Differences between anxiety and pathological anxiety

These are the keys to distinguish between normal anxiety and pathological anxiety.

Worry and alertness are completely normal physiological events, not only in humans, but also in all other living organisms.

Sporadic stress sharpens our senses and allows us to respond more effectively to environmental impositions and, therefore, can be life-saving in a dangerous situation. In a borderline scenario, a two-second difference in responsiveness can mean the difference between life and death.

The problem comes when, in a society full of stimuli and responsibilities, the stress response is here to stay.. The World Health Organization (WHO) states that depression is a condition of global concern, as more than 300 million people suffer from it. In any case, anxiety disorders are not far behind: 260 million people see their quality of life diminished by long-standing anxiety disorders.

Establishing a limit between what is normal and what is pathological is a real challenge, since as individuals we do not have enough psychological tools to differentiate a clinical entity from something to be expected within our personality or condition as humans. For these reasons and many more, we will now take a look at the differences between normal and pathological. a review for the differences between the anxiety and the pathological anxiety..

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 diminish individual survival. A certain degree of anxiety is beneficial in the natural world.It makes animals sharpen their senses in times of danger, try to access food sources more insistently and, in short, "give their all" to stay in the environment for one 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 Blood vessels, dilates the airways and participates in the fight or flight response, mediated by the mechanisms of the sympathetic nervous system (CNS). 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 metabolization of compounds stored in the body, increases blood glucose levels and enables body homeostasis. In short, cortisol mobilizes resources to what is most important in the moment of stress, which is to obtain energy and maintain muscle tone to respond to dangers.

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 big problem of cortisol secretion, at the pathological level, is that it can have harmful effects on the body's immune system and many other organs.. Let us 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 in the group of anxiety disorders, which also includes panic disorder and several groups of phobias.

According to the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychological Association (APA) in the year 2013, GAD can be diagnosed based on a number of parameters.. These are as follows:

• Excessive worry that occurs every (or almost every) day for a period of at least 6 months. These worries are based on the patient's routine events and activities.
• The patient finds it very difficult to control the symptomatology.
• It is associated to at least 3 of the 6 symptoms that we will see later to the sustained picture of anxiety.
• The anxiety is not explained by another underlying mental disorder.
• The symptoms generate physical and mental distress in the patient, preventing him/her from functioning socially.
• The anxiety cannot be explained by the effects of a chemical substance or a metabolic medical condition (such as hyperthyroidism).

All of these diagnostic criteria are standardized in clinical practice. Thus, a generalized anxiety disorder is considered a pathology, whereas sporadic anxiety is not.

2. Pathological anxiety is sustained over time

This is the most important differential factor in distinguishing between illness and normality. As we have said, feeling occasional anxiety is normal (and even positive), but if it spreads once the original stressor has disappeared, it is time to suspect a more complex condition.

For a patient to be considered within this pathological spectrum, the anxiety symptoms must remain for at least 6 months continuously over time..

It is possible that a person with pathological anxiety always feels that his fears are justified. Therefore, he/she perceives that he/she worries with foundation and does not believe that his/her condition is out of the normality. Nothing could be further from the truth: finding reasons to worry cyclically is also a sign of an emotional disorder, however valid these may be.

If you doubt these statements, place chronologically on a timeline what your most intense worries have been in recent times.You'll find that almost none of them last for more than half a year. If you are chaining one worry with another and you feel that you have not been feeling well for a long time, it is possible that anxiety has taken more control of your life than you think.

3. Pathological anxiety has a series of associated symptoms.

As mentioned above, for GAD to be considered as such, it must meet a number of criteria, among them that the patient manifests at least 3 of the 6 symptoms that we expose: lack of rest (pigeonholing), ease of fatigue, difficulty concentrating, irritability, muscle tension and / or sleep problems.

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.The most common symptoms of anxiety are 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 an illness. One of the most famous physical pains is that of the stomach and intestines, since the gastric musculature contracts due to the action of stressful nerve pathways without any apparent sense.

In other words, generalized anxiety can provoke pains that otherwise should not be there.. Although this does not directly affect the "real" health of the individual, it can be an important trigger for social and occupational difficulties, as well as generating even more worries and feeding back into the circle of anxiety.

Summary

As you can see, the key difference between anxiety and pathological anxiety is the time interval in which the sensations, feelings and psychological processes occur. If the duration of the worries is longer than 6 months and cannot be explained by other underlying illnesses, it is time to suspect this psychological disorder.

In any case, it should be noted that generalized anxiety disorder can be treatedEither 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 picture and the patient's wishes. If you feel that your condition is out of physiological normality, do not hesitate to ask for professional help.