The answer to that question depends on who you ask and on how the two phrases are defined. Like many words in the English language certain words can be used in a variety of ways and mean different things. Fear is one of these types of words. So, from this writer’s perspective, the answer can be both “yes” and “no.”
Definitions for Fear and Anxiety
One definition given for fear would indicate that it is not the same as anxiety:
Fear is defined as an unpleasant often strong emotion caused by anticipation or awareness of danger, whereas anxiety is defined as an apprehensive uneasiness or nervousness usually over an impending or anticipated ill.
The keywords here are “danger” in fear’s definition and “anticipated ill” in anxiety.; with “danger” implying an immediate threat state and “anticipated ill” a future, possible, threat state.
However, as you read further through the definitions, it becomes very clear that both definitions include words that are interchangeable, so it’s not very helpful.
Consulting the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which is the manual that all mental health professionals use for diagnosing, the two conditions are defined as uniquely separate:
whereas anxiety is the anticipation of future threat,”
By this definition, it can be seen that fear and anxiety are seen as occurring in response to two different types of situations.
So then how are we to understand the differences?
As a therapist, I find myself somewhere in the middle. I would say that fear is definitely not anxiety, but anxiety can be seen as related to fear if it is allowed to run unchecked. Let me explain using a couple of examples.
feeling anxious (experiencing feelings of nervousness, unease, worry, disquiet, apprehensiveness) or would you be feeling afraid (fright, horror, panic, terror)? My guess is that you would be feeling the emotions associated with what I’m going to label as TRUE fear. The feeling of TRUE fear is much more intense and immediate than those associated with anxiety. A TRUE fear response is designed to trigger the “fight or flight” response, which is a survival mechanism.
Now let’s say instead, that you just saw your doctor after having your annual colonoscopy and he informs you that they found a possible problem that he is concerned about and he wants to schedule you for a biopsy. Now the anxiety starts!
This is where my personal definition of anxiety comes in, in which I define anxiety as “A fear of a ‘WHAT IF!’”
Anxiety does not occur when a real threat is present, rather it occurs when we start playing the “what if” game. Returning to our example, you’re waiting for your biopsy, and if you’re like me, all kinds of worse case scenarios would be running through your head, “what if it’s malignant?” “What if it’s really bad?” and on and on. You have the biopsy done and now you wait for the results, and the “what if” game continues, most likely even worse, until you get the results. This type of anxiety is what is called “toxic anxiety” (I explain the difference between healthy anxiety and toxic anxiety here) and it serves no purpose other than to lead you down a dark path of negativity.
How anxiety relates to fear.
All emotions occur on a continuum, a fancy word for a type of range or comparison scale. A good example would be the feeling of pain. Just telling someone that you are in pain, doesn’t really tell them much and isn’t very helpful, because pain is a subjective feeling. Meaning that its interpretation varies from person to person and there is no set standard. That is why health care professionals use charts like this one, to better understand a person’s pain level.
Anxiety and fear are the same, in that they are subjective emotions. When you say that you are “anxious,” “afraid,” or “scared,” it doesn’t really say anything about the level or intensity of the emotion you are feeling. Continuum and scales can help to resolve this problem.
A continuum for anxiety
The continuum for anxiety might look something like this:
Discomfort Edginess Distress Dread Fear Panic
As can be seen, anxiety is a process that builds. It usually starts at a low level (which many times people aren’t even aware of) and continues to worsen unless something or someone intervenes. The ultimate level on the continuum is a full-blown panic attack.
Another way to look at this process is to use a rating scale, like from 0-10, as a way to more accurately indicate where you are on the continuum. This scale might use “0” as a “state of no anxiety,” that place where you’re relaxed and feeling mellow and chilled; with “10” being the beginning of a panic attack. (if you are having a full-blown panic attack the scale is not needed).
Rating your anxiety on this type of scale gives both you and the person trying to help you a more accurate way to judge what your anxiety state is.
So, while TRUE fear is not anxiety, anxiety, as it builds, can lead to fear, which the brain perceives as a TRUE fear, which will then trigger the “fight or flight” response.
TRUE fear is that state of being we experience when we are confronted with an immediate threat, that we perceive as dangerous and/or life-threatening. It is the emotion that immediately triggers the survival “fight or flight” system, kicking us into taking immediate action with the goal of “surviving.”
Anxiety, on the other hand, does not occur in response to an immediate threat, but rather as a response to a “what if” scenario. Toxic anxiety is a game of “what if” that if it isn’t stopped, it will eventually build to a point where an actual fear response is triggered and anxiety or panic attack results. An example of this would be a pot of water sitting on a lit burner. The pot starts at a low temperature, but the temperature slowly continues to build until it finally reaches the point at which it boils over.
The answer, to keep the pot from boiling over, is to turn the heat off; but when it comes to playing the “what if” game, that is easier said than done.
I hope this information has helped you gain an increased understanding of anxiety and that you choose to continue with me on the journey of better understanding emotions. In my next post, I will continue providing more information on anxiety, including a list of some ways you can turn the heat off before the water boils over.
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