Jenn is the mother of three young children and also holds down a full-time job as a paralegal at a family law firm. Her husband also works full time, and his job requires frequent travel away from home, which makes caring for their kids challenging at times. Nonetheless, Jenn told me that everything was going well for her despite her busy schedule.
"My kids are healthy, and I like spending time with them," she said at our first session. "My husband is wonderful. I like my job helping lower-income people get legal support and deal with complex family situations. It feels like meaningful, important work."
Then Jenn took a deep breath, and a troubled look crept over her face. "But I'm having all this... anxiety,"she said. "I'm feeling a lot of panic, including difficulty catching my breath and heart palpitations. I'm even having mood swings. Sometimes I get really angry and irritated and then I get afraid I can't control myself, which makes me feel really anxious about everything." She paused, but I sensed that she had more to say so I simply nodded.
"On top of that," she went on, "I'm having really uncomfortable physical sensations of anxiety. I feel a lot of muscle tension. My neck is particularly painful, although I also feel tension in my shoulders and my back. When I wake up in the morning, I have this dread that I'm not going to be able to make it through the day. And I often feel uncomfortable for an hour or more before bedtime because I'm thinking about everything that I have to do the next day. I'm feeling so overwhelmed and anxious, and I don't understand why."
After waiting for her to finish, I smiled and said, "Jenn, I have good news for you and bad news for you."
"Please," she said, "can I have the good news first?"
"The good news is that you're not anxious," I said.
"What?" she said with an incredulous look. "What do you mean I'm not anxious?"
"What you're describing," I said, "is not really anxiety. The bad news is that what you're describing is stress. You're so stressed out that you've become a bundle of nerves."
"Well, what's the difference between anxiety and stress?"
"That's a great question," I said, and I proceeded to explain by describing anxiety. (When people have a fear reaction that is disproportionate to the actual level of threat, that's anxiety.)
"Great," she said. "So what's stress?"
"When people have an excess of life demands over and above the resources they have to meet those demands, that creates stress," I responded.
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