Mental Health

Is it stress, anxiety or anguish? How to tell them apart.

Stress, anxiety and anguish are normal and useful emotions. In small doses, they allow us to act. In too high doses, they exhaust us. Learn to manage them in a healthy way.


The purpose of stress is to keep us alert and to protect us from potential hazards. Stress is thus essential to human survival, in addition to driving us to act, appropriately and effectively. For example, stress can help us to perform better at an exam, a job interview or a sporting event by motivating us and supplying us with supplemental energy.

When symptoms related to stress and stressors accumulate, this can undermine our proper functioning and lead to crippling effects.

Possible causes:

Stress is a response triggered in the body when a person is faced with an event that it perceives as threatening, even in cases where the event is a positive one (e.g., the birth of a baby or a wedding). The human body adapts by secreting hormones that drive the system to mobilize. However, when these hormones are produced in excessive quantities over a long period, they can be harmful to a person’s physical and mental health. When stress hinders day-to-day activities, it is strongly suggested to consult a psychologist or a doctor. 

Elements that trigger a stress response can be classified into four categories and are known by the acronym N.U.T.S.:

Novelty; something new
Threat to the ego
Sense of control; feeling you have little or no control over a situation

Other causes can also trigger stress-related symptoms, such as noise, for example. 

The more stressors are involved in a situation, the higher a person’s stress levels will be. Furthermore, an accumulation of stressful events may trigger anxiety problems. 

It is the body’s natural response to stress that can lead to mental or physical health problems, not stress alone. That’s why it’s important to learn to manage stress healthfully. Stressors vary from one person to another, as do our reactions. Our reactions to stress can be influenced by: 

  • Genetics
  • Childhood experiences
  • Personality
  • Environment
  • Health


Reactions to stress involve many stages: 

1. Alarm reaction or energy mobilization stage:

This is the reaction to a sudden source of stress. For example, this could be a collision narrowly avoided or the imminence of an event, such as a wedding.

  • Accelerated pulse and breathing
  • Cold sweat
  • “Butterflies” in the stomach
  • Loss of or increase in appetite
  • Dizziness or feelings of vertigo

2. Resistance or energy use stage:

In periods of prolonged stress, the body consumes its energy resources stored as sugar and fat.

  • Great fatigue
  • Difficulty concentrating
  • Increased frequency of bad habits such as smoking or drinking alcohol

3. Exhaustion stage:

When stress becomes chronic, it can sometimes lead to anxiety disorders, in which feelings of anxiety seem to never go away. 

  • Insomnia and sleep disorders
  • Irritability
  • Feelings of sadness
  • Other changes in mood

Other stress-related symptoms can also manifest themselves at any given time:

  • Sensation of having a lump in one’s throat or a knot in one’s stomach
  • Sensation of tightness in one’s chest
  • Decreased concentration


Anxiety is the anticipation of a future threat. Contrary to stress, the perceived “threat” is, however, not real. 

Like all emotions, anxiety exists for a reason: it protects us or helps us to face a difficult situation. Often, it is difficult to pinpoint what causes anxiety, even though it is associated with specific events. Anxiety quickly fades once its cause or trigger has passed. If symptoms of anxiety persist beyond the duration of the troubling situation, if they lead to distress or harm a person’s quality of life, it is recommended to consult a psychologist or a doctor. Indeed, it may be an anxiety disorder in need of treatment.


Stress hormones are secreted by the body when a person anticipates threatening situations.

It is normal and healthy to feel varying levels of anxiety depending on the situation (e.g., a wedding, a divorce, an upcoming exam and so on). Anxiety also manifests in situations where hypervigilance is required (e.g., walking in a dark alley). It protects us and often allows us to perform better. 

There is, however, a difference between having symptoms of anxiety before an important event and experiencing these symptoms regularly from fear of everything consistently going badly.


Anxiety is reflected in anxious thoughts as well as physical symptoms. Anxiety therefore does not just exist “in our head”.

  • Accelerated heart rate
  • Difficulty breathing
  • Cold sweat
  • Shaking
  • Dizziness or vertigo
  • Clammy hands, hot flashes, chills or excessive sweating
  • Muscle tension
  • Troubled sleep
  • Headaches
  • Numbness
  • Digestive problems
  • Feelings of uncertainty
  • Feelings of loss of control
  • Irritability
  • Sadness
  • Feelings of guilt
  • Difficulty concentrating

Anxiety becomes problematic when:

  • The intensity of symptoms is exaggerated in relation to the troubling situation
  • A person’s worries are unrealistic
  • It causes feelings of despair
  • Anxious thoughts become difficult to control
  • Symptoms do not disappear when life resumes its course
  • It seems unrelated to any event
  • Symptoms become overwhelming or disrupt the way a person functions day-to-day

If you are experiencing any of these situations, don’t wait – consult a healthcare professional like a doctor or psychologist. You can also call the Info-Santé mental health hotline to be referred to qualified services (8-1-1). 


