Mental Illnesses

Anxiety attacks vs. Panic attacks

Although most people and often times some licensed therapists interchangeably use the terms anxiety attack and panic attack, they are not the same and don’t manifest in the same way. However, should you be experiencing either of the two, they are a sign of extreme mental exhaustion and worth exploring for mental health instability. So how do you know if you’re experiencing an anxiety attack or a panic attack? I will give a brief account of how anxiety attacks and panic attacks manifest in myself and what I do that helps me in today’s post.

As mentioned in previous posts, I didn’t always know that I had any sort of mental instability until later in my early adulthood (probably around my early-20s). But even then, when I started to become aware of it, I didn’t immediately address it or try to seek any therapy. Because it’s a “feeling” I have always felt since childhood, I felt like, “Oh, no wonder I always felt weird. Ok, I now know what it is“, and I went on about my life. One reason (amongst many) I didn’t have the urgency to seek help was because I have what one would call “high-functioning anxiety.” This simply means that my fears often motivated me to act on things and made me seem “productive.” Of course, my reactions to situations and circumstances were unhealthy and often destructive, but as long as the job was done, surely I was fine!

However, going for long without addressing my anxieties only led to the accumulation of irrational fears over a long period. Before long, I found myself dealing with insomnia, chronic back pain, constant heart palpitations, and having panic attacks. Before I get into any technical terms and the current science about the two, I will share two personal accounts.

ONE

I had joined Twitter in my late teens. For as long as I can remember, my interactions, following, and followers had always been with people I knew or at least know of. Like most of my social media platforms, I tend to keep a small circle for my peace of mind and comfort. About 4-5 years ago, a trending topic popped up on my timeline from the WHO account on protecting, educating, and improving the lives of girls and young women, especially underprivileged communities (I believe it was women’s day or something). Now, everyone who knows me knows that I’m very passionate about amplifying women’s voices and seeing that the girl child is given just as equal opportunities as the boy child. Because this is a topic I’m naturally passionate about engaging, I started tweeting my thoughts and suggestions with the hashtag. No big deal, right?! I then put my phone down and proceeded to my life.

A couple of hours later, I logged onto Twitter to find countless retweets, likes, comments, and new followers from people I didn’t know. My tweets were OBVIOUSLY positive, and everyone who liked and retweeted was positive about them. However, gradually, I started this with irrational worry, thinking, “OMG, why are they all following me? What more can I provide them with? She has over 5K followers. Why is she following me? Does that mean all their followers will see my tweet and might come to my page? Yeah, sure, today I said something smart, but what if they find me boring every other day? What if my old followers start thinking I’m a phoney? What if they go through my timeline and they find something they don’t like? I’m genuinely not even this smart and cohesive. It was just a moment I had…..” I could go on forever…

I started feeling dizzy, my heart racing faster than usual, fast and heavy breathing, and was unable to concentrate on anything. I tried taking a nap to “relax,” but for hours, I was tossing and turning, worried: “What would people think of me…my old friends and new followers“. I couldn’t take the anguish any more, especially when I started experiencing spiking shotting pain in my back. I immediately took my phone and deleted my Twitter account. Moments later, though sad I had to delete my Twitter account, I felt calm. And to this day, I have not returned back to Twitter. That was an incidence of an anxiety attack I had.

TWO

Fast forward years later, the year was 2019. Your girl started with grad school. Already to any “normal” person, starting grad school would be a stressful period and would experience some anxiety. For me, this was a very difficult period of high anxiety. Life has no guarantee and no certainty getting one degree, let alone two or more, will set you up for success. More, I was taking a route barely many embark on, and this concept of a “physician-scientist” of this African black woman felt unrealistic and mythical (it still does). So I definitely was experiencing high anxiety with my preparations for grad school and would often experience anxiety attacks during the application and registration processes. However, over the months, I started settling in relatively well, and I got back to my “normal anxiety.”

One morning, I was seated at my desk working on an assignment. I got up to use the toilet. When I returned, an intense sensation of fear came over me. My heart started feeling “heavy” and palpitating. The feeling was almost too familiar, and I remember trying to talk myself out of it: “GURL, RELAX!! What the hell are you anxious about now? We’re doing good! We’ve been good now! Stop this and finishing your work!” Within seconds, I started feeling tingling sensations in my hands and light-headedness. At this point, real fear started kicking in because I could not understand what I was anxious about. The next moment, I fell to the floor – hyperventilating and unable to grasp air, trembling and shaking, heart-pounding and chest pain, the room spinning around me, sweating profusely everywhere.. (It is still a moment that scares me).

