Normal and Abnormal Anxiety: What’s the Difference?

On the most basic level, anxiety is an emotion. Simply stated, an emotion is a subjective state of being that is often associated with changes in feelings, behaviors, thoughts, and physiology. Anxiety, like all emotional states, can be experienced in varying degrees of intensity. For instance, we might say we are happy, but a more intense expression of this same emotion might be an experience of joy. But unlike the emotion “happiness,” which has several different words to convey these differing levels of intensity (e.g., intensity ranging from happiness to joy), anxiety is a single word that represents a broad range of emotional intensity. At the low end of the intensity range, anxiety is normal and adaptive; at the high end of the intensity range, anxiety can become pathological and maladaptive. As we will soon see, while everyone experiences anxiety, not everyone experiences the emotion of anxiety with the same intensity, frequency, or duration as someone who has an anxiety disorder. Let’s look more closely at some of the differences between the normal emotion of anxiety, and anxiety as a disorder.

The normal emotions of anxiety and fear
Anxiety, and its close cousin fear, are both considered emotions. While there is considerable overlap between these two terms, there are some important differences. Fear is generally considered a primary emotion, while anxiety is considered a secondary emotion that represents the avoidance of fear (including the avoidance of fear-producing stimuli). Primary emotions refer to emotions that are recognizable through facial expressions, and can easily be interpreted by an observer (e.g., happiness, anger, sadness, fear, surprise, disgust). Secondary emotions, such as anxiety, are not readily recognizable to an outside observer, and are usually considered an internal, private experience.

However, the most important distinction between fear and anxiety is that fear is the response to a danger that is currently detected in the environment, while anxiety refers to the anticipation of some potential threat that may, or may not, happen in the future. In other words, fear is a response to an immediate danger in the present moment of time, while anxiety is associated with a threat that is anticipated in a future moment in time. Anxiety reflects the anticipation of fear and represents an adaptive attempt to prevent the fear-provoking circumstance from occurring. In an anxious state, a person is readying themselves and preparing themselves to cope with a future problem or dilemma which they anticipate will cause some kind of harm if not prevented from occurring. In this respect, anxiety is a normal and adaptive emotion.

Emotions are simply part of the normal human experience; as such, they are neither good nor bad. It’s what occurs afterwards that determines whether we experience a particular emotion as good or bad; i.e., the changes in our feelings, behaviors, thoughts, and physiology. At this point you may be wondering, “What could possibly be good about fear and anxiety? Don’t these emotions just make people feel miserable?” Well, the answer may come as a quite a shock, but fear and anxiety are actually very important emotions when it comes to human survival and achievement. The reason behind this statement is that anxiety and fear actually motivate us for action when faced with an immediate danger (fear), or when we anticipate a future threat to our well-being (anxiety). For example, picture a young mother and her child are crossing the street when the mother suddenly realizes they are in the direct path of an oncoming car. Imagine what would happen is she did not feel the least bit afraid. Or, imagine a law student preparing to take his bar exam so that he can become an attorney. What if he didn’t have any anxiety over whether he passed or failed his bar exam? Clearly without fear and anxiety to prepare their minds and bodies for automatic action, these individuals would be at risk for some very serious, negative consequences. So, while the experience of fear or anxiety may at times be an unpleasant one, we can see that without these important emotions we’d actually be far worse off.

Fear and survival: The fight-or-flight response

When people speak of fear they are often referring to the body’s physiological response to fear, known as the fight-or-flight response. More specifically, when we are in the presence of an immediate danger, our bodies will automatically begin to prepare us to either attack the threat (i.e., fight) or more often, to escape from the danger (i.e., flight), in order to ensure our survival. For example, when we are faced with danger our hearts begin to beat very fast. The reason behind this increased heart rate is that the emotion of fear signaled our body and mind to prepare for action. The nervous system responds to the signal of danger by attempting to increase blood flow throughout the body in an effort to deliver the extra oxygen our muscles will need for energy during a fight, or an escape from danger (e.g., running really fast). This increased blood flow requires the heart work harder, and beat faster. Similarly, because increased oxygen is beneficial when faced with danger, there is a natural tendency for people to begin breathing more rapidly and more deeply to meet the demand for extra oxygen. This extra oxygen enables the body to rise to the challenge of fight-or-flight.

Like many adaptive mechanisms, the fight-or-flight response has evolved over time to help ensure our survival. In ancient times, our ancestors came into constant contact with many types of very real dangers in their environment (lions and tigers and bears, OH MY!). Over time, with repeated exposure to these threats, our ancestors’ nervous systems began to evolve in a manner that made the fight-or-flight response automatic and immediate. This adaptation was very beneficial because it ensured the necessary physical responses, (such as increased heart rate and respiration) would occur without wasted time (immediate) and without having to think about it (automatic). This adaptation makes sense because human beings would be at a significant disadvantage if they had to stop and rationally determine best course of action whenever they were in danger. Consider again the example of the mother and her child crossing the street when she realizes they are in the direct path of an oncoming car. Clearly she does not have time to stop and weigh out all her options.

Although in modern times we may not encounter the same sorts of danger our ancestors had to face, we nonetheless still encounter threats in our daily lives that make the fight-or-flight response useful (e.g., physical threats such as being attacked by a mugger, social threats such as being ridiculed or embarrassed, and mental threats such as “blanking-out” on a difficult exam). Unfortunately, a problem arises when the fear response is triggered when no actual threat is present in our environment, and thus serves no useful purpose. This is called a false alarm, which will be discussed further, but for now it is important just to realize that without a certain amount of fear in our lives, we would actually have a much more difficult time surviving.

Matthew D. Jacofsky, Psy.D., Melanie T. Santos, Psy.D., Sony Khemlani-Patel, Ph.D. & Fugen Neziroglu, Ph.D. of the Bio Behavioral Institute, edited by C.E. Zupanick, Psy.D. and Mark Dombeck, Ph.D. Updated: Jun 28th 2010