Understanding the Differences Between a Panic Attack and an Anxiety Attack

Since the beginning of the pandemic, we have seen a dramatic increase in General Anxiety Disorders and Panic Disorders. Many people think that an anxiety attack and a panic attack are the same things, and although they seem similar, they are different. Today, we are uncovering the major difference as well as ways to cope with and regulate each disorder. 

Anxiety Disorder

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, the DSM-5, classifies different types of Anxiety Disorders into several categories. In general, anxiety produces heightened hypervigilance, which means that we are very alert. It's an over-activation of the drive for safety.

Anxiety can be general anxiety, where we tend to worry excessively or have intrusive thoughts, which interferes with our daily lives or our daily activities. There is also Social Anxiety, which is brought on when we're facing or thinking about facing a social situation. 

Anxiety is broad, but it always involves a revved-up nervous system and heightened concern for safety. Heightened concern happens subconsciously, so many people who have anxiety don't have any idea that they even have it.

It's all autonomic and subconscious. We don't necessarily realize it when we are revved up with anxiety. We may tap our feet all the time or chew our fingernails. For me, I pull my hair, literally. For other people, it could just be a constant stream of to-do lists or worries about what we said or what we didn't say. 

Anxiety manifests differently in everyone. It is important to know that what most people call an “anxiety attack” is actually not clinically accurate. It is a panic attack, which is a symptom of Panic Disorder, a type of Anxiety Disorder. 

Panic Disorder

When I was 19, I had just come home from living in a halfway house after rehab, and I had what I would now identify as agoraphobia. I didn't want to leave the house or be alone. I would follow my parents around the house all day long. I was feeling insecure, and I felt really vulnerable. I had an appointment with a doctor across town, and it was a 45-minute drive. 

So, I drove out there alone, and at the end of my appointment, I walked to my car, and all of a sudden, it was like I had just run a couple of miles. I couldn't catch my breath, it really was so disorienting, and it seemed to have come out of nowhere. The panic attack really caught me off guard.

The nervous system and the subconscious brain are busy all the time. Leina remembers working early in her career with people who had Panic Disorders and figuring out that they really did not know what was triggering the panic attack. It was fascinating to her because what it helped her understand is that people who have panic disorder really are at the mercy of their nervous system. 

Both panic attacks and other symptoms of anxiety are clues that our nervous system is really dysregulated. And when our nervous system is dysregulated, it is because we have not been able to adequately heal from different events or from different patterns in our childhood, like lack of a secure attachment by a parent. So, it's another clue into our healing journey that our body is not going to let us ignore it anymore.

The Big Difference

One thing that I have observed is that panic attacks come with overwhelming terror. And “anxiety attacks,” at least, what I have experienced and what some of my clients have described in the past, is that there's not as much terror associated with it. Although anxiety has an extremely heightened nervous system response as well, the terror of a panic attack is that you truly believe you're going to die most of the time. 

How to Regulate During a Panic or an Anxiety Attack

As always, consult your medical doctor or consult a mental health professional. This blog is not a diagnostic tool. It is an informational tool to give you more clues and to help you figure out what to do next on your journey. 

There are ways to calm the nervous system medically, but there are also ways to calm the nervous system somatically. We've been working on this with our Mending Together Program members. We are teaching them to utilize their body's wisdom and to lean into the wisdom of their body to regulate their nervous systems. And so, like all healing, it’s multi-layered and complex. You can use pharmacology and use “natural remedies”, but there are clinically effective somatic tools showing great results for both anxiety and panic in terms of regulating the nervous system. 

Leina observed while working with teens in her private practice in California that sometimes parents misunderstand a teenager's or child's panic attacks as a bid for attention, and it's really important to clarify that there is no conscious volition. There's no will; there is no choice in whether or not you have a panic attack. If you have experienced panic attacks around people who tend to be dismissive or identify you as dramatic or doing it on purpose, I would really encourage you to learn a little bit more about how that is absolutely false. It is something that your body and your nervous system are doing without your conscious will and it's not your fault.

So what can you do?  I really like the double breath, sigh. It is two breaths in through your nose in succession without exhaling, and then an exhale through your mouth. You're trying to fill up your lungs as much as possible on the inhale, and on that second inhale, you're actually inflating some of the SACS in the lower lungs, and it's offloading carbon dioxide. This gives you more blood flow to the prefrontal cortex which is your executive function. It’s able to help calm your nervous system. 

I would like to point out though, that when you're in the middle of a panic attack, you are actually operating out of the most basic part of your brain and you are not able to connect with the part of your brain that contains memories of tools. That being said, it can be very helpful to have somebody co-regulate you. It is often not possible, but if somebody can say to you, “look at my eyes, follow my breathing, put your feet on the floor,” it encourages you to have some kind of different tactile experience. 

When we are cut off from the tools we have to self-regulate, it's critical to have someone help co-regulate us. We're going to do a whole episode on The Universe Is Your Therapist Podcast on mirror neurons and co-regulation, but being around someone else who your nervous system can regulate with and calm itself because of their calm nervous system is really an effective tool.

We would love to have you as a member of our program, Mending Together. We are teaching some really powerful tools and techniques on somatic work and how panic attacks and anxiety attacks are tried back to some sort of trauma. 

To learn more information, visit www.mendingtrauma.com/mendingtogether