20 Nov The Difference Between Fear, Anxiety and Panic, and When to Seek Help
I have been asked by many clients to explain the difference between fear, anxiety and panic and for help with determining what is normal and when to seek treatment.
I am going to explain the differences with the help of simple examples.
Let’s imagine you’re at the zoo standing in front of the tiger’s den. As you’re watching the tiger you realize it has dug a large hole underneath the fence, which extends to the visitor’s side. The tiger suddenly roars, exposing its sharp teeth and starts crawling toward you through the hole.
If you feel anything at that moment it is most likely fear. Fear is an automatic physical response to perceived imminent danger. It is a survival mechanism built in your brain to help preserve your life. You are in real danger, and you need to do something to save your life, such as run away, fight, or if all else fails, freeze.
In response to danger, your body is flooded with hormones such as Adrenaline and Cortisol to provide you with the energy and strength you need to save your life. As these hormones are rushing through your body, your heart starts racing, and your breathing becomes fast and shallow. You may experience shortness of breath, sweatiness or stomach upset. You will also experience the emotion of fear. Finally, you may feel detached from your body or the situation. You are experiencing FEAR.
But let’s imagine for a moment that another day you were contemplating visiting the zoo. Suddenly a thought or an image occurs to you of a tiger breaking loose from its den and chasing after you. “What if,” you tell yourself, “a tiger or another vicious animal, breaks loose, chases after me and mauls me?”
That thought may cause you anxiety, or an uneasy feeling which may include physical sensations such as butterflies in your stomach or tightness in your chest or throat. The symptoms of anxiety are unpleasant but are not as intense as the symptoms of fear or panic.
Note that the threat is not real. If it was, then you would have a fear response. But in this example, the threat is not there and most likely won’t be, but you are anxious about the possible future threat.
Contrary to my Fear example, in this case nothing happened. Your brain is reacting to your thoughts as if they you’re your reality.
If your anxiety is intense, it may result in you canceling your plan to visit the zoo. If you decide not to go to the zoo because of your anxiety, it means you are using avoidance to get relief from your anxiety. Many people avoid anxiety-provoking situations or places. The more anxiety they have, the more they will be avoiding and missing out on life. Such avoidance, when it becomes pronounced, may leave you house bound. When you avoid leaving your home because of anxiety you have probably developed Agoraphobia, a condition requiring treatment.
But what about a panic attack? How does it differ from anxiety and fear?
A panic attack is like fear in terms of including both emotional and physical symptoms. During a panic attack the heart is pounding, there may be shortness of breath or difficulty breathing, perspiration, tingling sensation, derealization and more.
The main difference between fear and panic is that panic occurs WITHOUT any real danger.
You may say that a panic attack is caused by a mistake in the so-called alarm system in your brain, located in the Amygdala, an almond shaped part inside your limbic system. Your Amygdala has interpreted a non-threatening situation as a threatening one, therefore providing you with the energy you need to survive. Except there is no need for extra energy because you are not really in danger.
Just like a smoke detector that sounds the alarm when you burn a toast, your brain sounds the alarm when it produces a panic attack over some small trigger, which does not put you in real danger.
To go back to the zoo for example, let’s say you’re standing in front of the tiger den. Nothing unusual is happening. In fact, the tiger is asleep and doesn’t notice you. And yet, you are suddenly overcome with dread, heart palpitations, shortness of breath and a sense of doom. The sensations intensify until they reach a terrifying peak in 10-15 minutes and then gradually subside. You’ve experienced a panic attack – A mistaken fear response in the absence of danger.
The good news is that panic attacks are not dangerous, and they do not mean that you are crazy. Rather, what they mean is that you have developed an oversensitivity to stress. Panic attacks can be eradicated with the right treatment.
If you would like to know the kind of treatment that can help overcome panic attacks or anxiety, read on.
When to Seek Help
If you experience anxiety or panic attacks, which compromise your ability to enjoy life or function as usual, you may wish to seek help.
For example, if you are worried about many things for a significant part of your day or week, or if your anxiety or fear of having anxiety (anxiety about having anxiety) causes you to cancel plans, not make plans, or even avoid certain places or activities, then you may want to seek professional help.
Cognitive-Behavioral Therapy (CBT) for anxiety and panic is time-limited (usually 12-14 sessions) and structured, which means that your therapist is going to follow a science-based treatment protocol. The rate of success demonstrated in dozens of studies is very high. Registered Psychologists are often trained in CBT for anxiety and panic.
To summarize, fear is a natural physiological response to real danger and is there to increase your chances of survival. Anxiety is the brain’s response to thoughts and feelings about the future in the absence of real danger. Panic is an intense and unpleasant physiological response to a mistaken perception of danger. It resembles a fear response, except it is not useful to you in any way.
I encourage you to reach out, stop suffering and get your life back. All you’ve got to lose is your anxiety!