If you’re reading this, you’ve probably experienced a particularly uncomfortable feeling—a degree of discomfort that made your body feel off, and left you thinking to yourself “something’s not right.”
Maybe it was a tightness in your chest, or unexplained sweating. Maybe it was a sharp change in intensity in your heartbeat. Maybe your muscles were tense, and you felt simultaneously tired and restless. Maybe you had sudden and unexplained feelings of worry or impending doom.
Maybe you mistook whatever this was for stomach issues—or a heart attack.
Does this sound familiar?
If so, the explanation may have been something less simple to explain: an anxiety or panic attack. Many people use these terms interchangeably, but in reality these episodes have distinguishing characteristics that set them apart.
Anxiety and panic attacks have many things in common, but understanding which one you’ve experienced is an important part of getting the right treatment. Let’s look at the differences between the two types of attacks.
Put simply, panic and anxiety are squares and rectangles: panic is a particular kind of anxiety disorder, but not all anxiety disorders include panic symptoms.
The National Institute of Mental Health explains that anxiety disorders are a blanket term for a group of disorders including generalized anxiety disorder, panic disorder, and other phobias. And in the simplest terms, panic is a more extreme version of anxiety. This is not to say that the disorders are on some sort of scale. Panic disorder sufferers often experience anxiety symptoms, and anxiety sufferers can occasionally experience panic symptoms. But to help you understand your particular symptoms, we can separate the two conditions into panic disorder and generalized anxiety disorder.
Generalized anxiety disorder is primarily defined by “excessive anxiety of worry” for an extended period of time. A single day of anxiety is not enough to qualify you—in fact, the National Institute of Mental Health says people with this disorder display characteristic symptoms “most days for at least six months.”
Symptoms of generalized anxiety disorder include being easily fatigued; feeling restless, wound-up, or on-edge; having difficulty concentrating; being irritable; having muscle tension; difficulty controlling feelings of worry; having sleep problems such as difficulty falling or staying asleep, restlessness, or unsatisfying sleep.
It’s hard to believe anyone can go six months without a day that feels this way, but the key difference between being “normal” and being “disordered” is the frequency or constancy of those feelings for a prolonged period of time.
Oh, and don’t let that make you think anxiety disorders are Unusual. Data from the National Institute of Mental Health shows that at some point in life, an estimated 31.1 percent of adults in the U.S. will experience an anxiety disorder.
Which one they have is a more complicated question, because symptoms can be fluid between some conditions. Which leads us to panic disorder.
Panic disorder is, in many ways, just anxiety dialed up to eleven. According to the National Institute of Mental Health, people with panic disorder “have recurrent unexpected panic attacks,” which are defined as “sudden periods of intense fear that come on quickly and reach their peak within minutes.” Scary, right? And worse yet, attacks can be triggered, but they can also come on unexpectedly.
Symptoms of a panic attack include sweating, trembling or shaking, sensations of shortness of breath, heart palpitations, or feelings of being out of control or doom.
The NIMH says that people with panic disorders often worry about when future attacks will happen, which can lead to the development of additional problems like agoraphobia.
Panic attacks, furthermore, are typically more visceral experiences. Whereas an anxiety attack may make you feel generally off, a panic attack can feel like an adrenaline spike, or like the fight or flight response has been activated by an unseen threat.
Panic attacks, according to Harvard Medical School, will have at least four telltale symptoms from a list including choking, chest pain, feeling faint or dizzy, chills, hot flushes, trembling, sweating, palpitations and rapid pulse, fear of losing control, abdominal discomfort, numbness, shortness of breath, fear of dying, and feeling of unreality or detachment.
As much as we know about the symptoms, we don’t really understand why people get these conditions. They can develop from trauma or stressful events, but there’s also reason to believe genetics play a role in acquiring panic disorder.
With so many symptoms and issues to worry about, both of these disorders can trigger, well, attacks. And the uncertainty of both conditions (tied in with the fact that there are no cures) can lead to additional feelings of doom and helplessness. But the good news is that there are treatments available to help you minimize, mitigate, and manage attacks, regardless of whether they’re attack or panic based.
Our guide to coping with anxiety goes into more detail about available treatments for anxiety disorders, but here’s a brief look at the options available.
Anxiety and panic disorders generally respond well to therapeutic treatment practices. One particularly effective form of therapeutic treatment is Cognitive Behavioral Therapy (CBT): a well-known psychotherapy form used to treat depression as well. CBT is designed to help disorder sufferers recognize disordered thinking systems that may let anxiety or panic set in and trigger attacks.
Correcting those behaviors requires a deeper understanding of the thought patterns that get you there, and a therapist can help you use CBT to craft coping strategies to prevent or minimize future attacks. Consult a mental health professional about CBT to decide if it’s right for you.
Antidepressants affect the serotonin levels in your brain, and while they’re primarily employed to combat depression, they can also be used to deal with panic and anxiety symptoms.
The most commonly prescribed antidepressants are serotonin reuptake inhibitors (SSRIs). They block serotonin from being reabsorbed into neurons, which keeps more serotonin available to improve transmission between neurons.
Be wary though, as side effects can include a lot of issues that you’re likely trying to combat in the first place, like disturbed sleep, anxiety, headache and others. And discontinuing these drugs can also increase your risk of suicide. So, be sure to communicate openly with your healthcare provider.
Whether you’re experiencing panic or anxiety attacks, the first step you should take in treating them is to seek professional help through a healthcare professional. A primary care physician is a great place to start, as they can help you with referrals and further codify your symptoms. They may also be able to offer some advice about general lifestyle changes and best practices that might help you gain some control over anxiety and reduce attacks.
And this might seem obvious, but if you’re struggling with these issues, don’t bottle it up. Talk to someone, be they a trusted friend or family member, or a counselor. And remember to contact a mental health professional for personalized advice and treatment.