I kept telling myself, “This is a panic attack, you’ve experienced one before, just breathe.” But I couldn’t find air, this one was different. I don’t remember the chest pain being this bad the last time. And that’s when I thought, maybe I keep telling myself it’s anxiety, and all along, I’ve had some undiagnosed heart condition. Now I am having a heart attack, and today is the day I die. I clenched onto my chest in a fetal position screaming for what seemed like forever. I couldn’t tell you how I got up and found myself at the emergency room. Everything was a blur..

The scariest feeling of it all was this feeling of dissociation or detachment from my own body. And this is what instilled more of my fear because I thought I was dead. You know in movies when someone supposedly dies and their “spirit form” gets up and looks at their physical dead body on the ground? Yep, that was the feeling for me. I didn’t feel like I was inside my own body. I felt like I was standing across me together with nurses and doctors telling me to breathe. I was shocked at myself: “What is happening to us? PLEASE JUST BREATHE! We are not dying!” But what I was physically experiencing was far past understanding any medical reasoning. I was screaming and crying at the pain I felt and at what felt like my death. Hours later, with the help of specialised nurses (God bless them)…

Can I just put a quick pause here to address and acknowledge people who advance their skills/craft? Because the way those nurses took care of me, no ordinary nurse or even doctor could have. They understood me wholeheartedly, and they knew exactly what to say and do. I'm still in awe of their work to this today. Ok, back to me...

So with the help of these nurses and two dear friends, whom I later managed to call, the trembling stopped, chest pain disappeared, heart rate slowed down, and I was able to breathe again. That was an incidence of one of two panic attacks I’ve had.

What are the driving force of anxiety and panic attacks?

Research has found that the amygdala and periaqueductal gray in the brain stem are overstimulated during a panic attack. The amygdala is responsible for fear and detecting danger, and the periaqueductal gray has a role in response to pain and stressful stressors. On the other hand, while the overstimulation of the amygdala has also been implicated in anxiety, it is the prefrontal cortex that seems more relevant. The prefrontal cortex is the area of our brain that is responsible for critical-thinking and problem-solving. Recent studies found that overstimulation of the prefrontal cortex leads to excessive thinking, leading to worry, hence the anxiety. It is also found that the prefrontal cortex usually inhibits the amygdala. Studies found that in some cases of panic attacks, the prefrontal cortex is under-stimulated and this permits the amygdala to take control unregulated.

Interesting fact: Practicing mindfulness, e.g., meditation, improves your prefrontal cortex activity, and regular aerobic exercise results in the association of the left and right halves of the prefrontal cortex for optimal functioning.

From my two accounts, there is a clear illustration of why it is important to make a clear distinction between these two. In most instances, anxiety attacks occur due to a stimulus – a situation you are excessively thinking about. This often leads to irritability, muscle pain, fast heart rate, insomnia, heavy breathing or shortness of breath, and extreme fatigue. The physical symptoms can be mild or severe, depending on the situation. If the stimuli are removed or confronted, more often, the symptoms usually disappear. But the condition can be debilitating to an individual because of its gradual onset, which can be hours, days, and even weeks.

On the other hand, panic attacks are sudden, abrupt, severe, and often without cause. Sometimes they can occur after a period of extreme anxiety but can also occur independently. Most people immediately seek help upon experiencing a panic attack because they feel like they are having a heart attack. These symptoms may include: shortness of breath, chocking sensation, heart palpitations, chest pain, abdominal pain and nausea, tingling sensation and numbness, excessive sweating, trembling and shaking, hot flashes, dizziness or faint, feeling detached from oneself, fear of loosing control and fear of dying.

More, Anxiety Disorder and Panic Disorder are two different diagnoses. People with anxiety can experience panic attacks but don’t necessarily have a Panic Disorder (topic for another day).

To the general public

I hope that this gives you a bit more insight into why a comment such as “CALM DOWN” is unhelpful if not an insult to most people who battle with anxiety and panic attacks. These are, but a few of the complexities occurring in one’s brain during such episodes. Should you find your friend, partner, child, or relative in a frantic state, the best help you can provide them is to hold their hand and count with them to breathe in deeply and out slowly.

NOBODY FREAKN’ CARES

Sharing my fears about "What will people think of me?!" has really helped me overcome and learn to rationalize most of my worries and fears fabricated from this thought. Because the logic and truth of the matter is: NOBODY FREAKN' CARES!! Everyone is too busy and focused on themselves (we're all egocentric and  in our own ways). So start something if you want and fail at it if you must.. Be loud and let your voice be heard.. Go out with that person.. Change careers.. Dream and Live your life to the best you envision it! Anyone who is focused on you and what you're doing is already someone behind you. Because no one with real goals and living a life of purpose has the time to stay focused on your goals and your life purpose!

Until the next time, leaving you with some of that good-good mental health vibes:)

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