Anxiety and fear are normal feelings that we all experience occasionally. They are essential for survival, as they activate instincts and body chemicals that help to protect us against harm. However, in chronic or acute forms they cause a great deal of unnecessary distress.
To many of us, anxiety and fear seem like the same thing. Both evoke apprehension about survival and their symptoms overlap. Both can even exist in the same person at the same time, but clinically they do differ.
Basically, the difference is that fear is triggered by sudden, immediate danger, whilst anxiety grows from worries about harm that may occur at some point in the future.
Anxiety can arise from realistic expectations about a clearly defined future event or from worries about imagined harm that may, or may not, happen. Though fear can also be triggered by imagined threats, these will be sudden events (like harmless noises or vivid delusions), not things we had been mulling over for a long time. Fear is a sudden response that fades quickly when the threat is removed. Anxiety builds up and lasts for a long time.
Chronic anxiety and excessive fear responses disrupt our lives in many ways. It causes erratic actions and leads to additional physical and mental disturbances.
Fear and anxiety are both natural instincts. Because we are all born with them, the average observer can usually see when a person’s response is excessive in relation to the severity of the threat. Whilst we do not need special training to notice abnormal responses, the causes and remedies are more complex and best left to mental health professionals. However, here are some observations for the inquisitively minded:
Fear causes a fight-or-flight reaction
Our bodies and minds are placed on high alert, adrenaline is released into the blood and we suddenly have more strength and agility available. On the other hand, anxiety prepares us for future harm and does not evoke such an explosive reaction. Both instincts can malfunction and cause us to overreact, though. The elevated reactions of affected people are not limited to defending themselves or escaping from harm, they also respond by aggressively attacking the source of the trouble or by slumping into unreasonable moods. Some people even become addicted to fear and evoke it with risky behaviour.
Both disorders can be treated with medication and therapy
Medication relieves the symptoms, but most medications have side effects and some are habit forming. Therapy aims for a long term solution without the need for medication. There are other, similar expressions (like panic, stress, tension) that we often use. This document is devoted to anxiety and fear, but some of the other expressions are summarised elsewhere on this web page for more clarity.
Other words for anxiety and fear
This is a simplified summary of some expressions related to fear and anxiety:
Anxiety: Intense anticipation of harm that may occur in the future.
Worry: Less intense than anxiety, but an overload can lead to anxiety.
Fear (fright): A response to sudden, immediate danger.
Terror (terrified): A more intense feeling of fear.
Panic (chaos): Frantic or uncontrolled reaction to fear.
Tension (suspense): Mental and physical strain, tautness, stiffness.
Stress: A more severe form of tension.
Nervousness: Mild anxiety about potentially harmful outcomes.
Phobia: Excessive fear of specific things, like airplanes, insects and more.
“Freaked out”: Loss of control over thoughts, emotions, actions.
Note: Panic attacks are not the same as the normal panic reaction described above. They are chronic components of complicated anxiety disorders which are discussed on other pages.
At the end of the day, it does not really matter what you call it – what matters is how it affects you and what you are going to do about it.
Comparison of fear and anxiety
Fear
- Caused by sudden, imminent danger.
- Danger is in close vicinity.
- Instinctive fight-or-flight reaction.
- Response to a threat that you must control immediately.
- Focused on a definite target.
- Starts instant life saving action.
- Decisive action against a clear target.
- Immediate physical symptoms like rapid pulse, panic, hyperventilating.
- May lead to excessive defensive action.
- Performance improvement.
- Can be addictive (dangerous sport, or other risky behaviour).
- Fades rapidly when threat is removed.
Anxiety
- Caused by thoughts of future harm.
- No danger in immediate vicinity.
- No fight-or-flight reaction.
- Response to potential harm that you can not control immediately.
- Focused on an indefinite target.
- Prepares against future harm.
- Search for potential harm and solutions.
- Same symptoms as fear, plus additional disorders (depression, insomnia, drug addiction)
- May become compulsive and cause long term mood disorders.
- No performance improvement. May degrade productivity.
- Can be compulsive, but not as a recreative or sought after activity.
- Lasts for a long time. Replaced by new threat when old one is removed.
Differences between fear and anxiety
Symptoms of fear
- Sudden alarm, confusion, panic, chaos
- Shouting, screaming, or loss of speech
- Aggression or frantic search for escape route
- Rapid heartbeat, high blood pressure
- Breathlessness, fast breathing
- Weak or immobile limbs (especially legs)
- Dry mouth, choking
- Tension, stress, short term anxiety
- Trembling, shaking, sweating
- Uncontrolled urinating or defecating
- Fainting, possible asthma, angina
- Delusion (imaginary threat caused by harmless event)
- Use of tranquilisers or alcohol to subdue phobia
- Fear fades rapidly when threat is removed
Symptoms of anxiety
- Compulsive worrying, intrusive thoughts
- Catastrophising (believing things are worse)
- Insomnia, anger, irritability, restlessness
- Headaches, dizziness, faintness
- Shaking, trembling, weakness
- Numbness or tingling in limbs
- Rapid heartbeat, high blood pressure
- Breathlessness, hyperventilating
- Chest pain, muscle pain, sweating
- Dry mouth, frequent urinating
- Tension, stress, depression, isolation
- Difficulty speaking, tight vocal chords
- Poor concentration, ringing in ears
- Stomach cramps, upset stomach, nausea
- Fainting, possible asthma, angina
- Worries persist for a long time
- New worries flood in when old ones subside
- Use of tranquilisers, alcohol or drugs
- Suicidal thoughts
Help for Fear and Anxiety disorders
People who suffer from fear and anxiety disorders can make use of therapeutic programs or they can use medication. Sometimes the best result comes from a combination of both psychotherapy and medication. Unfortunately, most medications for these disorders have side effects and also cause acclimation or addiction. In severe cases medication may, however, be prescribed in conjunction with therapy.
Depending on the analysis of the disorders, a residential patient receives different psychotherapy treatments, including counseling, in a combined, comprehensive treatment plan. It is individually designed to remedy the problems and to fully prepare the patient for a peaceful life after treatment. It is an established fact that this method delivers great results.
