When considering the differences between stress, fear, anxiety and agitation, we need to know that modern lay language and everyday usage of these terms redefined them somewhat, which can only increase the misunderstanding. For instance, anxiety is a term used for everything from feeling agitated, irritated, anxious, nervous. This only increases the confusion. However, all these terms are significantly different conditions.
Fear can be a healthy feeling
Fear is a common part of our lives and we will feel it when something we consider important is in danger. That can either be something material or it can be a value, social status, behaviour or way of living, thinking. It can be a threat to what we believe in or to us as beings, our health, integrity, to what we love.
Fear can be an authentic feeling, by which I mean that fear can be a very adequate feeling, depending on the situation. In the case of situations that violate our values, us personally or something we feel is important or loved, it is perfectly adequate to feel fear in response.
Repression of fear
The problem arises when fear is repressed. In such case, it will manifest itself as either another feeling or a somatised response to a situation. Repression of fear—similar to anger and sadness—is a common thing nowadays in modern western world. We are brought up valuing not being afraid, sad or angry as a respected personal trait. This can also be very culture-specific. Take for example the variety of European cultural psychological upbringing. It is part of overall British culture to repress anger, but often times also sadness and fear. As opposed to Eastern European cultures, where socially appropriate manifestation of anger is culturally acceptable. We could find more examples throughout Europe, but what is important in this is that different cultures treat different feelings in a different way. When working with a client in psychotherapy setting this needs to be taken into account.
The same goes for fear. Repressing fear can result in it coming out in various damaging ways. When somatised it can manifest itself as chest pains, feelings of emptiness in your stomach, feelings of hunger, muscle stiffness, cold, etc.. We of course shouldn’t oversimplify and say that we are experiencing somatised fear when we feel any of these symptoms, but we need to keep our mind open to the possibility that it might be the case. Also, it does not need to be in the form of bodily somatisation that fear will break out when repressed. We can also unconsciously disguise it with another feeling, such as anger or sadness. And sometimes it can also be the source of anxiety.
Anxiety can be induced by repression of fear
Anxiety is a complex mental health manifestation and can’t be contributed to only one factor. Each individual is unique and there will never be two people that have exactly the same source of anxiety. However, there are some general commonalities when dealing with it. When we refer to anxiety, we will usually refer to generalised anxiety, however, we need to keep in mind that there are many different mental health conditions that have their grounds in anxiety.
One of the sources of anxiety can also be repression of fear. The nature of anxiety will then also depend on the nature and quality of the fear repressed. So, in the case of social anxiety, the repression will tend to focus on the fear of humiliation, embarrassment, shame. It is worth pointing out that fear is not the only feeling that can, in the case of repression or suppression, be the source of anxiety. Feeling agitated can be a good indicator that something in this respect is going on.
Agitation and anxiety
Agitation, or better said feeling agitated, can be one of the symptoms of anxiety—especially in the case of generalised anxiety and social anxiety. Probably the best way to describe feeling agitated is as excess intrapsychic energy, condensed in behavioural form. Sometimes it will also be accompanied cognitively—as confusion. One of the elements of agitation, when it’s accompanying anxiety, is that a person is unconsciously discounting their ability to solve problems or think, which is also the backbone of anxiety. Feeling agitated is just a symptom of anxiety and not its synonym.
Fear of public exposure and speaking or fear of performing is not anxiety
But misunderstanding of anxiety doesn’t end with agitation. English language lacks proper vocabulary to describe the differences between the common types of fear of public speaking and the fear of performing (i.e. tests etc.) and pathological manifestation of anxiety—i.e. generalised anxiety or social anxiety. It is hence commonly interpreted that any fear of being exposed in public or any fear we feel when being tested (e.g. taking an exam) is regarded as anxiety. Because there is no difference between “common” anxiety and “pathological” anxiety there is often misunderstanding between the two.
However, there is an important qualitative difference between the two intrapsychic phenomenon. “Common” and non-pathological fear of exposure, public performance or generally fear of proper performance can also be felt as anxiety, however, it is generally a perfectly natural and healthy response to the situation in which we need to perform or are afraid of making a mistake.
Where this fear transcends from common fear to pathological anxiety is when we regard our exposure, making a mistake or the criticism we might receive as a confirmation of us as failures—as something shameful and as a confirmation of us not being good enough. In essence, when we regard it as a confirmation of our worth and importance as a person and not as criticism to our actions.