Have you ever worried about the way you worry? Worry is a normal part of life. But how can you determine if it’s gotten out of hand and it’s grown into something bigger like anxiety or panic?

Worry can be overwhelming, isolating, terrifying, draining, and is often a unique experience for everyone. To make it more confusing, the terms around our worry, like anxiety and panic attacks are often used interchangeably. Anxiety and panic attacks have many overlapping physical and mental symptoms, so it can be hard to discern what you’re actually experiencing. It’s important to understand the difference so you can identify which interventions and tools will most help you find relief.  

Anxiety v. Panic Attacks

What you need to know about anxiety

Anxiety is an important contributor to our wellbeing, even though it can feel very uncomfortable. It is our threat response system. We need anxiety to protect us, help us identify threats, interpret our environment, and signal us to reflect on our needs. Anxiety can be mild, moderate, or severe. For example, anxiety may be mild to moderate, happening in the back of your mind as you go about your day-to-day activities. Or, anxiety may be severe. A severe response to anxiety may mean that you are actively adjusting your life to respond to, distract against, or avoid your triggers and fears. For example, severe anxiety is common in romantic relationships. You may respond to this anxiety by confronting your partner directly and increasing conflict in an effort to resolve your fears or you may fear conflict even more and avoid bringing up anything uncomfortable with your partner to avoid your fears. 

Anxiety symptoms typically come on gradually and can endure for days, weeks, or months at a time, but they can also come on suddenly like a panic attack but are still much less physically intense. Check out our article on emotional flooding to learn more about what this might look like when you get triggered in a relationship.

Why anxiety attacks happen

Anxiety is frequently connected to an identifiable stressor or trigger. Triggers may include a perceived failure, the experience of learning something new, negative feedback from a boss, feeling left out by a friend, or rejection by a significant other. When you take a closer look at your anxiety triggers, you’ll find that they carry really important information about your core beliefs about the world, others and yourself. 

For example, If you worry about your performance at work, it may reveal how much you value excellence in the things you produce or achieve, how much stock you put in other people’s opinions of you, or how much you crave financial stability. Each of these most likely stem from big events or people in your past that shaped you, like experiencing financial instability growing up, your parents putting pressure on you to be a high achiever, or having to be hyper-aware of what others thought of you to succeed in social groups as a kid. We develop anxiety around the things we value to protect us from losing them and experiencing the greater pain of that loss. It functions as a signal to us to be cautious because we are approaching a situation that feels risky to us physically, socially, or emotionally. 

Anxiety is in normal range when the distress from your anxiety is proportionate to the stressors in your life. This means that your anxiety is not causing significant limitations in your day-to-day life. For example, it’s common to experience periods of higher worry and physical anxiety symptoms at work when a big deadline, presentation, or performance review is approaching or your company is making internal changes that may lead to uncertainty surrounding your position or team.

When your anxiety feels out of proportion to the stressors in your life, your anxiety could be described as disordered. This could include specific phobias that are negatively impacting your well-being, like social anxiety that is so consuming that you have stopped engaging with others, developing meaningful relationships, or even eating in public, going to school, or holding a job. Anxiety this severe or out of control can often make you vulnerable to other health issues like  depression and low self-esteem, and even psychophysiologic health conditions like chronic pain and fatigue, migraines and irritable bowel syndrome 

The symptoms of an anxiety attack

Like all of your emotions, anxiety starts in your body. You may not notice it until it’s taken control of your thoughts, but there are always physical sensations that accompany them. You may notice your breathing become more rapid and shallow, your heart rate increasing, muscles tensing, cheeks flushing and sweat beading. You may even notice some nausea, changes to your appetite and sleep patterns. 

“I often thought of [anxiety] as standing in a water tank. Sometimes you’re only in puddles, sometimes it’s knee level but still bearable, but there are days when the water level rises up too high and too fast and you’re struggling to stay afloat and breathe.”

