Panic attacks and anxiety attacks are often viewed by many as the same thing, but they are two different conditions.
Panic attacks are sudden and involve intense and even overwhelming fear. They are triggered by a sense of immediate threat, even when no threat is present, and are accompanied by frightening physical symptoms and a feeling of dread.
Consider “Michelle” who came to see me a few years ago. She had been having symptoms that were alarming to her, but her doctor could find nothing physically wrong. She described experiencing pains in her chest, shortness of breath, tightness in her throat, and the feeling that she was dying. The symptoms would come upon her suddenly - in her car, in the gym, in her office. She said, “When it happens, I feel like I’m dying.”
What she was experiencing were panic attacks, marked by the sudden onset of overwhelming and frightening symptoms, including feeling terror. Because panic attacks are associated with the amygdala (the threat detecting center in the brain) Michelle’s ‘fight or flight’ responses were being engaged, and she was experiencing the corresponding hormonal and physiological effects.
Anxiety attacks, on the other hand, seem to operate not from the amygdala, but from the prefrontal cortex, where planning and anticipation occur. Anxiety attacks, therefore, tend to come on more gradually and in response to the anticipation of a stressful situation or event. Anxiety attacks are marked by excessive and persistent worry over that anticipated experience.
Consider “Jill” who was having a series of tests run by her physician because of abnormal results in some earlier tests. She found herself in a vicious cycle of worry. Her mother had died around the age that Jill was approaching. Now, Jill wondered if she had inherited her mother’s condition. She worried more than ever about her health, which led to her fearing that she was dying, which led to her worrying about her children’s future, which led to her worrying about who would care for her kids and how they would survive financially.
These ever growing stressful anxieties stayed alive in the background of Jill's mind as she went about her day, and they protruded to the front of her mind when she was quiet - driving in her car, in bed at night, in the shower. She was now having anxiety attacks, marked by restlessness, difficulty sleeping, fatigue, irritability, and difficulty concentrating.
Both panic attacks and anxiety attacks are perplexing, to say the least. And it is understandable that the terms are sometimes used interchangeably, as panic attacks and anxiety attacks have many symptoms in common. But key are the distinctions we have touched on above. Panic attacks tend to come on suddenly and be immediately overwhelming, even terrorizing, whereas anxiety attacks tend to refer to persistent and excessive worry about an anticipated event. Below is a table outlining some of the most common symptoms of panic attacks and anxiety attacks.
In my next post I'll share some strategies that have helped my clients to downgrade their symptoms while they also engage in treatment to resolve the anxiety and panic issues.
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