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Is It Stress or Anxiety?

February 01, 2019

Women are twice as likely to experience anxiety, but how do you distinguish it from the usual ups and downs?

Jetting the kids to and from daycare. Getting into a fight with your significant other. Bills piling up sky high. You feel your heart is racing, but you haven't had time to exercise in three months. Stress is a part of everyday life and studies have indicated it's been on the rise for the past 30 years. But how do you know if you're dealing with something more serious?

Anxiety disorders are the most common class of mental health issues, affecting approximately 1 in 5 Americans at any given time. Studies continue to report that women are twice as likely as men to experience anxiety. The National Comorbidity Survey found that lifetime prevalence rates for any type of anxiety disorder were just over 30 percent for women and 19 percent for men. Furthermore, when women experience anxiety, they tend to report great illness burden (e.g., missed work, number of visits to the ER or doctor's office). So what's going on here? Why are women more likely to experience anxiety, and should you be concerned?

There are many possible explanations for the reported gender differences in anxiety disorders. The first concern has to do with the social stigma of getting a diagnosis of anxiety (or any mental health issue for that matter). Some professionals believe that men still experience a greater stigma when it comes to reporting mental health issues and/or seeking treatment. This raises the question of whether the reported gender differences are accurate: Do women really experience more anxiety, or are they just more likely to seek help as the stigma is not as great for women as it is for men?

If gender differences do exist (and there is some research to back this), it appears that your biology may be to blame. Gender differences in parts of the brain known as the amygdala and prefrontal cortex might actually make women more prone to anxiety. There is also some evidence that anxiety may be in part cyclical and hormonal in women as many women report that anxiety worsens in the second half of their menstrual cycle as they approach their period. Anxiety is also more common when women are pregnant—again, researchers suspect hormones are to blame here.

How do you know if you have anxiety? There are 28 types of anxiety disorders in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), falling into three broad categories: anxiety disorders (e.g., generalized anxiety disorder, panic disorder), obsessive-compulsive and related disorders (e.g., obsessive-compulsive disorder, body dysmorphic disorder), and trauma- and stressor-related disorders (e.g., post-traumatic stress disorder, adjustment disorder). Each condition within each of those three broad categories has its own set of diagnostic criteria. While I don't have space to detail the diagnostic criteria for all 28 of these disorders, general criteria typically mention that the anxiety must be recurrent and persistent, have been present most of the time for at least 6 months, and must interfere with "normal" functioning.


So how do you know if it's just stress or if it's an anxiety disorder? In general, if you've been experiencing anxiety, extreme stress, or feelings of being overwhelmed most of the time for more than 6 months, it may be time to seek treatment, especially if your anxiety is interfering with your daily life. While anxiety can be chronic or situational in nature (e.g., caregiver stress, pregnancy) and/or related to major life transitions (e.g., wedding, loss of a loved one), you do not have to suffer. If you believe you have an anxiety disorder, please seek out a medical professional for referral for diagnosis and treatment. Treatments are largely effective and may include medication to help get the anxiety under control as well as therapy to help the sufferer learn more effective coping strategies to deal with whatever triggers her anxiety.

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