Month: August 2025

It’s a common question: Is this anxiety, or is it just stress? The line between the two can feel blurry. Both involve tension in the body, racing thoughts, and feeling overwhelmed. Both can leave you lying awake at night, replaying the day or anticipating tomorrow. But clinically, there are some key differences worth paying attention to, because how we label the experience often shapes how we treat it.

Stress vs. Anxiety: Where They Overlap, and Where They Don’t

Stress is usually a response to an external situation—a deadline, a conflict, an exam. It tends to fade when the stressor passes. Stress can even be adaptive: it mobilizes your body’s fight-or-flight response, sharpens focus, and helps you perform.

Anxiety, on the other hand, doesn’t require an external trigger. It’s more internal, persistent, and disproportionate to the situation at hand. Anxiety disorders are marked by excessive worry, avoidance, and physiological symptoms (trembling, sweating, rapid heartbeat) that continue even when there’s no immediate threat. In other words, stress is situational; anxiety is longer-lasting.

What the Research Says

Our diagnostic guidelines (the DSM-5-TR) distinguishes anxiety disorders from stress reactions based on duration, intensity, and impairment in daily functioning. Research consistently shows that chronic stress can evolve into an anxiety disorder if the nervous system stays on high alert for too long (McEwen, 2007).

A useful marker is functional impairment. If worry or physical tension significantly interferes with work, school, sleep, or relationships, it’s more than stress—it’s likely an anxiety disorder. Self-report questionnaires, such as the GAD-7, can help screen for clinical levels of anxiety.

How Therapy Helps Both

Fortunately, whether you’re “just stressed” or living with an anxiety disorder, evidence-based therapies can help.

• Cognitive Behavioral Therapy (CBT) helps people identify distorted thought patterns (“What if I fail?” “What if something goes wrong?”) and replace them with more balanced, realistic thinking. CBT also includes behavioral experiments and exposure, which help retrain the nervous system’s response to fear.
• Acceptance and Commitment Therapy (ACT) prioritizes making space for difficult emotions while moving toward values-driven actions.  Instead of trying to control or eliminate worry, ACT helps change your relationship with stressful and anxious thoughts and feelings. This helps break the cycle of avoidance that often worsens both stress and anxiety.
• Mindfulness-based interventions (including Mindfulness-Based Stress Reduction, Kabat-Zinn, 1990) reduce both stress reactivity and anxiety by shifting attention away from rumination and toward present-moment awareness.
• EMDR (Eye Movement Desensitization and Reprocessing) helps with anxiety by reprocessing distressing experiences, calming the body’s overactive alarm system, and reshaping negative beliefs into healthier ones—allowing people to respond to stress with more flexibility and less fear.

Lifestyle and Sleep Hygiene

Clinical work is clear on this point: therapy is powerful, but it’s most effective when paired with supportive daily practices. Chronic sleep disruption, lack of exercise, and poor nutrition amplify both stress and anxiety. Evidence-based recommendations include:

• Keeping a consistent sleep schedule and limiting screen exposure before bed.
• Engaging in regular physical activity, which reduces physiological arousal.
• Building structured downtime into the day for recovery.

So, Do I have stress or anxiety?  

If you find that your distress is temporary, tied to clear external pressures, and improves when the stressor resolves, it’s likely stress. If it persists beyond circumstances, disrupts your functioning, or feels overwhelming despite your best coping efforts, it may be an anxiety issue.

The most important step isn’t the label itself, it’s reaching for support. Both stress and anxiety respond well to therapy, lifestyle adjustments, and evidence-based strategies that help restore balance to the nervous system.

Our specialists at Dallas CBT help people with stress and anxiety everyday get out of stuck patterns and start living the lives they are meant to be living.  If you are looking for the right support on your journey, reach out to schedule an appointment.

References

• American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.).
• Harvard Medical School. (2021). Anxiety and exercise: The connection. Harvard Health Publishing.
• Kabat-Zinn, J. (1990). Full catastrophe living. Delta.
• McEwen, B. S. (2007). Physiology and neurobiology of stress and adaptation: Central role of the brain. Physiological Reviews, 87(3), 873–904.
• Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092–1097.

 

Anxiety can feel like both the smoke alarm and the fire. Your chest tightens, thoughts loop, and then sleep starts to suffer, which makes it all that much harder. The experience of anxiety often feels strongly physical, which can prompt the question of whether there is a biological imbalance that must be addressed. If you’ve ever wondered, “Is there any way to calm down my anxiety without medication?” the answer is yes—though it requires patience, persistence, and a willingness to experiment.

Let’s go through some of the most effective, research-backed ways to manage anxiety—drawing from Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), and everyday lifestyle shifts that often get overlooked.  We teach and tailor these strategies to our clients everyday, and can attest to the positive changes that come from committed practice.

