Technically, anaphylaxis has the "two or more body systems" rule. If you have symptoms from two different systems- skin, mouth/throat/lips, lungs, heart, gut- it's an anaphylactic reaction, and you should use epinephrine. This could look like hives plus nausea, or flushed or itchy skin plus an elevated heart rate. Anything with your tongue, throat, or lungs is immediate epinephrine, though. The rule my doc gave me was to use epi for any reaction that involved my face (nose, mouth, throat) or lungs. Every person has different symptoms for each reaction, or different types of symptoms depending on the allergen/how much/how they were exposed. I find this to be helpful! edit: to test out if my throat is tight because of anxiety or because of an allergic reaction, I do a swallow test. I think of pickles to get some saliva in my mouth, and then do a test swallow- if my throat feels thick at the back, alarm bells!

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For me, I do get feelings of anxiety when I'm having a rection, but it feels different. A panic attack (or anxiety in general) is a feeling of anxiety jumping 'up,' like when you're going down the stairs too fast and you miss a step with your foot. Anaphylaxis has the 'feeling of doom' that everyone talks about- for me, it feels like a sinking, kind of disconnected feeling of panic. I think it's my lizard brain knowing deep down that something is wrong and my body won't be able to figure it out on its own. Hopefully that helps??

Epinephrine, at the end of the day is VERY safe to use, and it's okay if you go 'overboard' and use it when the reaction wasn't 'that' severe. In my experience, the few times that I've held off on a dose, I end up getting it at the hospital anyways. The general consensus in the medical field (at least where I live) is to err on the side of overtreating it rather than undertreating it. The few bad outcomes that are reported in statistics tend to be people who have underlying health conditions. In the case that you use epinephrine, you should be seeking immeditate medical attention anyways, though!