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Panic Attacks or Panic Disorder?

What’s the difference?

Having panic attacks does not always mean you have panic disorder. This week on The Anxious Truth we’re digging into what differentiates panic attacks – even recurring panic attacks – from panic disorder.

In a nutshell, the primary differentiator here is fear/avoidance.  When you begin to fear panic attacks because you interpret them as dangerous or too overwhelming, then you begin to modify and restrict your lifestyle to prevent or avoid them, you are panic disorder territory. Compare this to the very large number of people that will have panic attacks now and then without ever treating them this way. They have panic attacks, which they experience as individual events that they do not link together, and go about their lives mostly unconcerned or worried about a next panic attack.

This week we’re also talking about why being anxious all the time is quite common in panic disorder and how panic disorder relates to other closely related conditions all categorized as “anxiety disorders” from a diagnostic point of view.


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A Panic Attack ..

Is a discrete event with a start, peak, and end.  ALL panic attacks do eventually end, even for those members of our community that feel like they continuously panic. We’re covering this issue in other episodes. Many many adults in the western world will experience panic attacks at some point in their lives, but most of those will never develop panic disorder. I know, this seems amazing, doesn’t it?

Panic Disorder …

Is what we call it when you become fixated on your panic attacks, you’re terrified of the panic itself, and you start to take evasive action in the form of avoidance and restriction that impacts your lifestyle. The disorder is really defined by the fear of panic itself and the resulting avoidance that becomes ingrained in your life.

Sadly, for some (I was one of those people), panic disorder can quickly develop after just a few panic attacks.

Avoiding Panic Triggers …

If you find yourself carefully trying to avoid panic triggers or working overtime to engineer your life around panic attacks and the need to never let them happen, you may be in “panic disorder territory”. But while this seems like a good move, avoiding panic triggers can backfire on us in the end.  See episode 284 for more on this.

Anxious Between Panic Attacks?

Join the club!  Most people that develop panic disorder are anxious most of the time – even between panic attacks. This is often misinterpreted as Generalized Anxiety Disorder (GAD), but being anxious all day long because you’re looking for the next sign of panic is not GAD. Panic disorder and GAD can co-exist, but all day anxiety is not automatically GAD. It’s quite a common aspect of panic disorder.

“Anxiety Disorder”

From a purely technical perspective, there is no such thing as “having anxiety disorder”.  You can have AN anxiety disorder, or multiple anxiety disorders. Panic disorder is one mental health condition classified as an anxiety disorder. So is GAD. So it social anxiety. OCD isn’t officially an anxiety disorder any longer from a diagnostic perspective, but it’s so close to the anxiety disorders that they can often co-exist and are classified right next to each other in diagnostic guides.

Multiple Anxiety Disorders

It is possible, and quite common, to be diagnosed with panic disorder and another anxiety disorder related mental health condition. That’s OK. Don’t think of this is having multiple injuries.  The anxiety disorders are all so close together that someone with panic disorder will often show signs of the other disorders too and may or may not be diagnosed with a second or third anxiety disorder. Don’t get too stuck on the diagnostic labels. This is why you often hear me talk about “a disordered state of anxiety” on this podcast or on Disordered (the podcast I do with Josh Fletcher).

What About Panic Disorder Recovery?

Here’s where things get interesting!

A person fully recovered from panic disorder may still have panic attacks!  It’s true. A person that once had panic disorder (like me) might still experience panic attacks sometimes, but is no longer afraid of them and doesn’t in any way plan their life around panic or anxiety any more. This speaks directly to the difference between panic attacks and panic disorder. It also clearly reflects why the disorder is defined by the fear of panic and resulting avoidance.  If you find that you might panic now and then but once those panic attacks end you go about your life without being fixated on a possible next panic attack, then you’ve recovered and now just have regular plain old boring panic attacks like so many others do.

Yes, You Can Recover

Even if you do go from having panic attacks to being officially diagnosed (only a qualified clinician that knows you can do this) with panic disorder – or even multiple anxiety disorders – you can recover. Having panic disorder does not define you or your mental health forever.  Many people recover from panic disorder and related conditions. Cognitive behavioral – especially third wave CBT therapies like ACT or MCT – are quite effective when treating panic disorder. You can get better.

Links Of Interest

 

Disclaimer: The Anxious Truth is not therapy or a replacement for therapy. Listening to The Anxious Truth does not create a therapeutic relationship between you and the host or guests of the podcast. Information here is provided for psychoeducational purposes. As always, when you have questions about your own well-being, please consult your mental health and/or medical care providers. If you are having a mental health crisis, always reach out immediately for in-person help.


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Podcast Intro/Outro Music: "Afterglow" by Ben Drake (With Permission)

https://bendrakemusic.com


 

Drew

Drew

Founder and host of The Anxious Truth podcast. Graduate student and therapist-in-training. Author and educator on the topic of anxiety disorders and anxiety recovery. Former anxious and depressed person.