Similarities and Differences Between Anxiety Disorder, Fear, and Panic Attacks

Anxiety disorder, fear, and panic attacks are three conditions that have numerous similarities and differences. These similarities and differences can be classified according to their contributing factors; biological, psychological, social, and treatment methods. The purpose of this paper is to establish and discuss the similarities and differences between anxiety disorder, fear, and panic attacks. 

Similarities 

Biological Contribution 

The three conditions trigger the same stress response due to their high comorbidity with each other. In other words, anxiety disorder and fear directly trigger the fight or flight response, which results in several physiological changes like increased heart rate, muscle tension, and shortness of breath (Gevirtz, 2021). Without the stress response, the body will not prepare itself to act on the perceived sense of danger, real or not when anxious or directly jump to the fight r flight response when experiencing fear ( American Psychiatric Association, 2013) . On the other hand, a panic attack might trigger the fight or flight response indirectly by inducing fear. After all, the technical definition for a panic attack is a sudden episode where the victim experiences intense fear triggered by real or perceived danger (Perrotta, 2019). The body will then trigger the same physiological responses mentioned above. 

Similarly, an individual can experience anxiety and a panic attack simultaneously. Sometimes, fear and anxiety overlap ( American Psychiatric Association, 2013). The cause can be overwhelming fear about an uncertain event in the future. At the same time, fear can be caused by anxiety. For instance, an individual might experience anxiety and fear when they think they will be fired or after receiving life-changing news, like a cancer diagnosis. When the event happens, such as getting fired, the anxiety accumulated by fear will end in a panic attack. 

Psychological and Social Contributions 

As mentioned above, fear can cause anxiety, which accumulates and results in a panic attack when the perceived cause of the fear actualizes. At the same time, anxiety, especially about an unknown outcome, can result in fear and a panic disorder. This is more likely in a person who has a history of panic attacks. As a result, the three can be triggered by the same conditions. One of the psychological triggers is a specific phobia, such as agoraphobia. For instance, if an individual previously experienced a panic attack on an airplane or when standing in a large crowd, they will experience fear and anxiety when put in the same condition again and are more likely to have another panic attack ( Pamungkas, 2019) . 

Fear, anxiety, and panic attacks can also have a social root or trigger. Social anxiety disorder is a good example. Individuals diagnosed with social anxiety disorder will continuously worry and feel self-conscious in any social situation (Asher et al., 2017). The individuals will also feel intense fear or anxiety if they feel that they are being judged, ridiculed, or put in embarrassing situations. The outcome is mainly determined by the effect the stressor has on the individual. For instance, social anxiety disorder might cause a panic attack. At the same time, if the individual is exposed to the stressor for extended periods of time, their anxiety levels will also increase. As a result, it is more likely that they will manifest severe symptoms of anxiety, or even have a panic attack. 

Treatment 

Anxiety disorder and panic attacks can be treated pharmacologically. Individuals diagnosed with an anxiety disorder or who have chronic panic attacks are more likely to be treated with antidepressants like SSRIs and SNRIs like Lexapro, Prozac, and Effexor, among others (Bandelow et al., 2017). Benzodiazepines like Xanax are also a common depressant used to treat anxiety disorders and chronic panic attacks. Benzodiazepines work fast but are highly addictive. When they create a dependence, they are more likely to be another source of anxiety and fear, rather than help treat the condition (Guina & Merrill, 2018). As a result, specialists usually prescribe them as part of an existing medication regimen, and not the main solution. Furthermore, the treatment plans for anxiety disorder and panic attacks changes over time as the individual gets better or when their condition worsens. Pharmacological interventions are not the only treatment available. 

Fear, anxiety disorder, and panic attacks also share the same non-pharmacological treatment interventions. For instance, it is recommended for individuals diagnosed with anxiety disorder and panic attacks to practice emotional management, where they either learn to live positively or actively manage different stressors in their lives. Psychotherapy like cognitive behavioural therapy and support groups are another common non-pharmacological intervention that helps treat fear, anxiety disorders, and panic attacks (Stillman et al., 2019). Due to the close links between the three conditions, one intervention is more likely to help treat the others, especially in a patient with all three or at least two of the conditions. 

