Anxiety and Panic Disorders

Jaminah B
May 11, 2021
6 min read

Anxiety and Panic Attacks are commonly discussed but often misunderstood. People often jokingly refer to "my anxiety" without fully understanding some of the differences. Anxiety can be anything from normal emotional responses to stress to more severe and chronic disorders. The conversation around panic attacks and anxiety seems to be more common place as our norms have changed vastly during the pandemic and quarantine eras. This article will help clarify and briefly educate about anxiety , panic attacks and anxiety disorders. There are many anxiety disorders but we will only touch on the following: Generalized Anxiety Disorder, Panic Disorder and Social Anxiety Disorder. Then we will discuss the differences between a panic attack and anxiety, two commonly confused terms. Last we will discuss treatment and practical techniques to alleviate and cope with anxiety, worry, stress and panic. We all relieve and cope with stress differently. These are examples and everyone is encouraged to find their own rhythm and healthy coping skills. Please note this is only to inform and does not substitute seeking diagnosis and evaluation from a trained professional.

Introduction

Occasional anxiety is a normal part of life. You might feel anxious when faced with a problem at work, before taking a test, or making an important decision. Anxiety is defined in several ways oxford dictionary defines it as “a feeling of worry, nervousness, or unease, typically about an imminent event or something with an uncertain outcome.” And healthline.com defines it as “your body’s natural response to stress. It’s a feeling of fear or apprehension about what’s to come” . Both indicate fear, worry and some very natural responses to those emotions and ideas. Once we move into the realm of an anxiety disorder it is important to note they involve more than temporary worry or fear.

"For a person with an anxiety disorder, the anxiety does not go away and can get worse over time. The feelings can interfere with daily activities such as job performance, school work, and relationships."

When considering the differences between normal anxiety and more chronic anxiety disorders we will review some more common disorders, their signs and symptoms.

Anxiety Disorders: Signs and Symptoms

Generalized Anxiety Disorder

People with generalized anxiety disorder display excessive anxiety or worry for months and face several anxiety-related symptoms. Generalized anxiety disorder symptoms include:

Restlessness or feeling wound-up or on edge
Being easily fatigued
Difficulty concentrating or having their minds go blank
Irritability
Muscle tension
Difficulty controlling the worry
Sleep problems (difficulty falling or staying asleep or restless, unsatisfying sleep)

Panic Disorder

People with panic disorder have recurrent unexpected panic attacks, which are sudden periods of intense fear that may include palpitations, pounding heart, or accelerated heart rate; sweating; trembling or shaking; sensations of shortness of breath, smothering, or choking; and feeling of impending doom. Panic disorder symptoms include:

Sudden and repeated attacks of intense fear
Feelings of being out of control during a panic attack
Intense worries about when the next attack will happen
Fear or avoidance of places where panic attacks have occurred in the past

Social Anxiety Disorder

People with social anxiety disorder (sometimes called “social phobia”) have a marked fear of social or performance situations in which they expect to feel embarrassed, judged, rejected, or fearful of offending others. Social anxiety disorder symptoms include:

Feeling highly anxious about being with other people and having a hard time talking to them
Feeling very self-conscious in front of other people and worried about feeling humiliated, embarrassed, or rejected, or fearful of offending others
Being very afraid that other people will judge them
Worrying for days or weeks before an event where other people will be
Staying away from places where there are other people
Having a hard time making friends and keeping friends
Blushing, sweating, or trembling around other people
Feeling nauseous or sick to your stomach when other people are around

Anxiety Attack vs. Panic Attack

Clinically, anxiety and panic attacks are categorized based on the diagnosis they are associated with in the DSM: Diagnostic and Statistical Manual of Mental Disorders (a publication by the American Psychiatric Association for the classification of mental disorders using a common language and standard criteria according to wikipedia). More practically they are often lumped into the same category because they can have similar symptoms.

Panic Attack

During a panic attack, the symptoms are sudden and extremely intense. These symptoms usually occur “out of the blue,” without an obvious immediate triggering stimulus. The symptoms peak within 10 minutes and then they subside. However, some attacks may last longer or may occur in succession, making it difficult to determine when one attack ends and another begins.

