How Much Anxiety Is Normal?

anxiety can be healthy—to an extent

By Jonny Lupsha, Wondrium Staff Writer

Sometimes, fear and anxiety can be helpful tools in self-preservation. With them, we can avoid harm and danger, for example. What’s the difference between normal anxiety and an anxiety disorder?

Woman in distress from anxiety, stress, inner insecurities and negativity, suffering mental pain
With an anxiety disorder, anxiety that would normally be considered healthy takes on a life of its own, becoming the stressor itself. Photo by El Nariz / Shutterstock

Fear and anxiety may feel unpleasant, but they’re protective emotional responses that make us aware of potentially dangerous situations in our everyday lives. Fear is often an “in-the-moment” feeling, while anxiety focuses more on possible dangers in the future. Unfortunately, we can also suffer from anxiety disorders and panic attacks, which can be frustrating, and even debilitating, mental health conditions.

Our understanding of anxiety is always improving, leading to frequent headlines about anxiety. Recent reports suggest people often feel more anxious at night, while a blood test that could detect anxiety disorders may be on the verge of being a reality. Meanwhile, melatonin may reduce self-harm in young people suffering from anxiety.

How do we know how much anxiety is healthy or unhealthy? In his video series Cognitive Behavioral Therapy for Daily Life, Dr. Jason Satterfield, Professor of Clinical Medicine in the Division of General Internal Medicine at the University of California, San Francisco, differentiates between normal anxiety and anxiety disorders.

What Constitutes an Anxiety Disorder?

“In general, fear is conceptualized as an emotional and physiological response to a definite threat,” Dr. Satterfield said. “Anxiety is a diffuse, unpleasant, vague sense of apprehension. Anxiety can trigger fear and fear can result in lingering anxiety.”

According to Dr. Satterfield, fear and anxiety are central to our harm-avoidance systems, working in response to real or perceived threats. So, not all fear and anxiety are bad. However, some people suffer from anxiety disorders, in which anxiety manifests itself unnecessarily. How do doctors tell the difference?

“The diagnosis of an anxiety disorder is based primarily on the degree of interfering interference with normal function at work or in your social life,” he said. “Anxiety disorders refer to a heterogenous group of syndromes characterized by abnormally increased sensitivity to fearful stimuli, inappropriately intense experiences of fear or anxiety, or inappropriately extreme action based on that anxiety.”

With anxiety disorders, anxiety that would normally be healthy takes on a life of its own and the disorder becomes the stressor itself. This difference makes it become a mental illness.

How Are Anxiety Disorders Treated?

There are three kinds of medicines that are used to treat anxiety disorders. The first category is benzodiazepines. These are prescriptions like Xanax or Ativan. While they’re very effective, Dr. Satterfield cautioned that they can lead to dependency and abuse, and have a number of side effects even with normal use.

“There are [also] antidepressants, and here I’m mostly talking about the SSRIs, the selective serotonin reuptake inhibitors, things like Zoloft or Paxil, or Celexa or Lexapro,” he said. “These are sort of the broad-spectrum antibiotics of the psychiatric world, developed initially for depression, but they also seem to be helpful for anxiety—and fortunately these are not habit-forming.”

They can, however, cause a rebound syndrome when someone suddenly stops taking them after long-term use.

Finally, beta-blockers lower blood pressure and can “turn down” some of the physical sensations associated with panic and anxiety.

Aside from medication, anxiety can be treated with psychotherapy, including cognitive behavioral therapy, mindfulness, relaxation techniques, and others.

Cognitive Behavioral Therapy for Daily Life is now available to stream on Wondrium.

Edited by Angela Shoemaker, Wondrium Daily