Dear Dr. B,
What is the difference between an anxiety attack and a panic attack? I think I’m having one of them but I’m not sure what the difference is. And what can you do when you have them?
I’m glad you asked. I’ve had patients ask the same question. Most people experience anxiety at some point in their life, but relatively few actually experience a full-blown panic attack.
Out of nowhere, you experience an incapacitating feeling of fear and dread. Your heart races and pounds so loud in your chest that you hear it in your ears. The sudden overwhelming onset of panic leaves you feeling paralyzed and afraid—sometimes to the point of being afraid you might die.
If you can relate to that, chances are you have experienced a panic attack. Sadly, for many, panic attacks leave them overwhelmed, incapacitated, afraid to leave the house, and result in withdrawal from activities they previously loved and enjoyed.
The most distinguishing differences between panic attacks and anxiety attacks are with respect to the trigger (or lack thereof), the intensity of the symptoms and how long they last.
Typically, anxiety attacks are a response to a specific stressor or worry over a potential danger. For example, anxiety attacks may occur in response to fear of a medical procedure or having to go to court.
During an anxiety attack, a person may experience fear, apprehension, increased startle response, muscle tension, shortness of breath, dizziness, increased pulse rate, sweating, difficulty concentrating, fatigue, or irritability. Some of these symptoms could also be symptoms experienced during a panic attack but are generally less severe. Furthermore, the symptoms usually intensify over a period of time, don’t usually last very long and will typically end as soon as the stressful trigger goes away. In some cases, however, the symptoms associated with more general anxiety may be prolonged, lasting days, weeks, or months.
Unlike anxiety attacks, which are in response to a specific trigger or stressor, panic attacks aren’t a response to a specific stressor. They are unprovoked and unpredictable.
During a panic attack, a person may experience fear, apprehension, or sheer terror. They often feel like they are going to die, or perhaps have a heart attack. People often describe shortness of breath, difficulty breathing, heart palpitations, chest pain, trembling, nausea, intense sweating, chills or hot flashes, dizziness, chest pain and fear of dying or losing control. The onset of symptoms is generally very sudden, and the severity intense. The symptoms appear to “come out of the blue” without forewarning and may last several minutes.
Once someone has experienced a panic attack, they may be prone to anticipatory anxiety, which is fear of or worry about having another panic attack. Because the fear is so pronounced, they may even begin avoiding places they have had a panic attack before.
Whether you’re dealing with anxiety attacks, persistent anxiety, or panic attacks, help is available.
Here are 9 tips for managing anxiety or panic:
1. One of the most important things you can do in the moment when you experience an anxiety or panic attack is to breathe deeply from your diaphragm rather than from your chest. It is impossible to be fearful or anxious and relaxed at the same time. Deep breathing signifies to your brain that it’s time to relax.
2. Cognitive behavioral therapy can also be a helpful and effective treatment modality for those who suffer from anxiety or panic attacks. It helps someone who suffers understand why they have anxiety, change their thoughts about anxiety, as well as change how they react to the triggering stimuli that precedes anxiety or panic attacks.
3. Another treatment modality used by some clinicians is Exposure Therapy. This essentially teaches the anxious individual how to control their level of anxiety or panic by exposing them to graduated levels of panic in a safe environment, while helping them through exercises such as deep breathing to control their emotions.
4. Exercise is also beneficial for those who experience anxiety or panic attacks. As little as 10-15 minutes of physical exercise can flood the brain with positive, calming endorphins which help elevate mood and decrease anxiety.
5. Paying attention to our nutrition is important, particularly if we are predisposed to anxiety, worry, or panic. Many of the foods we eat (e.g. chocolate) or drink (e.g. coffee) are stimulants and can actually increase anxiety, cause heart palpitations, make us sweat, etc. It’s important to eat a balanced diet and avoid ingestion of stimulants that will bring about a physical response like anxiety or panic.
6. Some people will utilize prescription medication to help manage anxiety and panic attacks. Anti-anxiety medications slow down brain activity, and essentially, decrease over-stimulation of the nervous system during an attack, minimizing its fallout.
7. Music, depending on the style, volume, and beat, can have a calming influence when one is struggling with anxiety or panic. Nature sounds, like the sound of a rainfall or the ocean coming ashore can also help relax when anxiety comes calling.
8. Prayer is another key consideration during an anxiety or panic attack. When we pray, if we will focus on God and His strength, rather than pay such close attention to ourselves and our current situation, we can regain His peace. Scripture tells us, “You will keep in perfect peace all who trust in you, all whose thoughts are fixed on you!” (Isaiah 26:3)
9. Reciting Scripture and speaking truth back to your anxiety can be extremely effective in reducing anxiety or panic. This is one of the most under-utilized, but in my opinion, most important methods for managing anxiety. Not sure which Scripture to memorize or recite when anxiety comes calling? Be sure to read part 2 of this post: Your RX: 40 Scriptures that Combat Worry, Fear, Anxiety and Panic.
I’d love to hear other ways that you have learned to manage worry, fear, and anxiety in the comments below.
Because of Him, #PeacePrevails!
Can I pray for you?
More than 300 times in your Word you have told us to “Fear Not,” “Do not worry,” or “Be anxious for nothing.” I have to believe that you knew worry, fear, and anxiety would be something we would all struggle with or you wouldn’t have made it a point to tell us not to repeatedly in Scripture. Father, I pray for the one reading these words right now, that you would infuse peace into their heart in place of any worry or anxiety they might be experiencing. Let your heavenly calm and comfort replace all fear or dread. Grow their ability to trust in you for all things instead of worrying about their own limited capacity. I thank you that you care about everything that concerns us. Thank you for being our ultimate provider! In Jesus’s name, Amen.
Resources for Anxiety:
Other Helpful Articles for Anxiety:
Talk Back to Anxiety
Your RX: The Answer for Anxiety
7 Steps for Coping with Anxiety
It is Finished: What Jesus Would Say About Anxiety
Anxious for No Thing
Coping with Panic Attacks
Don’t Give Worry a Voice
Take a Deep Breath
The Thief of Peace