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Over the past few weeks I have made a discovery that genuinely surprised me. Until recently, I could not have really told you the difference between stress and anxiety.
Like most people, I used the words to some extent interchangeably. Fear too. If something was weighing on me, I called it stress, largely because that is what I had always called it. It never truly occurred to me that the words might describe genuinely different things.
Then tonight, intuitively puzzled by things, I actually looked up the definitions. Psychologists generally describe stress as our response to pressure or demands placed upon us. Fear is our response to a known and identifiable threat. Anxiety is different again. It is our response to uncertainty: the anticipation of something that may happen, might happen, or may never happen at all.
They overlap, of course, but they are not the same. They describe fundamentally different experiences, and they require fundamentally different ways of responding. The second part was key for me!
As soon as I understood that, something clicked. Stress had largely disappeared from my life. The real battle was anxiety.
My life had moved from a world where most problems could eventually be solved to one where many simply have to be lived with.
For much of my adult life, stress dominated. There were clients to satisfy, deadlines to meet, teams to lead, flights to catch and decisions that could not wait until tomorrow. Like many people in professional life, I accepted stress as part of the job.
If I am honest, I even enjoyed some of it. The adrenaline suited me. Pressure sharpened my thinking, focused my attention and often brought out my best.
If someone had asked me to draw my emotional life as a pie chart, I suspect it would have been something like 90% stress, 7% anxiety and 3% fear. Hardly scientific, but it captures how life felt.
Then something unexpected happened.
I retired because of Progressive Supranuclear Palsy (PSP), and most of that stress simply disappeared. That sounds almost absurd, because my life today is objectively far more difficult than it was when I was working. I live with a progressive neurological disease. I spend most of my time in a wheelchair. Tasks that once required no thought now require planning, assistance or both. Yet the stress has largely gone – and with it much of the adrenaline that fuelled me for decades, and the satisfaction I secretly took in solving difficult problems under pressure.
Stress still visits occasionally. If I commit to writing something by a particular date, or a task genuinely has to be finished, I can still feel it. Those moments remind me of my former life, but they are now the exception rather than the rule.
Fear is different. Fear arrived the day I was diagnosed, and it has never really left. Unlike stress, fear has a face. I know the disease is progressive. I know there is currently no treatment that will stop it. I know there are symptoms I have not yet experienced and abilities I may one day lose.
Those are not imagined threats. They are real.
Oddly though, fear is not my daily enemy. Most days it sits quietly in the background, and I can acknowledge it without allowing it to dominate everything else. In some ways it even serves a purpose. It reminds me not to waste the abilities I still have while worrying about those I may eventually lose.
Anxiety is another matter entirely. It has become my new nemesis.
Looking back, I think I finally understand why. Stress, difficult though it was, generally rewarded effort. Work harder, plan better, gather more information, solve the problem, and the stress usually diminished. It had a logic to it.
Anxiety does not. Anxiety often remains after you have done everything reasonably possible, because its fuel is not pressure but uncertainty. And uncertainty is the language PSP speaks fluently.
Recently I have been struggling with episodes of breathlessness, particularly at night. Is it asthma? Is it PSP? Is it medication? Muscle weakness? Anxiety itself? At the moment, nobody really knows. My entire professional life was built around gathering evidence, analysing it and reaching conclusions. I built expertise and with PSP I am learning on the fly. It presents questions I don’t know how to answer and and asks me to wait for someone else to possibly know a potential answer…more uncertainty.
The questions begin innocently enough. What am I feeling? Is it significant? Should I call my neurologist, or wait until tomorrow? Am I overreacting? Could it be something else entirely? Before long my mind has constructed possibilities that bear very little resemblance to reality.
Anyone living with a progressive illness, or indeed with any profound uncertainty, will recognise the pattern. The symptom fuels the worry, the worry magnifies the symptom, and the spiral takes on a momentum of its own. Round and round it goes.
One further thought interested me while reading about PSP. Researchers increasingly recognise that anxiety may not simply be a reaction to living with the disease. It may also be part of the disease itself. In other words, PSP may create the uncertainty while simultaneously making us more vulnerable to anxiety about it. Whether the cause is psychological, neurological or both, the practical result is much the same.
The more I have reflected on these three words, the more their differences have mattered. Stress asks us, where possible, to reduce the pressure. Fear asks us to recognise a genuine threat without allowing it to consume us. Anxiety asks us to live with uncertainty without allowing uncertainty to take over our lives. For me, that is by far the hardest of the three.
If I redrew that imaginary pie chart today it would look almost the opposite of the one I lived with for decades: perhaps 1% stress, 6% fear and 93% anxiety. The numbers are meaningless. The change they represent feels profoundly real.
Having the right word has changed how I respond. Instead of reaching instinctively for the tools that once worked on pressure, I have begun using tools designed for anxiety: deep breathing, music, yoga, medication when appropriate, a good film, time with my family and, perhaps most importantly, writing. None of them removes the uncertainty, but together they interrupt the spiral before it gathers momentum.
Writing may be the strangest of them. For thirty years I built knowledge for a living and solved problems by learning more. Today, many of the questions I ask have no answers, at least not yet. I still wonder occasionally whether writing helps or whether it simply keeps me focused on the illness more than I should be. For now, I think it helps. It brings a little structure to a world that often feels unpredictable.
It has certainly helped here. Until I sat down to write this, I did not have the words for what had changed. I am not managing stress any more. I am learning to live with uncertainty.
That may sound like a small distinction. For me it has been a profound one, and one of the hardest lessons PSP has taught me. Sometimes there is no problem to solve. There is only uncertainty to live with.
Sometimes the right word does more than describe our experience. Sometimes it helps us finally understand it. And sometimes that understanding is where the journey towards a solution begins.
Tonight I discovered I had moved from stress to anxiety. Now I fight the anxiety.
