How anxiety became a catchall for every unpleasant emotion

Here’s how to understand the difference between everyday anxiety and an anxiety disorder.

When you run a therapy practice called the Center for Anxiety, as David H. Rosmarin does, you encounter a breadth of anxiety-related experiences. Sometimes, after talking with new patients, Rosmarin will determine their distress may not be related — or solely related — to anxiety at all.

Because anxiety intersects with so many other aspects of mental health, like depression and substance abuse, Rosmarin says, many people are quick to attribute their emotional pain to anxiety alone. They may even mistake anxiety for something else entirely. He’s told patients they’re not anxious at all, but stressed. “I’ll say, sleep eight hours a night for the next two weeks,” he says. “Come back and tell me how you’re feeling. I’ve tried that trick many times with stressed-out patients, and they’re at 50 percent of their stress level two weeks later with no therapy at all.”

More Americans are seeking professional mental health treatment than ever before. Nearly a quarter of adults visited a psychologist, therapist, psychiatrist, or other mental health professional in 2022, compared to 13 percent who did so in 2004, according to a Gallup poll. No longer stigmatized or discussed in secret, mental health terms — and mental health-adjacent terms — have trickled out of the therapy room and into casual conversation. “Narcissism,” “gaslighting,” “and “boundaries” are just as readily discussed at brunch or online as in clinical settings. Self-diagnosis based on simplified videos and memes on social media can result in pathologizing seemingly mundane behaviors and thought patterns.

Normalization of mental health is undoubtedly positive: More people can feel empowered to seek care and to openly discuss their experiences. However, increased awareness has resulted in more people confusing “milder forms of distress as mental health problems,” according to one academic paper. Despite therapy’s wider cultural acceptance, we still don’t have a grasp on what we really feel. Without a nuanced vocabulary to describe these experiences, complex emotions are flattened with blanket terms. “We don’t have a sophisticated lexicon,” Rosmarin says. “We end up labeling everything as anxiety.” When we don’t accurately define our emotions, we don’t know how to properly address them. If we approach our feelings with curiosity, we can improve our emotional intelligence.

What is anxiety?

Anxiety is both a normal response as well as a pathological experience, says psychiatrist Tracey Marks. People often endure everyday levels of anxiety or nervousness before a first date or if they have to make a presentation at work. You might have physiological effects, like sweating, racing heartbeat, or butterflies in your stomach. Momentary anxiety can be functional, a signal to be on the lookout for potential danger or to prepare for that work presentation. After the nerve-wracking event is over, the feeling usually passes. In an increasingly anxiety-inducing world, where climate change, wars, and a contentious upcoming presidential election instill plenty of anxiety, “it’s normal for us to have some kind of distressing reaction to something that is threatening to us,” Marks says.

A sign of an anxiety disorder is when anxiety interferes with your daily life. If the thought of going to a social event elicits physical symptoms like vomiting and/or persistent worried thoughts of how others will perceive you, you may have social anxiety, Marks says. Avoiding people, missing work or school, a baseline level of fear (that may not be logical), and inability to relax are some of the signs of generalized anxiety disorder. “One of the characteristics of generalized anxiety,” she says, “is that you can worry about anything. You can worry about world peace.” Someone with debilitating anxiety might want to work with a therapist to better cope.

People may mistake anxiety for stress. Stress is when you have too many demands and not enough resources, like time or money to outsource some responsibilities, Rosmarin says. “Anxiety often happens in the context of an abundance of resources,” he says. You may be getting enough sleep, have a supportive partner, and a job you love, for instance, but still spiral over would-be worst-case scenarios that may never materialize. Even fear can be confused with anxiety. Fear is in response to a concrete threat, whereas anxiety is triggered by an amorphous or future risk.

