Anxious feelings are normal to have from time to time and anxiety generally happens in response to stressful circumstances. However, for people with severe anxiety, experiencing excessive levels of anxiety and fear on a regular basis is not uncommon. Many people with high anxiety levels basically experience attacks of intensive stress, which can be described as having severe anxiety, for a substantial period.
Severe anxiety occurs when a person has worrisome thoughts, nervous tension and physical symptoms like increased heart rate, shortness of breath and sleeping difficulties. This typically happens if the anticipation of an event or circumstance accumulates and reaches a point where it becomes overwhelming. At this stage, it may feel like an 'attack' that is accompanied by various unpleasant physical and psychological symptoms.
The term 'anxiety attack' is actually an informal term that is not officially listed in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). These types of attacks of anxiety are a casual term that anxiety sufferers generally use to describe severe and extended periods of anxiety. The definition of a panic attack, however, is listed in the DSM-5 so there is a clinical agreement on the definition of panic attacks.
Although the words 'panic' and 'anxiety' are sometimes used interchangeably, they are not identical. They may have a number of similar symptoms but there are essential differences between these conditions.
The intensity of a panic attack is usually more severe than an anxiety attack. Panic attacks involve a fear of losing control as well as depersonalisation or derealisation. They are also unpredictable and happen spontaneously. An anxiety attack typically results from a buildup of worry and tension associated with a certain event or circumstance.
Anxiety symptoms are usually related to other psychiatric health conditions like generalised anxiety disorder, obsessive-compulsive disorder or a traumatic life event. Panic attacks, on the other hand, mainly affect people with panic disorder.
The duration of a panic attack is also considerably shorter than an anxiety attack. The following table shows the symptoms that are associated with panic attacks vs those associated with anxiety:
|Psychological||Feelings of worry and nervousness||- Less likely|
|Difficulty concentrating||- Less likely|
|Restlessness and irritability||- Less likely|
|Fear of losing control or dying|
|Feeling detached from surroundings (derealisation)|
|A feeling of detachment from oneself (depersonalisation)|
|Physical||Increased heart rate, pounding heart or palpitations|
|Difficulty breathing or shortness of breath|
|Tightness in throat|
|Trembling or shaking||- Less likely|
|Feeling light-headed or unsteady||- Less likely|
|Nausea, upset stomach or abdominal pain||- Less likely|
|Numbness or tingling sensations||- Less likely|
Attacks of anxiety typically cause a person to feel on edge and wound up for long periods. This often leads to other symptoms like feelings of irritability, difficulty concentrating and sleeping problems. These attacks can be frightening and seem terrifying, but thankfully they are not physically dangerous.
You can be assured that these attacks will eventually pass and it is important to understand that the negative feelings associated with anxiety are temporary. People who experience attacks generally regain a sense of calmness and self-control soon enough and there are coping strategies that can help. In addition, clinicians often recommend the use of medications like benzodiazepines to help calm an anxious mind.
These attacks can vary in terms of duration, depending on various factors like what is causing the anxiety and how you treat it. Unlike a panic attack, which typically reaches a peak within 5-10 minutes and subsides within about 30 minutes, an anxiety attack tends to develop gradually.
They also last longer and may be persistent, taking days, weeks or even months before the anxiety subsides. These attacks typically disappear when the stressor, such as a health issue or relationship problem, has been resolved.
These attacks may induce unpleasant symptoms like chest pain and difficulty breathing but fortunately there are calming methods you can use to help. You can slow your heart rate, improve mood and reduce stress levels by taking deep breaths.
Start by breathing in for 5 seconds and allow 7 seconds to breathe out. This can increase the blood supply and oxygen to the brain, which promotes a sense of calmness. Another way to practise deep breathing is to learn how to breathe from the diaphragm of your body, also known as belly breathing.
Changing negative thoughts can also be a useful way to prevent anxiety or reduce the severity of it. If you feel anxious, try writing down the thoughts in your mind and see if they make any sense. Thoughts are often unclear and distorted when anxiety levels are high so they should be questioned. If you are experiencing automatic negative thoughts that make you feel anxious, try altering your thought process.
Identify negative thoughts and replace them with more positive, rational ones so you can have more control over your reaction to anxiety. In general, negative thoughts are associated with anxiety so restoring a positive mindset can help counteract anxiety. There are also lifestyle changes you can make to prevent anxiety or reduce the symptoms and these include:
If you find that coping techniques do not provide adequate anxiety relief, anti-anxiety medication is available for the short-term treatment of acute anxiety. Benzodiazepines such as Diazepam 10 mg tablets and Xanax 1 mg pills are generally most recommended for anxiety which is severe and causing a significant amount of distress.
Anxiety is believed to be caused by an imbalance of chemicals in the brain. One specific chemical is known as gamma-aminobutyric acid (GABA) and it is responsible for calming activity in the nervous system. Benzodiazepines enhance the production of GABA, which alleviates nervousness and an anxiety attack.
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Updated: 27th January 2021
Review Due: January 2022
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