The differences between anxiety and anguish

Concepts such as anxiety, anguish and stress have become widespread currently. It seems to be common for ourselves or someone around us to have suffered from these problems at some point. It would not be difficult to agree that they all refer to unpleasant states, which can range from a momentary annoyance to a generalized fear or terror, which can spread to overwhelm us in the day to day day.

Beyond understanding them as problems, do we know the differences between each concept? Is it possible that the confusion between terms makes it difficult for us to approach it?

The following is intended to provide information on the origin and nuances of each concept and the differences between anxiety, anguish and their relationship with stress, to clarify the ideas we have and perhaps shed some light when dealing with each one of them.

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Fear as an adaptive resource

Human beings have natural resources for protection against danger, which is sometimes known as adaptive anxiety or fear. It would be like a tool that would act as a warning sign in the face of danger. For example, imagine the following situation:

“We are walking quietly down an avenue, and we hear screams of terror and see people running in one direction. Without thinking, we run faster than ever, looking for somewhere to take refuge.”

In this situation, the interpretation of danger has been automatic, since it has generated the response of the sympathetic nervous system (SNS), key activation in what is known as “E situations” (escape, stress, emergency). When the SNS is activated, hormones to increase blood pressure are released, among other things. (such as cortisol) and neurotransmitters to prepare for explosive muscle action (catecholamines such as the adrenalin, norepinephrine and dopamine) that allow this flight reaction and therefore, protection in a dangerous situation. At this point, fear protects us from imminent danger and therefore has important functional value.

In this situation, Do we act based on fear or anxiety? The key difference between the two is that anxiety is related to anticipation, that is, to dangers. future, diffuse or unpredictable, while fear is related to one or several stimuli or situations present.

Now, what happens if this adaptive mechanism is related to stimuli or situations that do not represent a real danger or threat? Despite individual differences and the particular way of living of each person, if fear generalized or anxious state is maintained and intensifies, both in duration and frequency, generates negative consequences for overall health of the person to be cared for.

Differences between anguish and anxiety

At the beginning of the 20th century, Sigmund Freud was the first to introduce the concept of anxiety. in a technical way. He used the German term Angst to refer to a state of mind, with negative affect, with the consequent physiological activation and, most importantly, based on something indeterminate, that is, without a known object or definable.

This concept was translated into English as anxiety and in Spanish was translated with double meaning: anxiety and anguish. From here it could be understood that the two concepts appear as synonyms, in non-clinical fields, until now, used to describe a state unpleasant psychophysiological, which causes great restlessness, restlessness, restlessness in the face of imprecise dangers and/or that generates an exaggerated and maladaptive fear for the daily life.

Although they are used colloquially as synonyms, In the current clinical setting, the differentiation between anguish and anxiety does appear.. The most widely used international tool for the classification of mental disorders is the DSM-V (Manual diagnosis and statistics of mental disorders), which includes a section dedicated to mental disorders anxiety.

This manual deals with anxiety as a subtype of anxiety disorders. In this sense, anxiety is defined as what is commonly known as a “panic attack”, explained as an episode of intense fear that lasts for a short time. On the contrary, anxiety would refer to a state that lasts longer.

Anxiety can be found in a generalized way in multiple events or it can manifest itself in different areas and for different reasons or causes. In this point, the different known phobias (social phobia, agoraphobia, obsessive-compulsive disorder, phobias before a specific stimulus...) they would be driven by anxiety but would be differentiated according to the manifestations or events triggers.

Anxiety as such, beyond the nuances or explanations provided by the different currents within Psychology (psychoanalysis, gestalt, cognitive-behavioral...) must be understood from its complexity, since it encompasses a response multidimensional. This means that includes cognitive, emotional and physiological aspects, characterized by an activation of the autonomous nervous system (formed by the sympathetic and parasympathetic nervous system) that usually generates maladaptive behaviors and that can sometimes entail a high risk for the person who suffer.

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Stress: a set of physical, psychological and social ailments

Once the concepts of anxiety and anguish have been explained, the concept of stress can be understood, which can include the above. Briefly, stress could be understood as a negative relationship between the person and the environment. This maladaptive relationship between the environment and the person is dynamic, bidirectional and changing, but its core is the fact that the person perceives that they cannot face environmental demands.

The situation is understood as a set of factors that exceeds the available resources themselves. At this point, the person could develop anxiety, anguish and other diverse physical and psychological problems, which would have as a common point the generation of a deep malaise.

The complexity of relationships between the person and the environment make it a priority that both anxiety, anguish and stress be approached from a broad perspective and taking into account the multiplicity of factors involved (physiological, cognitive, emotional, social...).

Given the influence of social factors in the implication of these problems that are already beginning to be known as "diseases of the 21st century", it is responsibility of all people who are known, in order to detect them and work on their management, especially in their prevention. If a person perceives some type of related problem, either in herself or in someone around her, it is advisable to attend to the symptoms, to ask for help and the sooner the better, to prevent them from generating more serious consequences.

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Bibliographic references:

• American Psychiatric Association. "Diagnostic and Statistical Manual of Mental Disorders DSM-V." Washington: APA (2013).

• Martinez Sanchez, F. & Garcia, C. (1995). Emotion, stress and coping. in a. Puente (Ed.), Basic psychology: An introduction to the study of human behavior (pp. 497-531). Madrid: Pyramid.

• Sierra, Juan Carlos, Virgilio Ortega, and Ihab Zubeidat. "Anxiety, anguish and stress: three concepts to differentiate." Malaise and subjectivity magazine 3.1 (2003).