Anxiety is an emotional state that causes discomfort , feelings of suffocation, mental suffering and even sadness. It is related to fear (irrational fear), despair and, in many cases, uncertainty. Fear of separation, bullying at school or work, or irrational and intrusive thoughts, among other situations, can cause distress.

The term distress is often confused with anxiety. In this article we will talk about the differences between both concepts and we will go deeper into the causes, symptoms and possible treatments of anxiety.

Differences between distress and anxiety

It is not easy to understand the difference between anguish and anxiety , as these terms are often used as synonyms. There are authors who consider that the difference lies in the fact that while anxiety is used in the clinical setting, anguish has a rather philosophical origin, and is especially important in existentialism. For example, Heidegger and Kierkegaard already used the term, and the French philosopher Jean-Paul Sartre spoke about anxiety in his book “L’Être et le Néant” (1943).

However, in psychology (or psychiatry) Sigmund Freud also spoke of “realistic anxiety” and “neurotic anxiety” referring to the latter as a pathological state. Today, for many, the line between anxiety and distress remains blurred.

No consensus on the difference

Despite attempts by philosophers, doctors and psychologists to distinguish these concepts, these terms continue to be confused and used as synonyms in many cases. Some authors have considered that in anguish, physical symptoms prevail, while in anxiety, psychological symptoms prevail (although this distinction between symptoms is even more confusing).

Distress has also been considered to have a paralyzing effect on the individual, while anxiety triggers a shock motor reaction. However, nowadays, when talking about anxiety, both physical and psychological symptoms are also taken into account.

A clear example of how these concepts are used interchangeably is when panic disorder is mentioned, as it is also called an anxiety crisis or distress disorder. As Manuel Suárez Richards states in his book Introduction to Psychiatry (1995): “Both terms are used as synonyms nowadays, since it is taken into account that they are dysfunctional psychological states that present physiological symptoms in a habitual way, and are characterized by painful expectation in the face of an imprecise danger”.

Therefore, in this article we will refer to anxiety as a synonym of anxiety, which causes great discomfort in the person who suffers it and in which there is not only a physiological and physical reaction, but also a psychological one.

What is distress?

Although anxiety and anguish stand out because they resemble fear , they are different from the latter in the sense that fear manifests itself before present stimuli, and anxiety or anguish before the anticipation of future dangers, which are indefinable, unpredictable and even irrational.

Distress can be adaptive and helpful, in the sense that it is a normal reaction in our daily lives, and even beneficial in certain contexts. For example, when we cross a road with a red light, it keeps us alert so that we are not run over.

But if we think of an anxiety crisis or an anxiety disorder , the person has a disproportionate anxiety reaction, which paralyzes the individual, and in which psychic symptoms such as the feeling of suffocation and imminent danger, which have nothing to do with reality, become present. This is why it can be considered a psychopathology.

Its causes

This situation of distress not only appears in an acute form as in the case of panic disorder , but there are other factors that can lead to suffering it. For example, when we are not clear about our future and we enter into an existential crisis that leaves us sleeping thinking about how we will solve the problem. For the anguish to occur, biological, psychological (and existential) and environmental factors come into play. That is why philosophers, poets, psychologists and psychiatrists have been interested in this phenomenon throughout history.

Generally, distress appears in situations in which the person faces difficult situations , where there is a threatening element (physical or psychological), but also in those situations in which the person does not see clearly the path to follow and, therefore, lives a situation of uncertainty.

At a biological level, there are also studies that claim that genetic predisposition is present in this condition , and that some neurochemicals play an important role in the distress.

For example, an increase in adrenaline or a decrease in gamma-aminobutyric acid (GABA). Finally, some environmental causes such as difficulties in social relations or bad daily habits, among others, can precipitate the appearance of distress.


The anguish presents a series of characteristic symptoms . They are the following:

  • Excessive worries and fears.
  • Imagination of catastrophic scenarios.
  • Despair.
  • Shortness of breath, dizziness, sweating, muscle tension, dry mouth or fatigue.
  • Tightness in the chest.
  • Hot flash.
  • Avoidance of feared situations.
  • Sleeping difficulties.

Possible treatments

Problems of anxiety are very frequent nowadays and, without a doubt, the most effective treatment to solve them is to go to psychological therapy.

Psychologists are professionals prepared to treat this type of problems , who can help patients discover the underlying causes of their worries and fears; and can provide them with certain tools that help them relax and look at situations from a new perspective. They can also help them develop better coping and problem-solving skills.

Psychological therapy for problems of distress is usually short, as patients improve in 8 or 10 therapeutic sessions. Cognitive behavioural therapy has been shown to be very effective as a therapeutic model in the treatment of anxiety disorders, but other types of psychotherapy such as acceptance and commitment therapy or mindfulness-based cognitive therapy (MBCT) are also effective.

In extreme cases, the use of drugs can be a good help as an adjunct to psychological treatment, especially in those situations where it is necessary to reduce symptoms quickly, for example, to treat a distress disorder. However, medication should never be the only treatment option chosen, and is always initiated by medical indication.

  • If you want to go deeper into the treatment of anxiety, you can read this article: “6 effective treatments against anxiety”.