- Symptoms of fear and panic are remarkably similar. They involve the physiology of threat.
- The difference between fear and panic is that the former is based on real threats, whereas the latter is unnecessary.
- Panic is much less dangerous than we think and represents an inner strength that can save our lives.
Over the past few years, you may have had a “false positive” COVID-19 test. This occurs when the test result is “positive” even though you didn’t have COVID-19.
You may also have had a “false negative” test, which showed that you did not have COVID-19 when you were infected.
Of these two options, which is better?
In the medical world, false positives might be annoying, but they are usually safer because they lead people to take more precautions than necessary. On the other hand, false negatives can be outright dangerous since they erroneously indicate that everything is fine when, in fact, there is a problem that needs to be managed.
If you got a false positive COVID-19 test, the worst-case scenario is that you stayed home when you could have gone out. If you got a false negative, you might have unknowingly infected others.
Viewed through this lens, panic is a great blessing. Allow me to explain.
Jenn, a busy mother of three young children, came to my office with panic disorder. She reported having regular panic attacks involving a rapid heart rate, shortness of breath, muscle tension, dizziness, and stomach upset multiple times per day. She was convinced that there was something very wrong with her body.
Given her distress, she was incredulous when I told her that her panic was a blessing: “I’m going out of my mind! How can you say that?”
I explained that the fact that she was having panic indicated that her fight-or-flight system–also known as the fear response–was working properly. I went on to explain that fight-or-flight is what keeps us safe in the event of an actual emergency.
I asked Jenn if she had ever experienced a situation that was genuinely unsafe, and she told me the following story:
It was early in the morning on a crisp fall day, and her children were playing in the front yard as Jenn made final preparations for their departure for school. The family was ahead of schedule, and Jenn took the opportunity to pick up a quick basketball game with her kids when the ball rolled into the street. Jenn nonchalantly went down the driveway to retrieve the ball when suddenly, a car came screaming toward her.
In the flash of an eye, Jenn’s breath and heart rate went into hyperdrive, and her muscles got a burst of fresh oxygen, which enabled her to jump out of the way. In the wake of the event, Jenn felt dizzy, and her stomach was in knots.
“The panic symptoms you’re experiencing these days are simply a false positive fear response,” I told Jenn. “There is nothing wrong with your body. If you didn’t have a healthy fear response, you would probably have been hit by that car.”
I went on to explain that symptoms of fear and panic are remarkably similar, because both involve the physiology of threat. When we perceive a risk to our safety, adrenaline secretes into our bloodstream, resulting in a host of effects:
- The pupils dilate to expand your field of vision and increase your perception.
- The digestive system slows to divert energy to muscles and vitals.
- Blood gets diverted from your extremities into the torso to help your organs function optimally.
- Muscle fibers tense up to prepare you to act with greater strength.
- Heart-rate increases to circulate more oxygenated blood to the muscles (which enables them to respond stronger and faster).
- Breathing-rate increases to supply the increased need for oxygen.
All these “symptoms” of fear help us notice danger and respond to it by springing into action. And so, fear is a good thing–a very good thing.
The only difference between fear and panic is that the former is based on real threats, whereas the latter is unnecessary.
“So, how can I feel less anxious without eliminating my fear response?” Jenn asked.
It was a great question. It was exactly the question to be asking.
I shared with Jenn that when she feels panicky without a real threat being present, she should reappraise her panic as simply being a misfire of her natural physiological response to threat.
I went on to explain that she should remind herself that having a robust fear response saved her life once, and that it’s a critical tool to maintaining her physical well-being and increasing the chances of her survival.
I then told her, “Anything as powerful as the fear response will, at times, be overactive. But better a false positive than a false negative.”
Jenn had an “aha” moment from that final comment. “So, when I feel panicky, I should just think that this is normal and there is nothing wrong with my body. I should be thankful that my threat physiology is working?”
“Exactly!” I responded.
Jenn followed up with me one week later and said that our one meeting had taken a huge bite out of her panic. I reflected that this is consistent with recent literature suggesting that a single session of psychoeducation can have up to 82 percent efficacy in treating panic disorder, with effects lasting a full year or more (Mitsopoulu et al, 2020).
In sum, panic is much less dangerous than we think and represents an inner strength that can save our lives. Thinking about this simple fact can make a huge difference in reducing our distress when we feel anxious.
Titika Mitsopoulou, Yiannis Kasvikis, Lia Koumantanou, Georgios Giaglis, Petros Skapinakis & Venetsanos Mavreas (2020) Manualized single-session behavior treatment with self-help manual for panic disorder with or without agoraphobia, Psychotherapy Research, 30:6, 776-787, DOI: 10.1080/10503307.2019.1663956