Stress vs anxiety: how they differ and when they overlap

People use stress and anxiety interchangeably, and the NHS descriptions help to separate them. The NHS says most people feel stressed sometimes and some find stress helpful or even motivating, but that if stress is affecting your life there are things you can try. It defines stress as usually a reaction to mental or emotional pressure, often related to feeling like you are losing control over something.

Anxiety is described differently. The NHS says most people feel anxious or scared sometimes, but it becomes something to act on when it affects your life. The NHS GAD page describes the main symptom of that anxiety disorder as feelings of stress or worry that affect your daily life and are difficult to control.

A working distinction, based on those descriptions, is that stress is framed around pressure and a sense of losing control, while anxiety is framed around worry and fear that can become hard to control. The NHS notes that sometimes there is no obvious cause for stress either, so the boundary is not clean.

The table below uses the NHS pages on stress, on anxiety, fear and panic, and on generalised anxiety disorder (GAD).

The NHS stress page notes that when you are anxious or scared your body releases stress hormones such as adrenaline and cortisol, which can be helpful for some people and make you feel motivated, but can also cause physical symptoms such as a faster heartbeat or sweating. It adds that if you are stressed all the time, it can become a problem.

This is why many symptom lists look alike. Headaches, a racing heart, poor sleep and trouble concentrating appear in both. A sensible approach is not to try to pin the label with certainty, but to notice how long the symptoms last, how much they interfere with daily life, and whether worry continues after the stressor has been dealt with.

The NHS GAD page also notes that it is common to have more than one anxiety disorder at the same time, such as GAD alongside panic disorder or phobias.

The NHS says the main symptom of generalised anxiety disorder is feelings of stress or worry that affect daily life and are difficult to control. Other symptoms include difficulty sleeping, restlessness, irritability or difficulty concentrating, getting tired easily, feeling tense, stomach problems, palpitations, light-headedness or dizziness and low mood.

It says it is more likely to be GAD if you feel anxious most of the time and it affects your everyday life. A GP may diagnose GAD if you have typical symptoms and you often worry about a wide range of things, anxiety is affecting your daily life, you find it hard to control your feelings and you have felt anxious a lot of the time for at least 6 months.

The NHS anxiety page also describes panic attacks as sudden, intense anxiety and fear with symptoms such as a racing heartbeat, feeling faint, sweating, trembling, shortness of breath and tingling. A panic attack usually lasts 5 to 20 minutes, and the NHS says they can be frightening but are not dangerous and should not harm you.

The NHS self-help suggestions for stress include talking about your feelings to a friend, family member or health professional, trying exercise and time management, using breathing exercises, planning ahead for stressful days and peer support. It advises not trying to do everything at once, not focusing on what you cannot change, and trying not to use alcohol, cigarettes, gambling or drugs to relieve stress.

For anxiety the NHS suggests similar steps and adds regular exercise such as running, walking, swimming or yoga, a healthy diet with regular meals, calming breathing exercises, getting enough sleep, avoiding too much caffeine, and not avoiding situations that make you anxious but building up time in them gradually.

Professional help is also available. For GAD, the NHS says a GP may offer talking therapies, usually cognitive behavioural therapy (CBT), medicines such as an SSRI antidepressant, or referral to a community mental health team, and will usually advise trying talking therapies before medicine or specialist referral. For stress, NHS talking therapies for anxiety and depression may help.

The NHS says to see a GP if you are struggling to cope with stress, if things you are trying yourself are not helping, or if you would prefer a referral from a GP. For anxiety it says the same if you are struggling to cope with anxiety, fear or panic and your self-help efforts are not working.

If you need help urgently but it is not an emergency, the NHS says to call 111 or ask for an urgent GP appointment. It says to call 999 or go to A&E if you or someone you know needs immediate help or has seriously harmed themselves, for example by an overdose, and that a mental health emergency should be taken as seriously as a physical emergency. The Samaritans can be contacted at any time if you need someone to talk to.