Maybe you’re not anxious. Maybe you’re just stressed

Something rather odd has happened to the way we talk about worry. The straightforward term ‘stress’ has been overtaken by the quasi-medical concept of ‘anxiety’. The problem is that the words don’t mean the same thing and treating them as interchangeable can have unhappy consequences.

The way we use the term ‘stress’ is different to the semantics of ‘anxiety’. Stress tends to have its causes outside – deadlines, bills, crying kids, nagging bosses. Events can be stressful. We all suffer from occasional stresses and strains. These are things that happen to us. Stress is circumstantial, episodic, even inevitable.

When the word destresse first entered the English language in the Middle Ages, it was used to describe sieges or famines – more acts of providence than individual failure. In physics, stress is a force that an object is placed under. In biology, a stress is something that comes from the environment and negatively impinges on the organism’s proper function. This is the traditional framework in which we’ve discussed human worry. Yet somewhere around 2014, Google searches for ‘stress’ were surpassed by ‘anxiety’. 

The two concepts lead us in different directions. Unlike stress, anxiety is the first step down a medical route. It exists in tandem with terms like ‘disorder’ and ‘trauma’ and a slew of acronyms. People ‘have anxiety’ much like they would a disease. You don’t just put up with anxiety, you start thinking about how to treat or cure it: maybe a wellness app, some therapy or even seeking antidepressants. Crucially it’s something that happens within us, a sign that we are somehow amiss with ourselves. ‘The ego is the actual seat of anxiety,’ wrote Freud, who thought it the result of a mind at conflict with itself. You don’t have to sign up to Freudian psychobabble to recognise that there is a conceptual difference between ‘stress’ and ‘anxiety’. 

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According to the Mental Health Foundation, nearly four in ten British women report high levels of anxiety, and around a third of men do too. The core definition of a generalised anxiety disorder, according to NHS guidelines, is ‘excessive anxiety and worry about a number of events or activities and difficulty controlling the worry’, along with at least two of the following: restlessness, being easily fatigued, difficulty concentrating, irritability, muscle tension, and disturbed sleep. All of which sounds… fairly mundane? 

If just under half of women believe they’re suffering from high anxiety that seems like prima facie evidence that this isn’t a medical issue, more a fact of life. Why the pathologisation? Maybe it’s that the words we choose also influence the way we feel. Emotions are unlike other medical conditions in that the labels we assign them come with a whole load of conceptional baggage. Tell yourself you have OCD, rather than just a desire for a tidy kitchen, and you’ll start to exhibit compulsive behaviour. This is called the ‘nocebo effect’, where patients become unwell simply because they believe themselves to be unwell. 

There are a whole number of reasons why ‘anxiety’ replaced ‘stress’ when it did. Growing medicalisation in the preceding decades, the release of a new Diagnostic and Statistical Manual in 2013 (the gold standard for American psychiatric diagnosis) and mental health-aware companies keen to shift blame away from stressful workplaces and onto employees. It was also around this time that front-facing cameras became universal on smartphones, which invited confessional-style videos that we mostly watched alone (as it happens, selfie cameras also led to a massive rise in rhinoplasty because the curvature of the small lenses did odd things to the appearance of women’s noses).

But the shift from ‘stress’ to ‘anxiety’ reflects a deeper cultural change. In 2015 the Korean-born German philosopher Byung-Chul Han published The Burnout Society. In it he argued:

Today’s society is no longer [Michel] Foucault’s disciplinary world of hospitals, madhouses, prisons, barracks, and factories. It has long been replaced by another regime, namely a society of fitness studios, office towers, banks, airports, shopping malls, and genetic laboratories. Twenty-first-century society is no longer a disciplinary society, but rather an achievement society.

Han’s argument is that western culture puts a greater emphasis on self-actualisation. People are no longer forced to work or marry but are instead expected to culturally advance through their own decisions. Failure in this world is a failure of the individual. This explains how ‘stress’ became ‘anxiety’. Rather than worry attaching to an external cause as it did when we used the term ‘stress’, it becomes something internal, a concern about the failure to achieve. It becomes ‘anxiety’.

A similar argument is put forward by the Harvard professor Joseph Henrich, who suggests that Protestantism turned Europeans inwards, where redemption could only be found sola scriptura. Westerners are strange because of this. They have become much more individualistic: traditional concepts like shame, the feeling of judgement by the community, have mostly been replaced by guilt, a feeling of not living up to one’s image of oneself. 

‘Stress’ and ‘anxiety’ have undergone the same process of external to internal blame. While ‘stress’ invites us to examine the world around us, ‘anxiety’ compels us to look inside. Anxiousness is a sickness of the individual and if you’re struggling with it, well, so much the worse for you. It’s a callous way of thinking about ourselves. Better, I think, to shun anxiety and return to the happier, more stressful days of old.