Anxiety

Anxiety, on the other hand, generally intensifies over a period of time and is highly correlated to excessive worry about some potential "danger." The symptoms of anxiety are very similar to the symptoms of panic attacks

The Differences

While some of the symptoms of anxiety are similar to many of the symptoms associated with panic attacks, anxiety symptoms are generally less intense. Another important distinction is that, unlike a panic attack, the symptoms of anxiety may be persistent and very long-lasting—days, weeks, or even months.

Treatment

Anxiety disorders are generally treated with psychotherapy, medication, or both. Two specific types of therapy used to treat social anxiety disorder are cognitive behavioral therapy (CBT) and exposure therapy.

CBT focuses on identifying, challenging, and then neutralizing unhelpful thoughts underlying anxiety disorders.
Exposure therapy focuses on confronting the fears underlying an anxiety disorder in order to help people engage in activities they have been avoiding. Exposure therapy is used along with relaxation exercises and/or imagery.

Everyday Tips

Practice deep breathing, meditation, or relaxation: Breathing and meditation can help you focus on the present moment and reduce ruminative worry and anticipatory anxiety. Regular relaxation exercises lower overall physiological arousal.
Look back to other stressful times: Reflect on past stressors and remind yourself that stressful periods are temporary and will pass.
Identify effective coping from the past: You’ve been through tough times in the past. Review what helped you during those times.
Accept negative feelings: Don’t deny anger, guilt, sadness, or negative feelings. Try to accept and acknowledge your feelings. Journaling can provide a safe space to express and process feelings.
Engage in active problem solving: Identify aspects of the situation that you have control over and appropriate responses.
Maintain and utilize supportive relationships: Build loving and warm relationships with trusted others you can lean on during difficult times.
Get plenty of sleep: Aim to get seven to eight hours of sleep each night. Establish a regular bedtime and wake-up time.
Exercise: Daily exercise is one of the most effective ways to reduce stress and anxiety. If cleared by your physician to do so, try to exercise vigorously four or more days a week.
Eat well: Eat a balanced diet, and don’t skip meals and snacks.
Schedule rest breaks: Set an alarm on your phone to remind you to take a few minutes several times a day to meditate, breathe, or otherwise relax.
Engage in pleasurable activities: Be sure to carve out time to engage in things you enjoy on a daily basis.

My Personal Tips

Healthy lifestyle habits practiced over time can help us cope with anxiety, fear, worry and stress. Learning to recognize your signs and symptoms of stress is a good way to understand when you are reaching burn out or being overwhelmed. The following are tips that help me pull myself through the anxieties that often come up in my life.

Routines: I enjoy a good morning and evening routines. They give you a sense of normalcy and are mindful actives that allow you to focus on the moment. I’ve combed through Pinterest and found realistic routines that work for me including a good skin care regiment, finishing my cup of coffee before it gets cold and stretching.
Affirmations: there is power in words and saying it aloud can make it real. Most times I write my own or you can find tons of lovely ones that empower you the way you need. I like to think of affirmations as the words I need to hear. I say them every morning and night so as to remind myself of all that keeps me joyful.
Grounding: I find this to be one of the most powerful tips in the moment. Taking a deep breath slows down your heart rate. It affords you the chance to slow everything down which often speeds up in anxiety and worry. I orient myself to today and the moment. I visualize, I write, I count or even name things in the room of different colors.
Expression: I encourage you to find a safe outlet of expression. Art, music, gaming, esoteric, spiritual, cooking, writing, sports, activities, etc. Often all of our emotions and thoughts are bottled up inside our physical and mental that they build up energy. We must allow this energy a safe and healthy way to release. Explore the things that give you peace. Make it a regular practice to express yourself. Creativity comes in many forms. One does not need to be a professional. Expression is simply releasing in a way that gives you peace.

I leave you with this. Worry and anxiety stem from concerns of a future that hasn’t occurred or a past that has already gone. I remind myself that I am capable. I am able to get through this. It is ok to feel. I give myself grace and patience. And I repeat I will get through this. Seek support of your tribe, the people that you trust and are safe. We are not alone and there is community in support. Connection is healing. Seek a professional, peer community support, a friend, a family member or a hotline.