Differences between anxiety and pathological anxiety
Jul 16, 2021
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 a borderline scenario, the two-second difference in responsiveness can make the difference between life and death.
The problem comes when, in a society full of stimuli and responsibilities, the stress response is established 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 diminished by long-lasting anxiety disorders.
Establishing a limit between the normal and the pathological is a real challenge, as we do not have enough as individuals psychological tools to differentiate a clinical entity from something expected within our personality or condition such as humans. For these reasons and many more, below we will
- Related article: "Types of Anxiety Disorders and their characteristics"
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 decrease individual survival. Some degree of anxiety is beneficial in the natural world, as it makes animals sharpen their senses in times of danger, they try to access the sources of food more insistently and, in short, "give it your all" to stay in the environment a more day.
When humans perceive a noxious stimulus, the adrenal glands begin to release adrenaline. This is a hormone that increases the heart rate, constricts the blood vessels, dilates the pathways and participates in the fight or flight response, mediated by the mechanisms of the sympathetic nervous system (SNC). 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 causative agent has disappeared. Cortisol suppresses the action of the immune system, promotes the metabolism of compounds stored in the body, increases blood glucose levels and allows homeostasis bodily. In summary, cortisol mobilizes resources to the most important thing in times of stress, which is to obtain energy and maintain muscle tone to respond to dangers.
- You may be interested in: "Cortisol: the hormone that causes us stress"
The 3 differences between anxiety and pathological anxiety
As we have seen, adrenaline promotes the immediate response to danger, while cortisol is responsible for a more modulated and sustained reaction over time.
The great problem with cortisol secretion, on a pathological level, is that can have harmful effects on the body's immune system and many other organs. Let's see 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 is maintained over time, it becomes a diagnosable disease. Generalized anxiety disorder (GAD) is included within the group of disorders of anxiety or 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 number of parameters. These are the following:
- An excessive worry that occurs every (or almost every) day for a period of at least 6 months. These concerns are based on routine events and activities of the patient.
- The patient finds it very difficult to control the symptoms.
- It is associated with at least 3 of the 6 symptoms that we will see later with the sustained picture of anxiety.
- Anxiety is not explained by another underlying mental disorder.
- The symptoms generate physical and mental distress in the patient, preventing it from functioning on a social level.
- Anxiety cannot be explained by the effects of a chemical or a metabolic medical condition (such as hyperthyroidism).
All these diagnostic criteria are standardized in clinical practice. Therefore, 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 in distinguishing between disease and normality. As we have said, feeling anxiety from time to time is normal (and even positive), but if it is spreads once the original stressor has disappeared, it's time to suspect a little more complex.
For a patient to be considered within this pathological spectrum, anxiety symptoms must remain for at least 6 months continuously over time.
A person with pathological anxiety may always feel that their fears are justified. For this reason, he perceives that he worries with foundation and does not believe that his condition is out of normality. Nothing could be further from the truth: finding reasons to worry cyclically is also a sign of an emotional disorder, no matter how much they are more or less valid.
If you doubt these statements, chronologically place on a timeline what your most intense concerns have been in recent times, and you will see that almost none of them extend for more than half a year. If you are chaining one concern to another and you feel like you haven't felt well for a long time, anxiety may have taken more control of your life than you think.
3. Pathological anxiety has a series of associated symptoms
As we have said before, for a GAD to be considered such, it must meet a series of criteria, including that the patient manifests at least 3 of the 6 symptoms that we expose you: lack of rest (typecasting), ease of feeling fatigue, difficulty in concentrating, irritability, muscle tension and / or problems with to sleep.
In addition, these signs must be present for more than half of the days of the week during the 6 months mentioned above. This sustained clinical picture causes the patient to feel continuously 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 a disease. 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 routes without apparent sense.
In other words, generalized anxiety can lead to pain that shouldn't otherwise be there. Although this does not directly affect the "real" health of the individual, it can be a major trigger for social and labor difficulties, in addition to generating even more concerns and feeding back the circle of anxiety.
As you can see, the key difference between anxiety and pathological anxiety is the time interval in which psychological sensations, feelings, and processes occur. If the duration of the worries is longer than 6 months and cannot be explained by other underlying diseases, it is time to suspect this psychological disorder.
Anyway, it should be noted 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 wishes of the patient. If you feel that your picture is escaping from physiological normality, do not hesitate to ask professionals for help.