment, or how we’ll do on a test at school, etc. — our brains become stimulated. In this case worry calms our brains down by giving it a focus, and is likely to lead us to problem-solve or to act, both of which are positive things. In essence, worry keeps us safe. The key to remember regarding worry, is that it is helpful, only if it leads to change. If not, it may lead to a more complicated second category condition, such as Stress.

Stress: Physiological Response to External Demand

Stress is a physiological response to an external event or force that places an excess demand on one’s distress tolerance resources. The cycle of stress begins with a stressor, an event that interrupts the nervous system’s neutral flow state. Think of how the natural stress response system may have operated for our prehistoric ancestors. Imagine a predator jumps out of the bushes prompting a behavioral response, activating the fight, flight, or freeze response, firing up the limbic system’s release of stress response hormones of cortisol and adrenaline, and prompting the tendency to run away, engage and defend, or collapse in a freeze state. This situational stress experience is known as an “acute” stressor because it’s an isolated incident, and usually, once that threat has passed, the body returns to its usual baseline function, and life proceeds as expected.

Chronic Stress and Its Impact

Chronic stress, on the other hand, occurs when your body stays stuck in this fight-or-flight mode continuously, due to having no immediate resolution, as with financial stressors or relationship difficulties. Chronic stress is known to be linked to health concerns such as digestive issues, an increased risk of heart disease, and a weakening of the immune system, which can leave one vulnerable to physical illness. This makes sense considering that the body has limited energy resources available for dealing with stress.

The Confluence of Worry and Stress into Anxiety

The body has two immune systems: one for responding to external threats outside the body, and one for dealing with internal threats from inside the body (bacteria, viruses, etc). When both two immune systems are called to action simultaneously, the body must prioritize its resources to meet the most pressing need first, which in this case, is to resolve demands of those present external environmental stressors. Chronic stress hormone release can eventually have a detrimental effect on the brain, since too much of these hormones can be toxic to the hypothalamus, the organ that directly influences the autonomic nervous system. It can also be abrasive to the hippocampus, which is part of the brain responsible for long term memory storage. Over time, it can even change the genetic encoding of the body’s cells*. When stress and worry combine, over time, it may culminate in an Anxiety condition, the third category.

Understanding Anxiety: The Fusion of Cognitive and Physiological

Anxiety has a cognitive element (worry) and a physiological response (stress), which means that we experience anxiety in both our mind and our body. It’s important to note that there is a difference between feeling anxious — a normal part of everyday life — and having an anxiety disorder. An anxiety disorder is a serious medical condition that includes stress and worry.

Managing Stress and Anxiety: Seeking Support

Anxiety can often be subdued with certain anti-anxiety medications, which are usually prescribed while working in tandem with a therapist to help illuminate and ultimately alleviate the source of the worries and stressors that chronically activate the stress response system. Once the body has been restored to homeostasis, medications can be effectively replaced with other structured stress release activities, which can serve to regulate the autonomic nervous system’s natural response to threats that activate its arousal response system.

*Research in the Harvard Stress Report supports the findings that high stress conditions can have a negative effect on genetic expression. In the experiment, cortisol levels of two groups were compared. The control group, who were a group of experienced relaxers regularly practicing stress reduction activities, produced measures of regular cortisol levels in the blood. The experimental group on the other hand, produced very high levels of cortisol in their blood streams. After practicing a structured stress reduction plan for 6 weeks, the high cortisol levels of the experimental groups had significantly reduced, and researchers noted a positive effect on gene groups known to be involved in cellular regeneration. Changes in the expression of 1,561 genes were counted as a result of the relaxation training.

Looking for Help Managing Stress and Anxiety?

Worry, stress and anxiety are not an indictment. If you are finding yourself somewhere on the worry/stress/anxiety spectrum, please do not hesitate to reach out to us at 412-856-WELL or by filling out the form below. We will connect you with a therapist who can work with you to explore options and help you design a plan for reducing your anxiety.

Written by: Ron Schulz, LPC.