There's a pretty clear line for me between anxiety and ambition. The difference is my perception of the goal and the theoretical positive benefit I would gain from working through this struggle. Anxiety implies and unknown underlying driver. Ambition implies I understand, to some degree, what I am getting into and am choosing to work through the discomfort anyway.

They are the same thing mechanically, they affect me the same way emotionally as I am going through them. The difference is mostly about how well I could predict and plan for this struggle.

I do understand where you are coming from but would argue that the healthy and unhealthy line you are drawing has more to do with the outcomes you are expecting, rather than the struggle itself. Severe anxiety is a symptom, not necessarily a source of struggle.

I don't know the mechanics of why it works, but my personal experience has taught me that the transition from unhealthy to healthy isn't something I had to put energy into doing. It felt more like a consequence of reframing how I felt the rewards at the end of a struggle. It was difficult at first to separate the anxiety I felt from the negative physical symptoms I associated with it, but once I did, I started to understand what situations triggered them.

Caring intensely about meeting self-defined performance standards made me really anxious about performing or getting reviews about my performance. I also realized that I won't ever stop caring. I don't think any part of me wants to stop caring. But after finding something I felt passionate about, I realized that caring was positive. I feel anxious because I want myself, or something I made, to do well. That realization made me feel relief, and I was able to let go of some of the spirals of negative thinking that I had previously assumed had to be attached to things that make me anxious. I guess you can say it helped attenuate the anxiety to healthy levels.

I think you can agree that anxiety is a symptom and not a direct cause of harmful behavior, medication treating the symptom is at times necessary but if the underlying cause isn't addressed, the anxiety will come back worse. The article seems to be addressing anxiety as closer in intensity to performance anxiety, and the fear of failing, and not crippling anxiety, to the point where it interferes with daily functioning.

The grey area is when you end up in a situation where high-functioning feels like the bare minimum due to ambition. This is why I agree that ambition and anxiety are two sides of the same coin, and the bridge between once side and the other is passion.

I know anxiety isn't nearly as simple or easy to categorize as I am making it sound. It's a very personal and subjective thing, but this is my general take on it.

I don't believe ambition is a disorder, but like most things in medicine and psychology, the definition of disorder is relative. If you have a room full of people that self-select themselves as highly ambitious, certain struggles will be shared and feel natural, even if isolated the same struggles would not seem worthwhile to go through. I say I don't believe it's a disorder, while accepting that I am one of the self-selecting highly ambitious.

Ambition also has nothing to do with execution. Ambition and passion is a signal of how persistent someone will be in pursuing their goals. Anxiety is a product of discomfort and discomfort is inherently tied to growth and ambition.

Not all forms of anxiety are rational or necessary. But I strongly believe that achieving something and realizing your ambition will always involve anxiety.

The deeper question I am still working on figuring out is the relationship between success and passion. Is passion defined by something innate and so someone will put themselves in uncomfortable and anxiety inducing situations in order to be successful? Or is the opposite more likely, where passion is clear only with hindsight and the natural drive to give struggle meaning, causes certain anxieties to be rewarded, and anxiety itself is foundational to being human. As the reflex of fight or flight, and startle response, is built into our biology, I have started believing the latter to be true. The source of passion is most likely a consequence of probability and nurture, not nature.

Being ambitious and continuously increasing expectations for myself means I also see "if not today, then there's always tomorrow" as a source of relief. I would say ambition and anxiety have strong parallels, if not ambition being a subset of anxiety.