When we think of “anxiety,” we tend to think about feeling stressed out.
Actually, anxiety is our body’s reaction to a threat to our well-being. Without anxiety, we would not react when we are in danger, and we likely wouldn’t be alive today without it.
However, anxiety can be so much more than whether or not we need to run away from a situation. Since we’re primed to survive, our minds assume that more things are threats to us than they are—which can lead us to be more anxious than needed.
The truth is that all humans experience anxiety. For many, the anxiety can feel unbearable. Approximately 19% of adults in the United States struggle with anxiety every day.
Having anxiety, or being diagnosed with an anxiety disorder, doesn’t mean someone is weak. With the right care, they can become stronger than their anxiety and lead happy, successful lives.
Anxiety is our body’s normal reaction to stress. When we’re presented with potential danger, our bodies respond to that stress.
Fear is a similar emotional response. Fear is the body’s response to a real or perceived imminent threat, and anxiety is our body—and mind—anticipating a future threat.
For example, if you’re starting a new job, waiting for test results from a doctor, or driving in bad weather, you may feel anxious. This is a normal reaction to our emotions and happens to everyone. When anxiety stops being temporary fear or worry, it may be a sign that help is needed.
A person who has an anxiety disorder may always be anxious or easily become anxious about many things. Temporary fear or worry is normal, but if the feelings associated with anxiety disorders linger, they can continue to get worse over time.
Through understanding the condition and seeking the right treatment, anxiety can be managed.
Panic Disorder
Panic disorder is a more severe form of GAD. Though it typically develops in folks between 18 and 35, it can occur at any time. Women are nearly twice as likely to develop panic disorder as men.
Unlike anxiety, which often has clear triggers, panic typically is sudden, uncontrollable fear or anxiety. This can often cause impulsive behavior.
The fear response is one of the largest differentiators between panic disorder and other anxiety disorders. In panic disorder, the person is fearful of the fear they’re feeling.
A person with panic disorder may feel terror even if there is no real danger. Many individuals with panic disorder have explained that their panic feels like they are losing control.
Panic happens quickly and unexpectedly and typically only lasts a few minutes. Anxiety tends to appear gradually and can last for extended periods.
Panic attacks can happen to anyone at any time. But people with panic disorder have recurring attacks, and they can’t be explained by other mental health conditions.
Individuals with panic disorder will often change their behavior related to attacks to try and avoid another attack from happening. They’ll often be concerned or worried about additional panic attacks as well as the consequences—like feeling they are losing control or having a heart attack.
This constant concern and attempts at avoiding future attacks can majorly impact areas of the person’s life. It can lead to the development of additional mental health issues, like agoraphobia, which is a fear of being in certain places or situations, such as being in a crowd.
Some physical symptoms of panic disorder include:
- Rapid heartbeat or a pounding heart
- Sweating
- Trembling or shaking
- Chest pain
- Shortness of breath
- Dizziness, unsteadiness, or lightheadedness
- Stomach distress
Some of the mental symptoms of panic include:
- Feeling detached from oneself or reality
- Fear of losing control
- Fear of dying
- Feelings of impending doom
What You Need to Know About Panic Disorders
Unlike anxiety, which often has clear triggers, panic attacks occur suddenly and unexpectedly and typically only last for a few minutes.
Those who experience panic attacks have reported lightheadedness, chest pain, hot flashes, chills, and stomach discomfort. Some say they feel like they were being choked or suffocated. Others say an attack made them feel “detached from reality.”
Occasional panic attacks can happen to anyone, although for some individuals, they occur more frequently and cause significant distress and impairment.
Evidence-based treatments for panic disorder are similar to those for anxiety and involve exposure-based treatment. Mindfulness and meditation can also be useful to curb stress and promote increased psychological flexibility.
Sometimes medications are used to augment behavioral treatments for panic disorder and include beta-blockers, selective serotonin reuptake inhibitors, and serotonin-norepinephrine reuptake inhibitors.
If you have had continued panic attacks, you may need to seek professional help. Your doctor will ask about your symptoms, other mental health and medical conditions, and whether you are experiencing abnormal stress or anxiety. Blood tests and a heart examination may also be required.
Both panic and anxiety are treatable and manageable—even when they may feel as if they are out of your control.
Distinguishing between anxiety and panic disorder
We, as humans, need anxiety. Why? Anxiety is information.
It tells us when we must freeze, flee, or fight and mobilizes our body to respond quickly, without thinking. Without anxiety, we would not be able to avoid real threats to our well-being.
However, we also feel anxiety about imagined threats that may or may not be meaningful or real. In a sense, our minds have evolved to be extra careful about threat detection. They are more likely to evaluate things as threats than not. This way we do not miss anything that might harm us.
Also, our minds do not have an “off button.” This means that sometimes anxiety becomes a problem because it doesn’t give us useful information and contributes to our distress and avoidance.
All humans experience anxiety when they experience stressful events, such as receiving an upsetting medical diagnosis. Public speaking, social events, relationship problems, stress on the job, and financial worries are also common triggers that make people feel anxious. However, sometimes life events can trigger anxiety disorders or panic disorder. So, what’s the difference?
Understanding the differences between naturally occurring anxiety, worry, and panic can help people take steps to address their feelings. Knowledge of these conditions can also help individuals recognize if their condition is serious enough to require treatment.
Example 1: A Normal Level of Anxiety
This describes an individual experiencing very natural, understandable anxiety around a challenging situation. Fear of an uncertain future, memories of a difficult past, threats (both real and perceived), and confusion about the world around us are all triggers for anxiety.
Example 2: A Concerning Level of Anxiety
The second example describes an individual experiencing worry and depending on the level of distress and functional impairment caused, may indicate that treatment for anxiety might be helpful.
Worry is a mental activity that, somewhat counterintuitively, functions as an anxiety avoidance strategy, though it’s one that doesn’t work very well. It’s hard to simply stop worrying.
Typically, when individuals find themselves stuck in a worry cycle, learning acceptance and mindfulness skills from acceptance-based behavior therapy can be useful.
Example 3: Panic
This is an individual experiencing a panic attack. Panic attacks are rarer and more severe than anxiety. They can come out of the blue, without warning or provocation.
People having panic attacks can experience shortness of breath, dizziness, nausea, and numbness. Some shake and sweat. Individuals struggling with panic often are very watchful for the physical sensations that might be harbingers of panic and avoid places where panic attacks may have occurred in the past. Sometimes those struggling with panic avoid leaving their homes at all.
The good news is that panic disorder is highly treatable with exposure therapy.
De-Escalation: Treating a Panic Attack
If you are having a panic attack, it is important to know how to respond.
If you are experiencing a panic attack, try the following:
- Take a deep breath
- Recognize that you are having a panic attack and accept it
- Remember that all panic attacks are temporary and will eventually pass.
- Do a mindfulness exercise, focusing on each individual part of your body and telling it to calm down; doing this will keep you grounded in reality
- Focus on a single object in the distance and do not waver from it; for example, focus on the hands of a clock, the colors of leaves, and the movements of those around you
- Relax your muscles one at a time, focusing on each muscle individually, telling it to relax
Though it may not feel like it in the moment, it’s important to remember that every panic attack eventually ends. By responding to your panic attacks in a gentle and logical way, you will create a softer landing for yourself.
Whether this is your first panic attack or your hundredth, you should try to work with your body, relax your muscles, and calm your mind. If you are able to do this, the panic may pass more quickly.
How to Help Someone Who Is Having a Panic Attack
It can be frightening to witness someone having a panic attack. Many of the symptoms resemble life-threatening medical conditions.
If someone is experiencing a panic attack:
- Remain calm: If you look frightened, this may make the panic attack worse; try to be understanding and nonjudgmental
- Help the other person by encouraging them to breathe; breathe slowly and breathe together
- Encourage them to focus on something else; for example, you may ask them to name five different objects in the distance
- Whatever you are asking them to do, try to do that same thing: If you lead by example, the other person will likely follow
- Once the panic attack ends, encourage your friend or loved one to get help
Remember that many people are embarrassed if they experience a panic attack. Remind them there is nothing to be embarrassed about, but that it is important to take steps to prevent panic attacks from happening in the future.
Stopping Stigma Surrounding Panic Attacks
In addition to helping people who suffer from panic attacks, it is important to dispel stigma. Unfortunately, the public holds common misconceptions about panic attacks.
Some of the most common of these include:
- Folks who have panic attacks are simply weak-minded
- People who experience panic attacks are “just faking it”
- Panic attacks are not as serious as they appear
- People with panic disorder are doing it to themselves
The only way to stamp out stigma surrounding panic attacks and panic disorder is to educate others.
If You Need Help for Anxiety, Seek It
Anxiety is common, but only a third of people with an anxiety disorder seek help. If you are experiencing prolonged anxiety or anxiety that causes you significant distress or impairs your ability to function, it may be time to seek help.
If you experience any of the following symptoms for longer than six months, you should consider seeking help from a health care professional:
- Excessive anxiety or worry about various events or activities, occurring more days than not, for at least six months
- Difficulty controlling the worry
- Loss of interest in things you used to enjoy
- Spending increased time alone or avoiding social events
- Suicidal ideation (thinking about harming yourself)
- Experience disruptions to daily life and/or relationships because of obsessions and compulsions
- Cannot control your thoughts or behaviors even when they impact daily life in a negative way
- A sense of impending danger, panic, or doom
- Difficulty concentrating, remembering things, or mind going blank
- Fear or anxiety about one or more social situations where the person is exposed to possible scrutiny by others
Anxiety disorders should be diagnosed by licensed clinicians, such as mental health professionals or primary care providers.
If your anxiety has physical symptoms, a provider may run lab tests during the evaluation to make sure that other conditions aren’t causing symptoms. X-rays, scans, or other imaging studies may also be required before a diagnosis is made.
The provider will ask a series of questions from a standardized questionnaire about anxiety disorders or may have the patient complete a self-assessment of symptoms.
Anxiety often occurs alongside other mental health conditions. Conditions like depression, substance misuse, PTSD, and OCD may also be present. If this is the case, additional screenings and treatment may be required.
References
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