Anxiety vs Panic Attacks


There are no winners, but there are solutions!

| By John Wohlert, MSW, LCSW, LCADC

Ever have that feeling of sweaty palms, upset stomach, tension in your body, feeling like you may pass out, racing thoughts, hyperventilating, your mind goes blank?

I think most of us have experienced those symptoms a few times in our lifetime, be it giving a speech (the worst), studying for an exam, preparing for an interview, getting married, having a child, or any other big changes in our lives. This is what I would categorize as “normal” anxiety.

But what if these symptoms are persistent over a long period of time? Do you have generalized anxiety disorder, are you experiencing panic attacks, or both (yikes!)? 


Luiz Rogério Nunes via


Let’s take a brief look at the definitions of both provided by the therapist’s Bible, the Diagnostic and Statistical Manual of Mental Disorders (DSM), Fifth Edition. 

*For a proper diagnosis of either, please consult with a primary doctor, a licensed clinical therapist, psychiatrist, or an APN (Advanced Practice Nurse).

Generalized Anxiety Disorder 

  1. Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (ex. work or school performance) 
  2. The individual finds it difficult to control the worry. 
  3. The anxiety and worry are associated with three or more of the following six symptoms with at least some symptoms having been present for more days than not for the past 6 months.
    1. Restlessness or feeling keyed up or on edge.
    2. Being easily fatigued.
    3. Difficulty concentrating or mind going blank.
    4. Irritability.
    5. Muscle tension.
    6. Sleep disturbance: difficulty falling or staying asleep, or restless, unsatisfying sleep. 
  4. The anxiety, worry, physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. 

Panic Disorder

  1. Recurrent unexpected panic attacks. A panic attack is an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes, and during which time four or more of the following symptoms occur: 
    1. Palpitations, pounding heart, or accelerated heart rate. 
    2. Sweating.
    3. Trembling or shaking. 
    4. Sensations of shortness of breath or smothering. 
    5. Feelings of choking. 
    6. Chest pain or discomfort. 
    7. Nausea or abdominal distress. 
    8. Feeling dizzy, unsteady, light-headed, or faint. 
    9. Chills or heat sensations.
    10. Paresthesias (numbness or tingling sensations)
    11. Derealization (feelings of unreality) or depersonalization (detached from one-self).
    12. Fear of losing control or “going crazy”
    13. Fear of dying. 
  2. At least one of the attacks has been followed by 1 month or more of one or both of the following:
    1. Persistent concern or worry about additional panic attacks or their consequences (e.g., losing control, having a heart attack, “going crazy”). 
    2. A significant maladaptive (marked by poor or inadequate adaptation) change in behavior related to the attacks (e.g., behaviors designed to avoid having panic attacks, such as avoidance of exercise or unfamiliar situations).  

So that is the long and short of the characteristics describing anxiety and panic attacks.

I should note, once a member of both disorders in my youth, when I experienced for the first, second and third time any of the 13 symptoms described for a panic disorder, I went to the ER to rule out having a heart attack. There was comfort in knowing I was not having a heart attack that I was having a panic attack (I guess it was the best of two evils).

It all sounds terrifying, but there is hope through implementing positive coping skills that will help you to manage and regulate any symptoms of anxiety and panic attacks. 

Faris Mohammed via

Coping Skills

Once I knew I had a propensity to experience symptoms of anxiety and panic attacks, I started researching how best to manage/regulate my symptoms.

First, I learned there are no miracle cures for either disorder. It takes hard work and consistency to rewire your brain and feel in control. 

The list below are a few coping skills, techniques, and strategies to help yourself minimize the severity of symptoms you may experience: 

  1. Deep breathing exercises: Breathe in for a count of 6 seconds through your nose, hold your breath for a count of 6 seconds, and exhale, slowly, for a count of 6 seconds. Repeat as needed. Hopefully you will feel your body relaxing and your symptoms lifting. 
  2. Exercise. Exercising can take on many forms such as going to the gym, working out at home, doing cardio exercises, cleaning your home, stretching, yoga, walking, playing a sport, having sex (Yes, I said it!).
  3. Stimulate your mind. Read a book, a magazine, journal, make to-do lists, plan a project to do, watch mindless TV shows (avoid the news if possible. You don’t want to elevate your blood pressure), engage in stimulating conversations. 
  4. Meditate. There are many self-guided meditation apps out there to help you with this process. Also, listening to calm, soothing music and sounds can benefit in reducing your symptoms. 
  5. Develop a structured routine. And follow it consistently. There is comfort knowing what to expect each day. 
  6. Be observant. Use your five senses: notice the colors around you, identify each out loud. Focus on the sounds you hear, identify each sound out loud. Touch items around you, notice the textures, what are you feeling? Take in a deep breath through your nose, what do you smell (hopefully it is pleasant!)? When you are eating, what are the different tastes you are experiencing? 
  7. Change your environment. If you notice you are experiencing any symptoms of anxiety or a panic attack in a certain environment, change it. Move your body, go for a drive, visit a friend or family member, or go to a park.
  8. Own it, accept it, normalize it, get angry at it. I found this technique to be most useful for me. Once I was able to understand my symptoms, I would normalize what I was experiencing, I owned it, then I would curse it, out loud. I did this through yelling, screaming (outside the presence of others). This helped two-fold; yelling and screaming caused me to inhale and exhale deeply and the yelling and screaming relaxed my mind and body.

Those are a few coping skills you can implement to help yourself reduce the symptoms you may be experiencing associated with anxiety and panic attacks.

Another avenue available is medication management, or more specifically, medical marijuana. I found each client has a different preference and means in which they want to treat their symptoms. Please discuss the advantages/disadvantages of either with your primary doctor, therapist, psychiatrist, or APN.

There is hope.

Lastly, as I stated before there are no miracle cures. It takes consistency and hard work to help yourself manage and regulate any symptoms you are experiencing.

Sasha Freemind via

In Shirzad Chamine’s book Positive Intelligence, he references a Dr. Maxwell Maltz, a plastic surgeon, who noticed it took approximately 21 days for an amputee to stop feeling phantom sensations. Through Dr. Maltz’s research he discovered to create new habits and develop new neural pathways and for old ones to waste away, it took 21 days.  

Our brain is a muscle, it will react to whatever we feed it. We must ask ourselves, am I worth 21 days to change my thinking, how I view my world, how I view myself, am I willing to practice/implement, consistently, positive coping skills for 21 days to reduce, manage, regulate your symptoms?

Be kind to yourself.


John Wohlert, MSW, LCSW, LCADC

In his free time, John is passionate about spending time with his “whacky, unique” family, playing golf, basketball, bowling, walking in nature, the ocean/boardwalk, and traveling.

Check out John’s professional bio here!


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