The importance of emotional intelligence

The boundaries of anxiety are blurry and subjective, says Nick Haslam, a professor of psychology at the University of Melbourne, so it makes sense that lay people would label all of their upsetting experiences as “anxiety.” But we can stand to improve our emotional intelligence — the ability to accurately identify what we’re feeling, Haslam says. Because many don’t receive emotional education beyond primary school, says Rosmarin, we have a limited emotional vocabulary. Feeling “bad” is a significantly different experience from feeling “distressed,” “frustrated,” “jealous,” “overwhelmed,” or “anxious.”

An emotional binary of “good” and “bad” emotions actually makes matters more confusing. “You don’t understand how you should respond to what’s going on,” Haslam says, “whether you should flee or fight, whether you should bite your tongue.” People who struggle to put their emotions into words have more difficulty coping with complex feelings, Haslam says.

When we don’t have a deep knowledge of common human emotions, we may pathologize normal experiences. Feeling uncomfortable in a room of new people is incredibly common. It is not, however, social anxiety, Marks says. Online and social media content created by non-professionals may paint anxiety with broad strokes, leading viewers to self-diagnose as having an anxiety disorder. “Even if you do have anxiety, it doesn’t necessarily mean that you have an anxiety disorder,” says psychologist Juli Fraga. What’s often at the root of situational anxiety — like feeling anxious in social scenarios — may be relational trauma dating back to unhealthy social interactions during childhood, Fraga says.

What’s lost when every experience is “anxiety”

Labeling yourself as an anxious person, even if you do have a diagnosis, can make it more difficult to overcome your emotions. If anxiety is so baked into how you see yourself, you could use it as a crutch or an excuse to avoid social situations, new experiences, or other potentially enriching events. “As soon as you attribute some sort of noun label to yourself — I’m an anxious person or anxiety is who I am,” Haslam says, “people tend to infer that they’ve got something deep-seated and lasting and a reason not to engage with the world.”

Avoidance is generally the wrong way to address anxiety, Haslam says. Believing you have social anxiety, for example, may lead you to isolate, which only entrenches the anxiety. Avoidance may offer temporary relief, but doesn’t offer a long-term solution.

When we don’t have the appropriate vocabulary to describe our emotions, we lose the ability to effectively intervene, Rosmarin says. “Imagine going into a board meeting with a sophisticated company that has a lot of different projects,” he says, “and you have one word to describe anything negative that’s going on in any of those projects.” Determining whether we’re stressed or anxious greatly impacts how we move forward: It’s the difference between getting a good night’s sleep and moving your body (effective ways to manage stress) and working with a therapist to confront what makes you anxious.

How to get a little better at defining anxiety

Getting to the root of emotions takes some thought. When it comes to anxiety, Marks says to consider how much disruption it causes. Do you feel anxious in certain situations or does it significantly impair your ability to perform day-to-day tasks? For example, if you experience such intense, constant distress about the safety of your loved ones — even if there is no present threat to their safety — that it actually damages your relationships, you may feel inspired to seek professional help for your anxiety. If you have trouble sleeping and feel nervous during exam time, you may be stressed. “Maybe [try] exercising more, or making sure that you’re trying to get the best sleep you can,” Marks says, “things that you can do to help you cope better as these situations come.”

Whenever feelings of anxiety do arise, get curious about its causes, Fraga suggests. Think about what it is about parties that deters you from social gatherings. Maybe you don’t like talking to strangers. Again, ask yourself why. Perhaps you had an embarrassing rebuff in the past. Anxiety isn’t a truth-teller. Just because you had a negative previous experience doesn’t mean you’re doomed to repeat the same patterns or should feel afraid of repeating those patterns.

Rather than relying on labels to describe our emotions, we owe it to ourselves to use a vocabulary as vast and complex as our experiences. Accurately describing the causes of anxiety, how it physically manifests, and when and how often it occurs, allows us to pinpoint the exact form of support we need, too, whether it’s therapy or just talking to a loved one. That’s how we move forward.

It can be helpful to depersonalize anxiety. Try reminding yourself, “Yes, I’m anxious but that’s a temporary thing which I can do something about, and I’m actually pretty courageous to be able to deal with it,” Haslam says. “I’m not just a damaged individual.”