Being able to discern an anxiety attack versus a panic attack is challenging, as the two mental health concerns overlap greatly. At times, people do not see panic attacks and anxiety attacks as separate issues since many use the terms interchangeably. After learning the facts, noting panic vs. anxiety attacks becomes possible.
The differences are significant, with panic attacks being a diagnosable, discrete burst of symptoms, and anxiety attacks being a colloquial phrase used to describe periods of anxiety. As this article will show, the term “panic attack” does not just mean a spike in anxiety, but a set of specific symptoms and criteria.
Signs and Symptoms of Panic Attacks & Anxiety Attacks
There is plenty of confusion over panic attacks and anxiety attacks that mostly stems from the two issues having many overlapping symptoms. Both issues are marked by strong feelings of anxiety, stress, fear, worry, and confusion, but they are unique.
Panic attacks are well-documented and researched mental health concerns. Panic attacks are listed in the American Psychiatric Association’s (APA) text called the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which defines and validates the condition.
On the other hand, anxiety attacks are only a phrase people use to express times of feeling very anxious. The term “anxiety attack” is found nowhere in the DSM, so it is not an officially recognized condition.1
Symptoms of a Panic Attack
Panic attacks can occur connected to other mental health conditions like specific phobias, or they can be at the center of the issue like in the case of panic disorder. Panic attacks have an unmatched power to quickly shape a person’s thoughts, feelings, and behaviors.
The emotional symptoms of panic attacks include:1
- Extreme fear: Some fear that they are having a heart attack, that they are dying, or that something is seriously wrong with their body. Other people fear that they are losing control of their body, their mind, or that they are “going crazy”
- Derealization: A sense that a person’s surroundings or experiences are unreal or not actually happening
- Depersonalization: A sense or feeling that a person is not connected to their body, they are in a dream, or that they are observing their actions from outside of the body.
- Intense worry about the next panic attack and the possible outcomes
- Strong urge to flee the situation to find safety
Unfortunately, symptoms do not end there. Panic attacks trigger a host of physical health symptoms like:1,2
- Cardiac changes like increases in heart rate, palpitations, or heart pounding
- Feeling sweaty, especially in the hands, feet, and underarms
- Being shaky or trembling
- Struggling to catch one’s breath or the feeling of being smothered
- Feelings of choking
- Discomfort, pain, or tightness in the chest
- Feeling nauseous or sudden distress in the abdomen
- Feeling dizzy, unsteady, light-headed, or like one is going to faint
- Temperature changes like feeling hot or having chills
- Being numb or having a tingling sensation in locations like hands, feet, or face
Panic attack symptoms often begin very quickly but last for a limited amount of time. A full panic attack may end less than a minute after it begins, or it could last for 30 minutes.3 If someone experiences symptoms lasting an hour or more, panic is not likely the source.
Symptoms of an Anxiety Attack
Whereas panic attacks have a distinct set of symptoms outlined by groups like the APA, anxiety attack symptoms are defined less rigidly.
Each person’s experience with anxiety and anxiety attacks will differ, but some of the most common emotional anxiety attack symptoms are:1,2
- Strong and persistent worry
- Feeling restless
- Poor concentration and focus
- Fear that a situation will turn out badly
- Being irritable or moody
- Feeling hot or cold and clammy
- Feeling jittery or shaky
- A sense of being “keyed up” or restless
- A wanted or unwanted burst of energy
- Feely sweaty
- A queasy feeling in the stomach
- Increased heart rate
These periods of high anxiety could last for hours depending on the situation, but they will never escalate to the intensity and severity of a panic attack. They will present as discomfort, rather than extreme distress.
Could Both Occur at the Same Time?
Yes. Experts note that panic attacks and anxiety can occur simultaneously.2 Imagine a situation in which someone is having high anxiety in anticipation of a confrontation with a loved one. Then, when the confrontation is set to occur, the situation triggers a panic attack. During the panic attack, the preceding anxious symptoms do not go away. They are only covered over by the intensity of panic attack.
After the panic attack resolves, many symptoms linked to anxiety will remain and return to the foreground. The panic attack is over, but the anxiety continues.
Key Differences Between Anxiety Attack and Panic Attack
Panic attacks and anxiety attacks are not the same thing. The key differences between anxiety attacks versus panic attacks involve intensity, duration, and onset:2,3
- Intensity: Panic attacks live up to their name. These attacks bring on a sudden rush of emotional and physical changes. The symptoms are so intense that many people cannot immediately identify panic as the source, and instead, they believe something serious is happening physically. Anxiety may be more subtle and present with a slow build. Of course, anxiety may be intense as well, but it cannot match the force of a panic attack.
