Panic Attack and Anxiety Attack
Anxiety is a common emotional response to stress, but for many people, it can escalate into more intense episodes, such as anxiety attacks and panic attacks. While both involve overwhelming feelings of fear or unease, they differ in their onset, duration, and symptoms. Anxiety attacks typically develop gradually and are often linked to ongoing stress or worry, whereas panic attacks come on suddenly, reaching their peak intensity in a matter of minutes. Understanding these differences is crucial for recognizing when help is needed and finding effective strategies to manage and treat these distressing experiences. Anxiety is a real and heavy burden, the Bible consistently offers comfort and practical advice for dealing with it, calling believers to trust in God, seek His peace, and share their concerns with Him.
An Anxiety Attack is a response to a perceived threat. The feelings of anxiety may build gradually over time, with symptoms varying from mild to severe, along with variation in duration. Anxiety Attack does not stand alone as a diagnosis according to the DSM-5-TR, but includes a list of anxiety disorders like generalized anxiety disorder, panic disorder and social anxiety order, to mention some. Anxiety symptoms such as nervousness, rapid breathing, increased heart rate, trembling, and difficulty concentrating, to name a few, may follow after a period of excessive worry or fear, which can be triggered by stressful life events and situations. Symptoms of anxiety may also last longer, and persist for days all together. Since Anxiety attacks are not diagnosable, symptoms could be understood through GAD - Generalized Anxiety Disorder.
The APA defines Panic Attack as “a sudden onset of intense apprehension and fearfulness in the absence of actual danger, accompanied by the presence of such physical symptoms as heart palpitations, difficulty breathing, chest pain or discomfort, choking or smothering sensations, sweating, and dizziness. The attack occurs in a discrete period of time and often involves fears of going crazy, losing control, or dying”. The attack normally subsides after a few minutes but may cause a sense of detachment from themselves or their surroundings during the attack.
What Happens To The Brain?
Panic is a natural human response to threat. It activates the fight-flight-or-freeze reaction in order to protect us from the threat. What happens then to individuals experiencing a panic or anxiety attack? The brain sends signals indicating that the threat is bigger than what it actually needs to be, causing us to react in a way that intensifies the situation, when in reality, it is actually not that big of a threat, or it is not even a threat. The amygdala, which is the instinctive part of the brain, takes over, setting an alarm for the threat that it detected, even if the threat is false, and releases certain chemicals in our body which signals us that there is a threat. These then cause the physical symptoms of an attack; which includes but not limited to - rapid heartbeat, shallow breathing, tensed muscles, trembling or shaking, and sweating.
Causes and Risk Factors:
Panic or anxiety attacks can occur due to threats that are either predictable or unpredictable, and these threats may be real or imagined. It could be due to environmental stressors, life stressors and social situations, concerns relating to gender and sexual identity, underlying medical factors, or withdrawal from drugs or alcohol. Unhelpful thoughts, catastrophizing and worrying can also keep the panic going.
The Bible points to several factors that can lead to anxiety or anxiousness, many of which stem from the stresses and challenges of life, our human limitations, or a lack of trust in God. Anxiety often arises from our tendency to fear what might happen in the future instead of focusing on today, when we feel uncertain about having our basic needs met, uncertainty and insecurity; whether in circumstances, relationships, or the world around us, life’s struggles—whether illness, loss, or other hardships—can create anxiousness.
Fear often leads to anxiety when we focus more on the dangers or challenges rather than trusting in God's protection and provision. Anxiety can sometimes arise from not fully trusting in God's ability to handle our problems. Guilt, shame, or unresolved issues from the past can also cause inner turmoil and anxiety
Individuals are more likely to experience these attacks if there has been a family history of panic or anxiety attacks which mostly deals with the genetic makeup of the individual, they have underlying mental health issues or chronic medical conditions. Chemical imbalance also plays a potential role in panic attacks. Studies show that imbalance in GABA, cortisol and serotonin is related to individuals experiencing panic attacks. Personality traits - mainly neuroticism - emotional instability, sadness and moodiness, and extraversion - sociability, assertiveness, excitability, high levels of emotional expressiveness; play a role in such individuals. Individuals with low levels of extraversion and high levels of neuroticism are more prone to have panic attacks.
Key Differences between Panic Attacks and Anxiety Attacks:
| Panic Attacks | Anxiety Attacks | |
|---|---|---|
| Onset | Sudden | Gradual, after a period of excessive worry. |
| Duration | Brief but intense | Much longer |
| Symptoms | Not limited to - Intense distress, fear of losing control, heart palpitations, shortness of breath, trembling and shaking. | Nervousness, irritability, increased heart rate, difficulty in concentration, trembling and sweating, and a sense of impending danger. |
Next Steps:
The next steps to be taken would be to focus on treatment and management for the attacks. It involves the combination of psychotherapy, and medications.
