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4. What is the difference between anxiety and fear?

The difference between anxiety and fear is an important distinction. Anxiety serves as the body’s warning system - the brain’s way of telling the body that something bad could happen. This response relates to but is distinct from fear, which alarms us when something actually dangerous is happening or is just about to happen. For example, if you become scared that you will lose your spouse from medical illness in anticipation of his routine medical checkup, in the absence of any known medical condition, this reaction would be considered anxiety about losing your spouse.

The reasons for this anxiety are very important; you may well have suffered from some prior significant loss and/or trauma. In turn, the fear that this trauma could recur (“once bitten, twice shy”) might cause your anxiety that something bad might or will happen again. This situation- anxiety - would differ from someone who lives with a spouse with metastatic cancer. In this situation, the patient’s spouse will die, even if the right treatment is provided; it is simply a matter of when the emotional pain and loss will occur. In this situation, fear of the spouse’s dying - with its host of mental and physical reactions - would be entirely appropriate and in keeping with reality.

This example highlights the essential interface between anxiety and fear and underscores the historical origins of any particular individual’s anxiety. Most of the time, people seem to become anxious about events in the present based, in part, upon genuinely fearful situations from their past. The fear of today can lead to the anxiety of tomorrow. This phenomenon allows us to think about anxiety as a form of remembering prior traumas, losses, or significant life events.  

Rick’s comments:

I remember reading a quote from Mark Twain; I believe it was who wrote that the worst things in his life never happened. Anxiety sufferers such as me know what Mr. Twain means. The time and attention I give to possible negative outcomes and events - to things that have little likelihood of happening - is all out of proportion to the time and attention they deserve. The waste of energy is enormous!

Plus, it means I’m spending less time either doing things that could actually be productive or taking an action that could help me avoid some real, not phantom, difficulties.



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