Stress, Anxiety and Panic Disorder: What’s the Difference and What Can I Do About It?

It seems like many people nowadays are willing to share that they’re “having a panic attack”, from reality TV moments (Ari on the Bachelor and most of the Kardashians at some point), to media personalities (Dan Harris on GMA or Carson Daly sharing with People magazine) and athletes (thank you Kevin Love). Which is great. Helping to reduce the stigma of mental health challenges is a critical part in boosting our ability to provide more people the quality help they need.

We also need to be cautious about how we proceed with this new found sharing as over-generalization and often times flippant ways some people throw down the concept that they’re “having a panic attack” can also minimize the severity of what’s going on. Non-celebs who are struggling and isolated may feel like what they’re dealing with is different or “crazy” or should be easier to overcome, making their loneliness and anxiety even worse.

I know, because I silently suffered from panic attacks and other related conditions for the majority of my life, and it’s still something I have to keep a close eye on every day so that they’re not triggered.  Some situations still aggravate my nervous system enough to cause an issue (for me it’s usually most of the symptoms listed below, plus I will actually pass out – a little known and seldom understood condition called anxiety induced vasovagal syndrome).

People who are highly sensitive to light, noise, crowds and easily pick up other’s emotions may be at higher risk of developing an anxiety or panic disorder, especially when their sensitivity is not appreciated or supported early in childhood. (You can take a free quiz at to find out more).

So, what exactly is a panic attack? And how’s it different from stress or anxiety?

Simply put, stress is what happens when demand exceeds capacity. It’s not good or bad, but you can think about it as being like energy potential that can be used in positive or negative ways. There are several stress reactions that happen that help us with short term solutions – fight, flight, freeze or faint. If stress is too intense or continues for too long, this helpful energy can quickly turn against us causing inflammation and internal wear and tear.

If stress is energy, anxiety is what happens when that energy gets stuck in the body. Anxiety can linger well after the stress is gone and can be triggered when no real stress is around, but we worry that it might come back again. If left unresolved, anxiety can become chronic and lead to other conditions like depression, substance abuse, compulsive or aggressive behavior.

According to the American Psychological Association ( a panic attack is “a sudden surge of overwhelming fear that comes without warning and without any obvious reason. It is far more intense than the feeling of being “stressed out” that most people experience.”

Depending on your source, to qualify as a panic attack, the episode may need to include up to four or more of the following symptoms:

  • Heart palpitations, or rapid heart rate
  • Hot flashes, or sudden chills
  • Sweating
  • Trembling or shaking
  • Tingling in the fingers or toes
  • Sensations of shortness of breath or smothering
  • Feelings of choking
  • Chest pain or discomfort
  • Nausea or abdominal distress
  • Feeling dizzy, unsteady, light-headed, or faint
  • Derealization (feelings of unreality) or depersonalization (being detached from oneself)
  • Fear of losing control or “going crazy”
  • Fear of dying

What separates a panic attack from a more general anxiety response is the intensity and duration of the symptoms. Panic attacks tend to escalate quickly and have more extreme highs and lows, returning back to normal within about 10 minutes or so. But, everyone experiences panic attacks differently, so it’s important not to minimize your experience or feel bad if you’re symptoms don’t seem to line up with the norm.

In addition to the above symptoms, a panic attack is typically marked by the following conditions:

  • it occurs suddenly, without any warning and without any way to stop it.
  • the level of fear is way out of proportion to the actual situation; often, in fact, it’s completely unrelated.
  • it passes in a few minutes; the body cannot sustain the “fight or flight” response for longer than that. However, repeated attacks can continue to recur for hours.

While panic attacks may seem to pop up out of the blue, many people experience more subtle warning signs leading up to an actual panic episode. Mood changes, nervousness, irritability, lack of sleep or too much sleep, changes in appetite or sex drive may all be signs that stress and anxiety are starting to impact your ability to regulate your nervous system effectively. The quicker you can identify these gentler symptoms, the easier it will be to adjust your lifestyle to manage stress more effectively.

Most importantly, be kind to yourself.  Know that your stress, anxiety and even panic-related experiences are just trying to be helpful, even if they feel like they’re turning against you. Do your best to create daily habits that nurture and nourish your nervous system like deep breathing, meditation, physical exercise, time in nature, social support, humor appreciation, laughter, massage, music and gratitude journaling – all of which have been scientifically proven to help you soothe stress and boost resilience.

I’ll share a few more techniques along with a bit more about my personal journey with panic disorder on a short vlog here:

For more information, visit these helpful resources: ADAA Anxiety and Depression Association of America; American Psychological Association

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