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Anxiety, Panic Attacks and Stress: What’s the Difference?

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“A panic attack? Really?” Craig asked, repeating the diagnosis the ER doctor had given him.

Craig’s wife had rushed him to the ER believing he was having a heart attack. How could it only be a panic attack? The doctor went on to explain more, but Craig heard little as a wave of embarrassment flooded him. He did not want anyone else to know about this.

Panic attacks and anxiety are not uncommon. According to research in the Archives of General Psychiatry, 22.7 percent of people will experience a panic attack during their lifetime.1 Over 40 million people in the US experience chronic anxiety.2

However, few people know the differences or can identify what they are experiencing. The words “stress,” “anxiety” and “panic attacks” are often used interchangeably to describe frantic, overscheduled lives. Common phrases are tossed out like, “I felt like I was having a panic attack.” “He was dealing with a lot of anxiety.” “I’m so stressed out!”

Without accurate distinctions, the physical and mental experiences of chronic anxiety and panic attacks can be easily misunderstood and go untreated. Additionally, because of the stigmas surrounding mental health disorders, many people remain silent about their experiences feeling embarrassed or weak for having them.

So, what are the differences? And how can we create more public and personal understanding when it comes to stress, anxiety and panic attacks? Keep reading for answers and a crucial solution to this problem.

What’s the Difference?

Everyone experiences moments of anxiety, panic, nervousness and stress, such as when speaking in front of a crowd, hearing a noise in the dark or jumping away from a spider. These moments are normal, even necessary, for humans to interact in the world.

“We all know moments like these, ones when a period of anxiety – nervousness – passes over us. The difference between these experiences and a diagnosis of anxiety is primarily one of magnitude but also of impact.” says Anne Marie Dine, Director of Outpatient Services at Foundations Atlanta at Midtown.

According to Dr. John Mayer, Clinical Psychologist at Doctor on Demand, chronic anxiety will include three or more of these symptoms: restlessness, fatigue, lack of concentration, irritability, muscle tension and disturbances of sleep.3 People with a diagnosis of anxiety or chronic anxiety are unable to turn off those feelings. “Someone with anxiety, however, experiences many of these ready-making symptoms – adrenaline, heart rate increase, muscle tension and organizing thoughts – on an ongoing basis,” Dine explains. “Meaning, they are regularly searching their environment for what could go wrong as if something is already threatening them. This also means that their thoughts are dominated by these concerns, and their whole being is regularly engaged in dealing with a perceived threat to their well-being. Nervousness can be seen as an adaptive response, while an anxiety disorder is much too much of a good thing. Having an anxiety disorder is treatable and manageable, however.
Then, there are panic attacks.

“Panic attacks on the other hand don’t come in reaction to a stressor,” Dine says. “It’s unprovoked and unpredictable. During a panic attack, the individual is seized with terror, fear or apprehension. They may feel that they’re going to die or lose control or have a heart attack. They have a host of physical symptoms which may include chest pain, shortness of breath, dizziness and nausea. And in addition to these terrifying panic attacks, people start worrying about having the next one. So, there’s a lot of what’s called anticipatory anxiety.”

When Craig experienced his panic attack and was rushed to the ER, he firmly believed he was having a heart attack – the symptoms were that strong. The good news is that panic attacks and chronic anxiety are common and treatable. Often, it’s the stigmas surrounding mental illness that keep people from seeking help.

Breaking Down the Stigma

When basketball star Kevin Love of the Cleveland Cavaliers wrote an essay about a panic attack he experienced during a game and his subsequent decision to regularly see a therapist, it became national news.

In his essay titled Everyone Is Going Through Something, Love wrote, “Nobody talked about what they were struggling with on the inside. I remember thinking, ‘What are my problems? I’m healthy. I play basketball for a living. What do I have to worry about?’ I’d never heard of any pro athlete talking about mental health, and I didn’t want to be the only one. I didn’t want to look weak. Honestly, I just didn’t think I needed it. It’s like the playbook said — figure it out on your own, like everyone else around me always had.”4

Kevin Love ended his essay by writing, “Not talking about our inner lives robs us of really getting to know ourselves and robs us of the chance to reach out to others in need. So, if you’re reading this and you’re having a hard time, no matter how big or small it seems to you, I want to remind you that you’re not weird or different for sharing what you’re going through. Just the opposite. It could be the most important thing you do. It was for me.”

When star athletes and celebrities come forward and share their experiences with their mental health issues, people are more open to listen and to share their own experiences. After all, these are highly successful people, the best in their careers. If they have challenges with their mental health and aren’t ashamed of it, it opens the conversation and helps dispel the stigmas, myths and erroneous language. It makes everyone more comfortable with talking about their own mental health. Share this article with someone who might need help, and check out our other articles on anxiety and stress management.
By Cindy Coloma

1Stulberg, Brad. “When a Stress Expert Battles Anxiety.” Outside Online, March 7, 2018.
2Frank, Cathy. “The difference between regular feelings of anxiety and a true anxiety disorder” November 20, 2008
3Fellizar, Kristine. “7 Subtle Physical Differences Between Chronic Anxiety and Nervousness.” Bustle, March 2018.
4Love, Kevin. “Everyone is Going Through Something.” The Players’ Tribune, March 5, 2018.