by Andrew Thorn

Created on: September 08, 2009

To be clear at the onset, I have defined anxiety and panic below:

Anxiety: A normal physiological and cognitive response to a perceived threat. (this is commonly referred to as the 'fight or flight' mechanism)

Panic: An exacerbation of anxiety where there is a 'catastrophic misinterpretation' of symptoms and events.

There are important reasons to fully understand the difference between anxiety and panic. A lack of understanding of anxiety can result in panic and a lack of understanding of panic can exacerbate the symptoms and lead to an untreated and chronic state of generalised anxiety and complex avoidance.

Anxiety is a perfectly normal response to stress that affects us all to some extent. It is a primeval mechanism that can be understood and normally attributed to something real, for instance a job interview, driving test, an aggressive incident, a road traffic incident ( for the sake of brevity I will not go on but hope you get the picture). A series of physiological changes occur within our bodies that engage a kind of 'warp drive effect', principally the result of increased adrenaline and therefore increased oxygen in our bodies. This is in readiness as the term describes, to either defend ourselves against attack or to run away. Putting to one side the cognitive responses of increased vigilance for a moment, there is no significant difference physically between anxiety and that of normal arousal or excitement. We need this system in order to survive, both individually and as a species.

In panic attacks, again physically there is no difference to any other form of anxiety but the perception is that it is far worse and increasingly so. A person may not have a clear understanding of the cause or indeed effect of the uncomfortable sensations being experienced. This may lead to an impending and fast approaching sense of something terrible which is 'just about to happen'. The kind of catastrophic misinterpretations that people commonly describe are , 'I'm having a heart attack', 'I'm going to go crazy', 'I will faint', 'I am going to make a fool of myself', 'People will think I am 'odd'', or 'something terrible is just about to happen'. These cognitive responses almost always are generated subsequent to an anxious situation that has been mishandled or misunderstood.

The 'catastrophic misinterpretations' lead to a feeling of being out of control and a need to do something immediately.

Of course the dilemma for people who have experienced this first attack

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