Differences 

Biological and Psychological Contributions 

The main difference between anxiety and fear lies in their causes. From a developmental point of view, anxiety disorders are different from fear and panic attacks because they persist beyond established developmentally appropriate periods (American Psychiatric Association, 2013). Furthermore, anxiety disorders are different from transient fear induced by a stressful situation by being persistent. Lastly, individuals with an anxiety disorder are highly likely to overestimate the magnitude of the danger they will fear or try to avoid. These differences form the basis of other differences between panic attacks and anxiety disorders. 

For instance, while anxiety disorders might take time to appear, panic attacks are sudden. As a result, any panic attack episode is always severe and highly disruptive. In contrast, anxiety caused by any anxiety disorder manifests at different levels, from mild to moderate, and severe. The magnitude of the anxiety is determined by the individual’s response to the external stressor, such as dreading a performance review or walking down a dark alley alone. Furthermore, a panic attack can be sudden or acute then subside in a few minutes. In contrast, anxiety symptoms can take time to increase before manifesting. Compared to a panic attack, anxiety requires time before symptoms manifest. In a similar manner, the symptoms for anxiety take significantly longer to subside compared to a panic attack. 

However, there is a type of panic attack that has no trivial cause and is different from the expected panic attack. The Diagnostic and Statistical Manual of Mental Disorders handbook (DSM-5) recognizes this type of panic attack and calls it an unexpected panic attack (American Psychiatric Association, 2013;Park & Kim, 2020). The unexpected type is different because though it results in the same emotional and somatic response, it is not triggered by any known external stressor, like fear or anxiety. 

Conclusion 

In conclusion, fear, anxiety disorder, and panic attacks share more similarities than differences. For instance, the three conditions trigger the same stress response due to their high comorbidity with each other. Similarly, an individual can experience anxiety and a panic attack simultaneously. The cause can be overwhelming fear about an uncertain event in the future. At the same time, fear can be caused by anxiety. At the same time, the three conditions have several differences. For instance, while anxiety disorders might take time to appear, panic attacks are sudden. 

References 

American Psychiatric Association, A. P., & American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. 

Asher, M., Asnaani, A., & Aderka, I. M. (2017). Gender differences in social anxiety disorder: A review.  Clinical psychology review ,  56 , 1-12. 

Bandelow, B., Michaelis, S., & Wedekind, D. (2017). Treatment of anxiety disorders.  Dialogues in clinical neuroscience ,  19 (2), 93. 

Gevirtz, R. N. (2021). Psychophysiological Interventions for Stress‑Related, Medically Unexplained, and Anxiety Disorders.  Principles and Practice of Stress Management , 131. 

Guina, J., & Merrill, B. (2018). Benzodiazepines I: upping the care on downers: the evidence of risks, benefits and alternatives.  Journal of clinical medicine ,  7 (2), 17. 

Pamungkas, D. S. (2019).  The Analysis of Agoraphobia on The Main Female Character in The Woman in the Window by AJ Finn  (Doctoral dissertation, Universitas Buddhi Dharma). 

Park, S. C., & Kim, Y. K. (2020). Anxiety Disorders in the DSM-5: Changes, Controversies, and Future Directions.  Anxiety Disorders , 187-196. 

Perrotta, G. (2019). Panic disorder: definitions, contexts, neural correlates and clinical strategies.  Current Trends in Clinical & Medical Sciences, Curr Tr Clin & Med Sci ,  1 (2), 1-10. 

Stillman, M. A., Glick, I. D., McDuff, D., Reardon, C. L., Hitchcock, M. E., Fitch, V. M., & Hainline, B. (2019). Psychotherapy for mental health symptoms and disorders in elite athletes: a narrative review.  British journal of sports medicine ,  53 (12), 767-771.