Stress is a normal and useful reaction: faced with a deadline, an exam or a threat, the body mobilises its resources. The problem begins when that mobilisation never switches off, and the body stays permanently on alert with no real threat. That is the point at which stress tips over into pathological anxiety.

Stress or anxiety disorder: where is the line?

Three criteria help tell them apart.

  • Proportionality. Stress is proportionate to an identifiable situation. Pathological anxiety is disproportionate, or attaches to multiple, vague situations.
  • Duration. Stress subsides once the event has passed. Anxiety persists — we speak of generalised anxiety disorder beyond six months.
  • Impact. This is the decisive criterion. If your work, relationships, sleep or leisure are lastingly affected, this is no longer simple stress.

Physical signs rarely attributed to anxiety

Anxiety expresses itself heavily through the body, which explains many consultations for unexplained symptoms:

  • Palpitations, a sense of tightness in the chest.
  • A lump in the throat, shortness of breath.
  • Digestive problems: bloating, abdominal pain, disturbed bowel habit.
  • Muscle tension, particularly in the neck, shoulders and jaw.
  • Tension headaches, dizziness.
  • Waking up tired despite a full night's sleep.
  • Excessive sweating, trembling.

These symptoms are real, not imagined. They justify ruling out an organic cause — but when the workup is normal, continuing to investigate does not help; exploring the anxiety hypothesis does.

Psychological and behavioural signs

  • Constant worry, hard to control, jumping from one subject to another.
  • Difficulty concentrating, faltering memory.
  • Irritability, reduced tolerance of setbacks.
  • Taking a long time to fall asleep, night waking, rumination.
  • Progressive avoidance: transport, meetings, going out, driving.
  • Growing reliance on tobacco, caffeine or other substances to cope.

Panic attacks

They come on abruptly: violent palpitations, a feeling of suffocation, sweating, trembling, a sense of dying or losing one's mind. The peak is reached within about ten minutes, then everything subsides. Extremely frightening, it is not dangerous in itself. Many people attend the emergency department the first time, convinced they are having a heart attack — an understandable reflex, and an initial assessment remains justified.

What genuinely helps day to day

  • Regular physical activity: the best-documented non-drug measure. Thirty minutes of brisk walking several times a week has a measurable effect.
  • Regular sleep: stable bed and wake times, screens away an hour beforehand.
  • Cutting caffeine, which faithfully reproduces the physical symptoms of anxiety.
  • Slow, controlled breathing, a few minutes several times a day.
  • Naming what is happening to someone close: isolation feeds anxiety.

Alcohol and sleeping pills taken without medical advice relieve in the short term and worsen things in the medium term.

When to consult a professional

Do not wait if:

  • symptoms have lasted more than a month without improving;
  • your work, studies or relationships are suffering;
  • you avoid situations you used to handle;
  • your sleep is persistently disrupted;
  • you are increasing substance use to cope;
  • you feel persistent sadness or dark thoughts — in that case, seek help without delay.

Cognitive behavioural therapy has proven effective for anxiety disorders, alone or combined with medication when severity warrants it. Psychiatry and psychology lend themselves particularly well to teleconsultation: the setting is more accessible, more discreet, and continuity of care is better. You can book an appointment with a mental health professional in complete confidence.