1. Challenge the “What Ifs” and Catastrophizing (CBT)

Why do I always think the worst? An anxious brain can generate catastrophic predictions faster than you can fact-check them. Eventually, you stop even trying to fact check your predictions because they have become your default way of thinking.  They might even feel protective on some level.  CBT offers a systematic way to slow down and evaluate these thoughts.

• Catch the thought: Notice the catastrophic thought (“I’ll fail this project and lose my job”) and name the thought (this can be as simple as “there’s a thought”).
• Question it: Ask, “What’s the evidence for and against this?”  “But, is it really true right now?”
• Reframe it: Shift to something balanced (“This project is stressful, but I’ve completed challenging work before”).

This isn’t about toxic positivity; it’s about training your brain to separate probable outcomes from imaginative disasters. Over time, your mind will start producing fewer panic-inducing thoughts.

2. Stop Wrestling with Your Thoughts (ACT)

The CBT strategy above is about restructuring or reframing thoughts, while this ACT strategy is about relating differently to them. Sometimes, trying to challenge our thoughts can get us more stuck.  In that case, it is best to make space for the thoughts, instead of further engaging or fighting them.

Try this:

• Imagine your anxious thought as text scrolling across a movie screen. You don’t have to delete it, fix it, or interact with it—you just notice it and let it pass, staying in the observer role.
• Or picture yourself carrying anxious thoughts and feelings in a backpack. Heavy, yes, but you can still walk toward the things you care about, like relationships, career, or hobbies.

The paradox is that the less you struggle against anxiety, the more space you create for living fully.

3. Breathe to Calm Your Nervous System 

When you’re anxious, your body flips into fight-or-flight. You can help reset it with simple breathing practices:

• Box breathing (4-4-4-4): Inhale for 4, hold 4, exhale 4, hold 4.
• Physiological sigh: Two quick inhales through the nose, long exhale through the mouth.

Research shows slow, deep breathing helps regulate the vagus nerve, lowering heart rate and restoring balance to your nervous system.

4. Move Your Body

Exercise is not just for physical health—it’s one of the most reliable anxiety reducers we have. Aerobic activity (like brisk walking, cycling, swimming) can decrease anxious arousal, while strength training builds resilience. The best exercise for anxiety is sustainable and flexible.  The key is to pick something you don’t dread and have reasonable expectations. If it feels like punishment or a “should,” it can backfire and actually increase your anxiety.

5. Sleep Like It’s Your Job

This tends to be the hardest truth for our clients to accept: sleep plays such a critical role in your anxiety.  Cognitive performance, emotion regulation, and coping all tank when sleep suffers.

Try these sleep hygiene strategies:

• Keep a consistent bedtime—your brain loves rhythm.
• Reserve the bed for sleep (not for doomscrolling).
• Keep the room cool, dark, and quiet.
• If your mind spins at night, jot thoughts in a journal before bed.

6. Audit Your Habits (Gently)

Caffeine, alcohol, and scrolling at midnight are like jet fuel for anxiety. Instead of cutting everything cold turkey, try experimenting: reduce caffeine after noon, trade one late-night screen session for a calming activity, notice how your body responds. Again, be careful not to create a list of “shoulds” that you will be in trouble for not completing.  Try to slowly build in some healthy habits, and be gentle with yourself when you’re not perfect.

7. Anchor in Daily Practices

Small, steady rituals calm an anxious system:

• Mindfulness meditation (5-10 minutes of focusing on breath or sounds; Find a short guided meditation online that speaks to you).
• Journal your worries, then set them aside.
• Gratitude practice—name 3 things daily that your are grateful for and allow that to anchor you in the present.

Think of these not as immediate, magic fixes but as regular tune-ups for your nervous system.

Consider Therapy

Therapy can really help with these lifestyle changes.  Therapy helps you do the deeper work of thinking and behavioral patterns, but can also help you identify the best strategies for you and keep you accountable to them.  With consistent practice, anxiety can become a background character instead of the lead role in your life. 

The best treatment for anxiety includes CBT skills, ACT strategies (acceptance and values-based living), and lifestyle habits (movement, sleep, breathwork).  Therapy can help you make foundational changes in your experience of anxiety without relying on medication.

Progress with anxiety rarely arrives as one grand “cure.” It shows up in small victories: one night of deeper sleep, one thought you didn’t chase, one worry you let drift by without grabbing.

When should you consider medication for anxiety?  There is no right or wrong answer for this.  Medication is just one of many tools you might consider to help with your anxiety.  It can be helpful to talk this question over with your therapist.  Some people greatly benefit by medication, or the combination of medication and therapy.  It’s very personal and all about finding what is right for you.

If you would like to work with an anxiety specialist at Dallas CBT, please reach out.  We are honored to witness our clients gaining freedom from anxiety everyday.