A question I'm often asked relates to the differences between anxiety and panic and whether one is just an extension of the other. Well, there are differences, so what better place to start than in the brain itself.
If you were able to monitor the brain activity of someone who worries, you would see quite a lot of activity in the left hemisphere of the brain, even when the person is at rest. One of the many roles of the left hemisphere is the control of speech production. People who worry very often verbalize their concerns so it makes perfect sense to see such activity in the left hemisphere. Compare this with people who experience panic and the differences are clear. Right hemisphere activity is much more marked. Again, from a physiology perspective, this makes perfect sense. The right side of the brain is more concerned with the regulation of physical activities such as heart rate, blood pressure, sweating and the production of hormones associated with stress.
The ability to demonstrate certain differences between people who worry and those who panic is one thing, but forming an understanding of the neural basis of fear, panic and anxiety is quite different. We know that some of our fears are learned by communication or association, yet others appear to be innate. Then we have the sheer variety of anxiety-related conditions which some 19 million Americans suffer, such as phobias, generalized anxiety disorder (GAD), obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD) and panic disorder. Some of the symptoms are unique and others are shared.
A shared characteristic of anxiety and panic is the effect is has on daily living. Daily routines, relationships, work and pastimes are frequently disrupted. In turn, the relentless nature of such conditions can lead to depression and it is not uncommon to find people being treated for depression rather than its cause. The search for some physical meaning behind the condition is a very common feature in people who experience panic.
Panic is associated with very marked physical symptoms. These may include shortness of breath, dizziness, chest pains, tightness around the head, stomach cramps or other physical symptoms. The person has a genuine and sincere belief that they are about to die, or lose control or go crazy. The first experience of a panic attack is often followed by a medical examination and heightened concerns when the doctor can find nothing physically wrong. It is often left to the patient to work out that if nothing physical can be found, it must be psychological. Unfortunately many people either can't or don't make this association and simply cannot believe their physical symptoms could have resulted from panic.
People with more general levels of anxiety do not associate their situation with a medical condition, although at times of high anxiety they could well experience a general sense of being unwell and of feeling nauseous. It is quite common for people with long-term anxiety to experience problems with digestion, frequent urination, flatulence, constipation and/or diarrhea. People who suffer with generalized anxiety disorder experience a disproportionately high level of concern over a whole variety of issues, but often focusing on perceived dangers to members of their family, friends or others. They may get tired very easily yet have great difficulty getting to sleep. A sense of restlessness, tension, vigilance and the inability to focus or concentrate for periods of time is common.
It's important to end on a positive note and to point out that anxiety-related conditions tend to respond very well to treatment by a qualified therapist. For some people their problems can be completely treated whilst for others they invariably feel better for the intervention.
Published On: June 16, 2009