Is It a Panic Attack or Anxiety?

A therapist explains how to distinguish between the two

Michele DeMarco, PhD
Elemental

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Person in a dark background with a cobalt blue light on their face, looking despondently at the camera.
Image: Kyle Cleveland/Unsplash

I was eight years old when the wrecking ball of doom came a-swinging. One minute I was riding my Huffy Sweet Thunder down the road, speed lifting my pigtails, adrenaline twisting the handlebars as I launched off the curb, bravado daring me to let go, as if to say, “Hell ya, I’m omnipotent.” And the next moment, invincibility took a digger. I landed with a face full of dirt and a mouthful of blood, heart on fire, trembling like a newborn in the cold, drenched as if I had just gone swimming. I can still feel my T-shirt clinging to my back.

I was in the world, but not of it. My mind was screaming, “run away…run away!” But my body was frozen. What exactly I was running from I wasn’t sure. All I knew was that some reality had just blindsided me, awakening a terror within.

After five or so minutes in Dante’s inferno, the terror gave way, and some sense of “normal” returned. I pushed myself up from the dirt, de-clung my shirt, took a deep breath, and tried to steady myself enough to ride. I was wobbly for a while — not only while peddling my bike, but also inside; my thoughts, feelings, and mood all were “off.”

Whether it was from fear, shame, confusion, or some combination thereof, I kept the whole disconcerting episode a…

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Michele DeMarco, PhD
Elemental

Award-winning writer, therapist, clinical ethicist, and researcher specializing in moral injury. I talk about the stuff many won’t. micheledemarco.com