“It’s a knot in your chest that’s always there lurking waiting to creep in and put seeds of doubt and worry into every thought.”

-Anonymous descriptions of anxiety excerpted from The Mighty

What you need to know about panic attacks 

Panic attacks are a rush of severe physical symptoms that come on very suddenly and typically do not last long. Panic attacks typically subside in less than an hour, even though it may feel like much longer. Anxiety can have moments of intensity, but cannot match the force of a panic attack. The symptoms of a panic attack can be so physically intense that many people may not immediately identify panic as the source, and instead, believe they could be experiencing a medical emergency like a heart attack.

Panic attacks are episodes of intense fear that are much less common than anxiety attacks. Someone can certainly experience panic attacks multiple times in their life, but it is not something that people experience daily or weekly like anxiety. 

Why panic attacks happen

Where anxiety symptoms are most often linked to a specific trigger or at least a general stressor, panic attacks are less often triggered by something so obvious. Genetics, brain chemistry, and trauma history are believed to increase your risk for panic attacks as doctor’s believe they are linked to an overactive or malfunctioning stress response system (more commonly known as your fight, flight, or freeze response). You can learn more about that here

A history or trauma is also linked to an increased risk for panic attacks because the body has adapted to be much more hypervigilant to any kind of threat in their environment, like loud noises and sudden movements for veterans recovering from a deployment where they engaged in combat. However, panic attacks can also be random — your body goes on high alert for no obvious reason or threat, you may have just finished an intense workout, had an excessive amount of coffee, or walked into an overly crowded concert with flashing lights when your body’s stress response gets falsely triggered.

Symptoms of a panic attack

If you have a panic attack, you may feel like you’re losing control, going crazy, or possibly dying. You may notice a pounding heart, chest pain, trembling and shaking, extreme difficulty getting a deep breath, sweating, dizziness, nausea, muscle tightness, chills, or hot flashes. Others describe an out-of-body experience where they feel detached from themselves or detached from the present moment, like experiencing a kind of tunnel vision.

If you’re having a panic attack or with someone who is, it’s not helpful to tell them not to panic. Even though there may not be immediate danger, to the person panicking, it feels like there is. Validate their experience, but let them know they are safe and that the panic attack will pass. 

“My panic attacks make me feel numb and cold all over. I feel like I’m going crazy, about to die, my heart is beating too fast, and I can’t get air. I often have to get up and go outside to get fresh air.” 

“Like an out-of-control, out-of-body experience. You’re watching yourself and can’t do anything to control it.” 

-Anonymous descriptions of anxiety excerpted from The Mighty

What should you do if you think you’ve experienced anxiety or panic attacks?

It’s not uncommon to have anxiety or a panic attack if you have proportional stressors in your life. It’s important to create a plan so you know how to care for yourself and your body while in distress. 

  1. Identify the severity level of your symptoms to discern whether you are having a panic or anxiety attack.  
  2. If it’s panic, focus your attention on something outside of your body and your symptoms and remind yourself that although this is deeply uncomfortable, it is temporary and not life-threatening. You can cope by distracting yourself and allowing your symptoms to pass. 
  3. If it’s anxiety, choose self-care practices and activities that are relaxing and soothing to your overactivated nervous system. It can be helpful here to focus on your body and symptoms and practice accepting the discomfort as tolerable and even welcome. 
  4. Be curious about the triggers, thoughts, and beliefs that could be contributing to your anxiety and ask yourself what you may need to challenge the worried thoughts or challenge yourself to do the things you’re worried about. 

If you believe your anxiety or panic could be disordered, take care of yourself by reaching out to expert resources like a therapist or psychiatrist who specializes in the treatment of anxiety disorders. You deserve the opportunity to work with someone who really understands your unique and personal experience with anxiety and panic. A professional can help develop interventions that work for you. If you’re interested in working with one of our expert therapists, you can reach out to us to get started. 

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