Your heart suddenly starts pounding, you can’t breathe properly and you feel like you’re going to die. It’s come from nowhere – no symptoms and no obvious triggers – and it’s very scary.

Many people have one or two panic attacks like this in their lifetimes. But some people experience this again and again, and live in constant fear of when the next one will strike. A panic attack is different from anxiety in its cause and intensity. You feel like you’re losing control – there’s an intense fear when there’s no real danger – and the physical reactions to this fear can make you feel like you are having a heart attack. They make no sense - they can occur when you’re relaxed or even asleep.

While occasional anxiety is a normal part of life, extreme fear and worry are not. Anxiety disorders, which include panic disorder, generalised and social anxiety disorders and specific phobias, are fairly common in South Africa, affecting about 1nin 5 people, according to the SA Depression and Anxiety Group (Sadag).

Anxiety vs Panic

Anxiety describes a number of disorders that usually bring about feelings of fear, nervousness and worry, says Megan Hosking, psychiatric intake clinician at Akeso psychiatric clinic. A panic attack, on the other hand, is sudden and can be very extreme.

“Anxiety can build up over a period of time and goes hand in hand with stress. It is difficult to locate the possible source of a panic attack. It also has more intense physical symptoms such as chest pains.

“An anxiety attack can be a symptom of unmanaged anxiety but it will appear as a result of a trigger or stressor. A panic attack doesn’t occur as a result of a specific trigger or stressor and is unpredictable.”

Hosking points out there are also similarities, such as sufferers experiencing nausea, a lot of sweating and discomfort. Probably the easiest way to distinguish between the two is by comparing the symptoms.

Signs and symptoms

Anxiety attacks follow a period of excessive worry and may become more pronounced over time. They are typically less intense than those of panic attacks and include:

  • Feeling nervous, tense or restless
  • Having a sense of impending danger, panic or doom
  • Having an increased heart rate
  • Breathing rapidly
  • Sweating
  • Trembling
  • Feeling weak or tired.


Take control – try not to let your fear overwhelm you. Do this by acknowledging what is happening and reassure yourself that the symptoms will soon pass and your anxiety will drop.

Breathe slowly and deeply – problems with your breathing during an attack are common. Try to slow your breathing down by focusing on your breath. Close your eyes and inhale and exhale as slowly and steadily as possible. Breathe deeply so that your lower belly expands when you’re breathing in. It might help to count as you breathe in and out.

Relax your muscles – this may not be easy, but anxiety causes your body to tense up so try to make a conscious effort to relax each muscle in your body, focusing on one at a time. Pull your shoulders up to your ears, squeeze them together then push them down slowly.

Learn relaxation techniques and mindfulness practises for prevention and symptom management – work with your therapist and ask them for programmes you can follow at home.

Name of the Publication: W24
Title of the article: 4 ways to manage anxiety attacks
Topic: Anxiety
Date: 15 Sept 2019
Author: Palesa Matjebele
Online link: