Abject Fear...Is It Anxiety Or Panic?

Anxiety presents itself in many ways, some of which you may not even be aware of. Whether it is anxiety over a big project at work, a familial problem or, simply an accumulation of several out of control situations, the manifestation of the constant stressors may culminate in an intense physical reaction.  


Most people interchange the two conditions.  Technically, they are different entities.

According to Healthline:

“You can experience both an anxiety and a panic attack at the same time.”

Some of the physical symptoms for anxiety and panic attacks are very similar. You may experience some of the following symptoms: 

  • A very common symptom is a feeling of detachment from oneself, as if from the outside looking in.
  • Chest pain (many people who experience these attacks believe that they are having a heart attack).
  • Rapid heartbeat
  • Sweating
  • Headache
  • Nausea
  • Choking or a tight feeling in the throat
  • Embarrassment or shame
  • Fear of dying
  • Ringing in the ears
  • Pins and needles in extremities

These are but a few of the symptoms, as many people have varying symptoms when experiencing an attack that are not considered commonalities between those experiencing the attacks. 

There is one aspect of both anxiety and panic disorders that frequently occur. That is, many people will begin to isolate themselves due to fear over experiencing another attack. This can present itself by avoidance of certain social situations. Discontinuation of traveling or changing the environment they are accustomed to. Avoidance of social situations such as restaurants where the onset of an attack would cause extreme embarrassment. Fear of situations where they cannot easily get to safety. Anxiety can be mild, moderate or severe. Panic Disorder (experiencing more than one anxiety attack), involve severe, disruptive symptoms.

Those experiencing these attacks are also fearful of judgment. While telling yourself to “get over it”, having someone else judge you and giving their opinion of what needs to happen is definitely not helpful, even if their intentions are good.

Prior to delving into the reasons behind your unexpected attacks, it is highly recommended that you have a complete physical examination performed to rule out any underlying conditions. Blood work to rule out thyroid, adrenal abnormalities or hypoglycemia is also encouraged. This will help determine any underlying conditions. Once your physical condition is determined, your physician will discuss the attacks in great detail. While uncomfortable for you to discuss with your doctor, this is a necessary step to evaluate you, diagnose you, and to devise a plan to help you address and manage the stressors and, the attacks while they occur.  Knowing your family health history is beneficial for you and your physician to know. 

Here is a link to a previously published article on the importance of knowing your family health history:

Your physician may prescribe medication to help you cope during an attack. Many of these medications are addictive, so learning to manage your attacks in conjunction with other methods is considered important for long-term control. 

Your physician may ask you to seek treatment with a psychologist to help you learn what your triggering mechanisms are. Once identified, finding ways to manage these triggers may include modalities such as therapy, medication or cognitive behavioral therapy (CBT).

If you are unfamiliar with CBT, it is generally used for anxiety. It may also be incorporated with bipolar disorders, panic disorders, phobias, eating disorders, and PTSD to name a few.


According to NHS.uk:

Cognitive behavioral therapy (CBT) is a talking therapy that can help you manage problems by changing the way you think and behave.”

While the thought of continued therapy for your attacks may be causing increased anxiety, the therapist will use CBT to break down your issues into smaller parts, and demonstrate ways to change the way that you perceive these issues.

NHS.uk further states that some people that have ongoing mental health conditions may not benefit from CBT.  While CBT focuses on current problems, NHS points out that critics of CBT believe it does not address underlying causes of mental health conditions, such as an unhappy childhood.

In another Healthline article entitled: “How can I stop Having Anxiety Symptoms?”, they present an excellent description of the “fight or flight” response.  Here is what they say:

“Here’s what happens: When we’re anxious, the heart races and the stomach swirls, which is a sign of the ‘fight or flight’ response – a stressful state the body enters when it senses danger. As long as the body remains stressed, these anxiety symptoms continue.

“The key to interrupting this cycle is to bring the body back into a place of relaxation.”

If you have tried different techniques to control your attacks, and you are feeling even more agitated, with nothing easing your anxiety, medication may be required as a tool in your arsenal. See Healthline's article here for more coping mechanisms. 

Learning how others cope with their anxiety may help you examine your personal attacks. Learning how to talk to others about your condition can go a long way to helping remove the stigma attached to having a mental condition.  Seek the support of family and friends. You might be surprised how many other people are also having difficulties with anxiety.

We will probably not know all of the ramifications of this global pandemic until long after we create a vaccine, and have time to study the physical and mental effects of this pandemic on our society.

Every day, we are reading and hearing more and more about heightened anxiety, depression, increased drinking and drug use, and increased numbers of suicides.

It is vitally important that if you are experiencing any of these symptoms associated with your panic disorder, that you reach out for professional advice to address these negative changes, and adjust your regimen to help you control these increased symptoms.

If you do not have friends or family you feel you can confide in, there are resources available such as the National Suicide Prevention Lifeline at 800-273-8255. 

September was National Suicide Prevention Month, and we published an article that you might be interested in reviewing if you are dealing with suicidal thoughts. To read it click here. 

I have two extremely close friends that experience panic disorders on a frequent basis. For each of them, I can pick out certain stressors that I know of and can visibly see weighing on my friends. What is extremely hard for me, is watching the toll that each attack takes on my friends, and not being able to change it for them.

Like most illness, it requires a tremendous amount of time and attention to address and maintain our health. Many people do not want to devote that much attention to a problem that they believe they can control themselves or just live with.

There is a hereditary risk associated with panic disorders and anxiety symptoms. Previous traumatic events are prevalent.  People with PTSD are also more likely to experience panic attacks. 

Taking on too many responsibilities may contribute to your panic disorder.

When a person isolates themselves and avoids certain public situations, their panic disorder may evolve to include agoraphobia. 

Agoraphobia is described as feeling unsafe in a crowd or public situation where they feel trapped or would be embarrassed should a panic attack occur 

With both of my friends, I have noticed that changing their normal environment can trigger attacks.  An unfamiliar group of people socializing, an unfamiliar hotel room or, publicly traveling with others.

Both of my friends are determined to gain control of their conditions.  Both have medication to use IF they feel an attack coming on.  That most often is not the case.  Both of my friends tell me that the majority of their attacks come on without any noticeable prompters. 

After their attacks and because they both continually work to improve their response to the attacks,  they are usually able to pinpoint going on in the background that are contributory factors to their attacks.

Both have incorporated daily exercise into their regimen, and they both have implemented healthier diets to help with their overall wellness.  Both have cut back on alcohol use, and both continue with ongoing psychotherapy to address persistent stressors that they believe are major causes of their frequent attacks.

Whatever the cause, both of my friends are rational, and understand that their conditions are treatable.  Both have had their confidence shaken, and both want back the level of control they thought they had prior to their initial panic attacks.

Another important facet to controlling panic attacks is proper rest and sleep. Easier said than done, right? When you are deep into your anxiety and issues, the nights can seem interminable. If prolonged, the lack of sleep can compound the severity of your attacks. Prolonged lack of sleep can impact your general health and wellness. 

Sleep affects every aspect of health, helping to improve and balance your immune system. Meditation and relaxation techniques may help you you well. 

Panic attacks are not intentional in order to gain attention.  The attacks are very real, and our loved ones deserve our encouragement and concern in order for
them to seek treatment for these attacks. 

We have to help to remove the stigma attached to ALL mental health conditions, and move forward in finding innovative and restorative ways to manage and control these conditions. Asking for help is never easy, but we never seem to know just how many people care about us and would help if they only knew what was going on. Reaching out may not be easy, but it may be the impetus to seek help and start managing your current situation.