Anxiety is so linked to stress that we tend to use the two interchangeably. This may work in ordinary conversation, but for our own understanding it is worth splitting hairs:
Think of stress as what happens when we react to a threatening situation. Part of the way the brain responds is by going into a state of heightened awareness, which includes anxiety.
A little anxiety is good. It keeps us sharp. It keeps us on our toes. It is only when anxiety interferes with our ability to function that psychiatry takes note. We may panic, We may make a scene. Or we may become immobilized. We may avoid people and situations, not get things done.
Stress and anxiety feed off of one another. Thus, while stress makes us anxious, anxious individuals tend to perceive ordinary events as stressful. Left unchecked, a destructive feedback loop takes over. The delicate ecology of the brain loses its equilibrium. Over time, under cumulative duress, resetting to normal becomes increasingly problematic.
Those of us with mood disorders find ourselves in double jeopardy. Some 30 to 40 percent of individuals with bipolar also have full-blown anxiety. Many more have at least some mania symptoms. Typically, bipolar patients with full or partial anxiety are more difficult to treat.
Anxiety and mood share many of the same brain pathways. Robert Sapolsky PhD of Stanford asks us to think of a lab rat manipulating a lever that no longer turns off mild shock. The rat will frantically press the lever repeatedly, attempting to gain control. This, says Dr Sapolsky, is the essence of anxiety.
As the shocks continue and the rat finds its attempts at coping useless, key neurotransmitters deplete. The brain literally gives up. In the words of Dr Sapolsky, the rat “has learned to be helpless, passive and involuted. If anxiety is a crackling, menacing brushfire, depression is a suffocating heavy blanket thrown on top of it.”
Or - the anxiety may trigger mania.
Call me Lab Rat Ishmael. Last year, my flight out of Philadelphia was delayed, meaning I would not make my connecting flight in Vegas. I was already in a state of exhaustion and sleep-deprivation, and now my biological clock was three hours out of phase.