Like anxiety, anguish occurs when a threat is anticipated. Anguish is always accompanied by a destabilizing physical response, a type of malaise. Symptoms are brutal and intense and are commonly referred to as a “panic attack”. Generally, panic attack symptoms last between 10 and 60 minutes.


It is extremely difficult to identify the source behind anguish. It is often characterized by feelings of internal unease or a perceived loss of control.


Seeing as the causes behind panic attacks tend to be unclear, they are often suffered in silence and confused with serious health problems (e.g., angina, digestive or respiratory problems and so on).

  • Difficulty breathing
  • Pressure on the chest
  • Increased heart rate
  • Pain or tightness in the chest
  • Sensation of having a lump in one’s throat or a knot in one’s stomach
  • Choking sensation, shortness of breath
  • Nausea or abdominal discomfort
  • Numbness or tingling sensation
  • Muscle tremors
  • Perspiration, chills or hot flashes

Anxiety disorder treatments

It is best to act preventively and not to wait until one is incapable of carrying out day-to-day activities or until feelings of despair occur before starting one of the treatments below.

  • Psychotherapy
  • Anti-anxiety medication, such as anxiolytics 

Before starting any course of treatment, consult your healthcare professional (doctor, psychologist or psychiatrist). They can refer a treatment that is appropriate and suited to your lifestyle. Your pharmacist can, thereafter, coach you in managing your treatment. Available seven days a week, they are a valuable ally you can rely on. 

There are also other ways to achieve calming effects, such as:

Engaging in pleasurable activities like reading can ease symptoms of anxiety. Confiding in a trustworthy person – a loved one, a psychologist or a psychotherapist – is also a very important part of the healing process. 

Get further advice to help you take care of your mental health by clicking here

Sometimes, non-drug treatment options do not offer relief. When that is the case and under a doctor’s or a psychiatrist’s supervision, the temporary intake of anxiolytics and, in some cases, mood stabilizers can help. Anxiolytics are above all used to reduce anxiety disorder symptoms. As for antidepressants, they are a form of treatment designed to cure said anxiety disorders. Nonetheless, it is important to know that on their own, antidepressants are not some kind of “magic bullet”. Their efficiency is significantly improved when they are combined with appropriate therapy (e.g., talk therapy, interpersonal therapy, cognitive-behavioural therapy), support from family and friends, as well as self-care, which includes exercise, a healthy diet and sufficient sleep. Furthermore, antidepressants must be taken at the correct dosage in order to minimize side effects among other things.

With the required medical support and when dosage is adjusted correctly, all these medicines can be taken in complete safety. The use of anxiolytics is appropriate as long as it is done occasionally and for short periods of times, because dependency can occur. Antidepressants and mood stabilizers do not cause dependency, but withdrawal symptoms can appear when a person’s body has gotten used to a treatment over a long period and if said treatment is stopped too aggressively. Your pharmacist can help you to phase out your antidepressants once your condition has remained stable for several months (i.e., approximately 6-9 months).

Side effects

Taking anxiolytics or antidepressants can sometimes lead to certain side effects, to a lesser or greater extent. Side effects vary from one person to another and depending on the dosage that is necessary for each treatment. Generally speaking, side effects can be properly managed by adjusting the type of medicine taken and by balancing its dosage.

Side effects include: When taken in high doses, anxiolytics may lead to:
  • Drowsiness
  • Sedation
  • Dizziness
  • Loss of balance
  • “Hangover” effect
  • Confusion or disorientation
  • Memory loss
  • Respiratory problems
  • Depression
  • In very rare cases, hallucinations and nightmares 

Side effects include: When taken in high doses, antidepressants may lead to:
  • Nausea
  • Vomiting
  • Diarrhea
  • Weight gain
  • Dry mouth
  • Drowsiness
  • Headaches
  • Sedation
  • Decreased libido
  • Nervousness
  • Insomnia
  • Dizziness

Your pharmacist is available, accessible and can support you in caring for your mental health. Feel free to consult them. Your pharmacist can: 

  • Coach you and support you through your medication therapy
  • Inform you regarding dosage, side effects and their duration
  • Make sure that your treatment is suitable and, if needed, make adjustments while following up with your attending doctor or healthcare professional
  • Perform regular follow-ups on your medication therapy, particularly if treatment is prescribed for a prolonged period
  • Propose alternatives if side effects are troublesome
  • Answer your questions and concerns

Medication therapy must be prescribed by an authorized doctor, psychiatrist or healthcare professional. Medication must be suitable for each patient depending on various factors. For further information and to get support, consult your pharmacist or healthcare professional.

This information is not a substitute for professional medical advice, and pharmacist-owners affiliated with Accès pharma chez Walmart cannot be held responsible for this information. The information was true and accurate at the time of publication, but it is subject to change. 

Latest articles

Subscribe to your Accès pharma pharmacist's newsletter

Subscribe to your pharmacist's newsletter to take advantage of his advice and offers.