Cognitive Behavior Therapy (CBT) is extremely beneficial. It helps identify faulty thought patterns which accompany the attacks, and the main goal is to neutralise and reframe the disturbing thoughts, and develop strategies for dealing with the triggers when they arise. CBT is conducted by trained professionals who guide individuals in understanding faulty thoughts and behaviors and to focus on other things that would help control and manage the attacks.
Therapists also would include relaxation techniques which may include breathing exercises, progressive relaxation and guided imagery.
Medications would normally include SSRIs, SNRIs, Anti-anxiety drugs and Beta-blockers. Medications help in reducing the symptoms and they may be prescribed with or without psychotherapy.
What can you do?
Panic attacks and anxiety attacks are sudden, and can be intense and distressing. The symptoms usually consist of rapid breathing, trembling, racing thoughts and heartbeat, and intense worrying, but there are certain steps we can take to help ourselves to relieve symptoms of an attack.
Breathe - the first thing we can do is take deep breaths. Shallow breaths accompany an attack and can lead to feeling tightness in the chest. Taking slow concentrated breaths will gradually start slowing down our heart rate. Trying the 4-4-4 breathing also helps. This means taking a deep breath, holding the breath and exhaling the breath, all for 4 seconds each.
Acknowledge the attack - Acknowledging that this is a brief period and it will pass, can help in calming ourselves at that point. The attacks generally peak within 7-10 mins of their onset and will gradually subside.
Identify triggers - Learning how to manage and avoid triggers can help in reducing the frequency and the intensity of the attacks. Triggers could be from certain environments, situations, individuals or thoughts. This could be done with the help of a mental health professional.
Ground yourself - Grounding is a technique that helps in reducing overwhelming feelings. It involves changing the focus to the present and the external rather than what is happening in the internal. An exercise could be to focus on what we can feel, touch, taste, see and hear. This activates our senses, and causes us to shift our focus on something tangible rather than something immaterial.
In Matthew 6:34, Jesus says, “Therefore do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough trouble of its own.” In this verse we find that Jesus encourages us to focus on the present and to not be worried or anxious about what is out of our control.
Shift your focus - Thoughts can easily overwhelm us and take up much of our focus and concentration, therefore shifting our focus from our thoughts to something physical in our immediate environment can help us focus on the present. This could be a stone, a rubix cube, or a small toy.
Repeat a phrase - Repeating certain phrases or words can help reassure that this feeling will pass. It can provide the strength to get through, and also shift the focus on something reassuring rather than what would add more to the attack. For example: ‘it’ll be okay, this feeling will pass’, ‘I need to slow down my breathing and it will be okay’, ‘I have gotten over this before, i can do it again’, 1 Peter 5:7 “Cast all your anxiety on him because he cares for you”, Psalm 94:19 “When anxiety was great within me, your consolation brought me joy.” These verses encourage believers to release their anxieties to God, knowing that He cares deeply for them. The psalmist also reflects on how God’s comfort can soothe and calm anxious thoughts.
Distract - Repeating a word, singing a song, taking a walk, picturing something in our mind that brings about calmness, are few useful techniques that help us distract ourselves. Relax your body - usually when we panic, our muscles start to tense up. Consciously relaxing the muscles helps. Identify which muscles are tensed up; the most common are our shoulders, the tongue may be on the roof of the mouth, or our fists may be clenched. Relaxing the shoulders, resting the tongue on the lower part of the mouth, and unclenching our fists, helps in relaxing our body.
Philippians 4:6-7“Do not be anxious about anything, but in every situation, by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus.” This passage directly speaks to the command to not be anxious and instead turn to God in prayer, promising peace in return.
While panic and anxiety attacks can be overwhelming, they are manageable with the right support and strategies. By gaining a better understanding of these conditions and identifying personal triggers, individuals can take proactive steps toward managing their symptoms. Seeking professional help, whether through therapy, medication, or coping strategies, can provide the support needed to regain a sense of control. It’s important to remember that recovery is a process, and with the right resources, individuals can lead fulfilling lives, even in the face of anxiety. If you or someone you know is struggling, reaching out for help is a powerful first step toward healing.
(All information in this article is Public Domain)
References:
- APA Dictionary
- Felman, A. (2018, October 26). Anxiety: Causes and diagnosis.
- Leonard, J. (2021, January 21). Panic attack vs. anxiety attack: What is the difference?
- Panic self-help guide. (2021, May 27). NHS Inform.
- Zugliani, M. M., Martin-Santos, R., Nardi, A. E., & Freire, R. C. (2017). Personality Traits in Panic Disorder Patients With and Without Comorbidities. The Journal of Nervous and Mental Disease, 205(11), 855–858.