Could Your Panic Be Anger?

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You feel trapped. Your heart begins to race, and your hands begin to sweat and tremble. As your chest begins to hurt, you realize that you cannot take deep breaths. You've been arguing with your spouse and as your words grow louder, you become afraid of losing control. You can't even remember how this started, but now you feel so overwhelmed that you want to throw something against the wall. You've just experienced a painc attack, right? Maybe not... What is an anger attack? Maurizio Fava, MD, and Jerrold F. Rosenbaum, MD, are leading the way in the research of anger attacks and their treatment. Their studies have included research on anger attacks in both depressed and anxious subjects. According to Fava and Rosenbaum, anger attacks may be defined as follows: Anger attacks are sudden intense spells of anger that resemble panic attacksbut lack the predominant affects of fear and anxiety associated with panic attacks. They typically occur in situations in which an individual feels emotionally trapped and experiences outbursts of anger that are later described by the patient as being uncharacteristic and inappropriate to the situation at hand. Anger Attacks vs. Panic Attacks If anger attacks and panic attacks are so similar, how do we tell the difference? The feeling of being trapped may trigger both kinds of attacks. Both attacks begin suddenly and feel intense. Fava and Rosenbaum point out that fear and anxiety are not predominant symptoms in anger attacks as they are in panic attacks. The problem is that sudden intense emotions often feel similar to one another. How do we know which emotion is predominant? To understand these two kinds of attacks further, it may help to see the symptoms of each type of attack: Anger Attacks (from Fava & Rosenbaum) 1. Irritable feelings in past six months 2. Angry overreaction to small irritations 3. One or more anger attacks experienced in past month 4. Inappropriate anger directed towards others 5. The occurance of at least 4 of the following- A. heart pounding, racing B. chest pains C. sweating D. shaking trembling E. shortness of breath F. dizziness, lightheadedness G. tingling, itching skin H. fear of losing control I. intense fear, anxiety J. cold or hot flashes K. feeling like attacking others L. attacking others (physically, verbally) M. throwing, destroying objects Panic Attacks During a panic attack, some or all of the following sypmtoms occur. A. Noticeably quick or pounding heartrate B. Pain or other discomfort in the chest C. Sweating D. Shaking E. Difficculty breathing, shortness of breath F. Dizziness G. Tingling sensations H. Fear of going crazy or losing control I. Fear of dying J. Derealization or Depersonalization K. Choking sensation L. Nausea M. Cold or hot flashes As can be seen, anger attacks contain the same symptoms as panic attacks; however, to be an anger attack, the experience must contain additional symptoms. By exploring feelings such as ongoing irritability and behaviors such as directing anger towards others or throwing objects, one may gain a better understanding of the differences between the two kinds of attacks.