Normal Versus Pathological Anxiety: What Is the Difference?

Here’s the beef, anxiety is not inherently a problematic emotion. Quite the contrary, anxiety can actually be helpful in life, and it appears it was “designed” to be so from an evolutionary perspective.

Let’s start by a discussion on what anxiety is and how it affects the body. Anxiety is differentiated from fear, in that fear is anxiety in the moment. For example, when you are in the woods and you see a bear, your fight or flight system kicks into gear and your heart starts to race, your muscles become tense, your respiration rate increases, your pupils dilate, stress hormones pump through your blood and your digestive system slows down. You prepare to run or fight. This is an example of FEAR, in that it is a response in the moment you are experiencing the threat.

"Anxiety is not an inherently problematic emotion....it is the ANTICIPATION of a feared event"

The anxiety response is similar to fear in that it kicks into gear your fight or flight response, but there is no immediate threat. Anxiety is the feeling you get the week before a test or a big presentation. It is the feeling you get the day you have to go to a social outing when social situations make you anxious. The feeling of having to make a phone call to someone you don’t want to talk to, having to leave your house, about to drive your car. The threat has NOT happened; however, you are feeling the uneasiness, tension, racing heart rate at the ANTICIPATION of the event.

Now I know you are probably asking yourself – How could this possible be an adaptive, helpful emotion? Good question and one I thinking the good old Yerkes Dodson curve can help explain. Study upon study have found that moderate levels of anxiety can actual help performance. When you are anxious about a test or a presentation, low levels of anxiety help to motivate you to prepare. When you are anxious after losing a job, helpful levels of anxiety help you to actively search for a new job. If there were no anxiety, it would be more difficult to focus and accomplish what needs to be done to meet goals.

The level of anxiety shown in the Yerkes Dodson curve at the peak is what is known as “adaptive anxiety” in that it helps you to perform! I put the term “normal” in the title due to common usage of this word, but the truth is there is no such thing as “normal.” Normal is a setting on a dishwasher, and is commonly used to refer to what a person believes the majority of people conform to. This is important because “normal” anxiety for two people will look different depending on their personalities/beliefs/values and so on. A better term is “adaptive anxiety”, which means a level of anxiety with which you are able to function in life.

Any treatment goal when treating anxiety should focus on learning to manage, adapt, or habituate to anxiety. Any treatment focused on “eliminating anxiety” should be avoided because, for one, it is probably not realistic (unless it involves turning you into a zombie) and for two, anxiety is a very natural part of being human. In fact, many anxiety treatment programs focus on the importance of accepting the anxiety in the first place. After all, there is nothing wrong with being an anxious person if you are living a fulfilling life.

Picture credit: https://en.wikipedia.org/wiki/Yerkes%E2%80%93Dodson_law#/media/File:HebbianYerkesDodson.svg