Having ignored her anxiety for years, Claire Eastham started getting panic attacks. Today, she explores anxiety vs. panic and how one may lead to another.

Something’s wrong.

Your heart is beating too fast. You're sweating, your stomach is cramping, and your mouth is dry. What's happening? Why can't you take a deep breath? Oh God - is this a heart attack, or are you going crazy? Something is VERY wrong. You need to get out of here, NOW.

In November 2012, I had my first-ever panic attack. It happened during a meeting with several of my colleagues. As the episode peaked, I gave in to the urge to flee and ran from the room as fast as my legs could carry me.

The whole experience was as distressing as it sounds. After the "hump," I was left feeling dazed and embarrassed (it's not every day you think you're going to die in front of half the office!).

As soon as I finished work, I rushed to my GP's practice, convinced I had a serious heart issue. I stammered out my symptoms and waited for the worst.

So, imagine my confusion when my GP's said, "Oh, I see," and not much more. In my head, I was out of control. I'd run from a room of people relying on me, I hadn't been able to breathe, and I'd felt inches away from death's door. But as my ever-pragmatic doctor explained, I'd “just” had a textbook panic attack.

"There's nothing to be alarmed about," she said.

NOTHING TO BE ALARMED ABOUT?!

At this point in my life, I'd become used to riding the waves of my anxiety disorder. I had learned, mostly, to self-soothe. I could read my mind and body like a book and take necessary precautions on a bad day.

Yet this "panic attack" had come out of nowhere. I'd gone from 0 to 100 in no time, and I didn’t understand why. How could I have felt so threatened in mere seconds when there wasn't a perceivable threat that had set it off?

Was my brain faulty? Was I going mad?

Fast forward to the present day, and I now consider myself a self-made "panic attack expert." I've even written two books on the subject!

So, take this from someone "in the know." Panic attacks can be unpredictable and illogical, but they can also be managed.

Anxiety doesn't act like this... does it?

Before that first attack, I'd lived for over a decade with high-functioning anxiety. Over the years, I'd learned to recognize the "warning signals" on my own. Bouts of insomnia? Used to them. Stomach cramps, sweating, and a hand tremor that never left? All part of the furniture.

Although I'd semi-accepted these "quirks," I did my best to ignore my anxiety. "Everyone worries," I told myself. "I bet everyone goes through stuff like this. Don't draw attention to it!"

It never occurred to me that my overthinking and physical symptoms weren't normal.

What is a panic attack?

A panic attack is "a sudden episode of intense fear that triggers severe physical reactions when there is no real danger or cause." (Mayoclinic, 2018)

Since 2012, many therapists have suggested I had a panic attack that day because I'd overstressed my amygdala. The amygdala is "a cluster of almond-shaped cells near the base of the brain" (Healthline, 2021). Everyone has two sets of these cell groups, one in each of the brain’s hemispheres. These cells help us regulate emotions, process memories, and make decisions.

In November 2012, my amygdala detected danger - i.e., talking in a group - and triggered my "fight or flight" response. My body became flooded with adrenaline, my heart went crazy, and it seemed like my only choice was to run away.

How are panic attacks different from anxiety?

It's easy to see why panic attacks and anxiety get confused, as they share many symptoms. In my case, the sweating wasn't anything new. Other signs, like an upset stomach, nausea, and trembling, were also familiar.

But while anxiety produces more of a gnawing worry, a panic attack is rapid and violent. It's impossible to ignore.

My symptoms looked like these:

• A pounding heart (quick to the point of being painful)
• Hyperventilating (unable to take a satisfying breath)
• Feeling the need to void my bowels
• Blurry vision
• Dry mouth
• Heavy/numb limbs
• Dizziness
• Excessive sweating (to the point it was visible to others)

Anxiety feels more like a series of paper cuts. It causes damage with each slice, but there isn't enough pain to grind things to a halt. Whereas my first panic attack was like a sledgehammer to the gut.

I've also learned that my anxiety usually has an identifiable trigger and lingers. I may be dwelling on something (past or future) that causes pressure to ramp up. Or I'm expected to do something I'm uncomfortable with. For example, knowing I have to do a presentation at work can cause countless sleepless nights. Acute periods of anxiety can last for months.

Panic attacks, on the other hand, swoop in and only last a few minutes.

Can you get different types of panic attacks?

Yes. Clinical Professional Counsellor Sheryl Ankrom, MS, LCPC, explores how different triggers may induce panic attacks.

My panic attacks are the result of long periods of anxiety.

In 2012, I was doing everything possible to ignore my anxiety symptoms. The resulting panic attack represented an "explosion" of bottled-up emotions. Although I didn't see the attack coming, it seemed inevitable once my therapists did some digging.

For others, panic attacks may be caused by overtiredness, illness, or even hangovers.

Medications, coffee, over-exercising, smoking, or prolonged stress may also trigger panic attacks.

Finally, the most extreme cause of panic attacks is a panic disorder. Usually, a panic disorder develops in someone with a history of panic attacks. Panic attacks are distressing, so they become overcautious of triggering another.

However, many people with panic disorder say their attacks have no explicit trigger.

How I deal with panic attacks

Panic attacks can feel overwhelming, but there are ways to manage them.

Here's how I deal with panic attacks when they occur:

1. I accept the attack is happening 

I accept the attack rather than exhaust myself by ignoring or fighting it. Although I'm scared and the symptoms are uncomfortable, nothing terrible will happen. The episode will stop in time.

Australian physician Claire Weeks referred to this approach as "masterly inactivity." Meaning that a person should float through panic and stop trying to control their fear. I accept the attack like a wave crashing over me and make myself as comfortable as I can while I wait.

2. I take deep breaths from my belly

I use breathing techniques to soothe many of the physical symptoms of panic. David Carbonell’s "belly breathing" strategy encourages breathing from the stomach. The idea is to increase the amount of oxygen in the body, easing the tension of struggling lungs.

He says, "Comfortable, deep breathing is the key to relaxation. Traditional relaxation methods like yoga and meditation place emphasis on breathing."

3. I try some light exercise

If I'm able (i.e., my heart's beating fast, but I'm not incapacitated), I do some gentle exercise, such as walking. This helps burn off the excess adrenaline triggered by the fight or flight response. If I'm stuck indoors, I might roll my shoulders or stretch my arms. On one occasion, I even tried star jumps! (I was alone).

Once the attack is over its peak, I watch something on YouTube that might make me laugh. I've become quite a fan of cute-but-naughty puppy videos! Laughter helps produce endorphins with euphoric and calming effects. 

4. I go to talking therapy

Many different types of therapy can help with panic attacks and anxiety. I like having someone I trust who's on "the outside" of my daily life. We can talk about what's going on at work, in my relationship, and within my social circle. Getting these worries off my chest is such a relief.

Therapists aren't there to judge or give advice. Sometimes, they make suggestions, but they don't get annoyed if I say "no thanks."

Conversely, some family and friends get offended if I don't take their advice. Talking therapy cuts out a lot of people-pleasing and sticky dynamics.

The takeaway

Panic attacks are highly unpleasant, and I won't ever "get used" to them. Still, I can accept them when they come and use strategies to help me through the worst.

Anxiety and panic aren't the same, though the link is undeniable. If you have symptoms, I recommend making an appointment with your doctor. While panic isn't curable, treatments and techniques can make your life more comfortable.

The individual(s) who have written and created the content in and whose images appear in this article have been paid by Teva Pharmaceuticals for their contributions. This content represents the opinions of the contributor and does not necessarily reflect those of Teva Pharmaceuticals. Similarly, Teva Pharmaceuticals does not review, control, influence or endorse any content related to the contributor's websites or social media networks. This content is intended for informational and educational purposes and should not be considered medical advice or recommendations. Consult a qualified medical professional for diagnosis and before beginning or changing any treatment regimen. 

NPS-ALL-NP-00733 NOVEMBER 2022