- Duration: Simply, panic attacks are short, and anxiety is long-lasting. For a person experiencing a panic attack, the minutes may feel like hours, but they rarely last longer than 30 minutes. Periods of high anxiety could last hours or days by comparison.
- Onset: A tell-tale sign of a panic attack is its discrete beginning and end. A person could be feeling fine one minute, have a panic attack start suddenly, and then it ends shortly after the initial symptoms. Anxiety usually ebbs and flows more gradually without a clear start and finish.
Although people cannot notice in the moment, panic and anxiety are controlled by different parts of the brain. Panic attacks are managed by the autonomic nervous system and the amygdala, aspects connected to the body’s fight or flight reaction. Anxiety is coordinated by the prefrontal cortex.2
Neither is a positive experience, but panic attacks will present with high intensity and short duration. Anxiety symptoms will be more chronic.
Causes & Triggers of Anxiety and Panic Attacks
Anxiety and panic attacks have triggers, and even though it may seem like symptoms randomly present at the oddest times, there is likely a connection. Any person, place, thing, or situation that makes someone feel endangered could be a trigger.3 Even imperceivable bodily sensations may start symptoms.
A person could have hundreds of triggers or only a handful. Additionally, something that triggers a strong reaction in one person may elicit no response in another.
The way people respond to triggers will be different, too. One trigger could send a person directly to a panic attack, while another trigger could spark some anxiety. With time and continued exposure, the anxiety could build towards panic.
Some of the most common causes of panic/anxiety attacks include:
- Specific situations like bridges, airplanes, heights, and elevators
- Certain animals like spiders, snakes, dogs, and mice
- Situations where a person could be embarrassed like public speaking and meeting new people
- Times of stress at work or school
- Periods of conflict with loved ones
- Financial, medical, or housing stress
Risk factors that predispose people to anxiety and panic attacks may overlap and come from a variety of temperamental, environmental, and genetic sources.
Someone more likely to have anxiety and panic attacks will have more risk factors, including:1
- Childhood experiences of physical or sexual abuse
- Long periods of relationship stress
- Disease or death in the family
- Experiences with substance use
- Having asthma, as asthma symptoms may correspond with the shortness of breath and fear linked to anxiety and panic
- Family members with anxiety, depressive, or bipolar disorders
- Overprotective or restrictive parents
Having anxiety is not necessarily a guarantee for having panic attacks, though. Many people have anxiety symptoms that never amount to panic attacks.
Each person’s unique balance of risk factors and protective factors increase or decrease the risk of symptoms. A person may have many risk factors but no symptoms because their protective factors are high. Conversely, a person could have few risk factors with symptoms because their protective factors are low.
For example, a person who has previous traumatic experiences, parents with anxiety, asthma, and high stress in life will be more likely to deal with anxiety and panic if these factors are unchecked by protective factors.
What to Do During an Anxiety or Panic Attack
Periods of high anxiety and panic attacks can be overwhelming and chaotic, so people may react emotionally, rather than using rational judgment and previously learned techniques to address the symptoms. Because of this, people should carefully consider and practice the best possible coping skills to manage symptoms and control their response.
Strategies that can help during a panic or anxiety attack are:3
- Notice the symptoms early: Prevention is always the best course of action, but if symptoms are already presenting, a person should work to identify and assess their experience. By checking in with themselves frequently, a person can notice symptoms changing and prevent them from worsening.
- Ride out the rush: The surge of feelings and sensations at the beginning of a panic attack are jolting and can send people into a state of alert. Rather than furthering the panic or anxiety, ride out this initial rush by staying presently aware of your surroundings and in the moment. Attend to the people and things around you.
- Label as discomfort, not danger: Anxiety is scary, and panic attacks are scarier. Even though these symptoms can trigger an intense emotional reaction, it is important to see these consequences as only discomfort, not danger. Tell yourself that the changes are due to anxiety or panic, so you do not escalate the worry by thinking you’re having a stroke or heart attack.
- Retrain thoughts: A person’s thoughts can improve or worsen the experience of anxiety and panic. Introducing calming and encouraging thoughts into the process can lower the intensity and duration. Tell yourself: “I can do this. This is only anxiety. I’m going to be okay. I can use my skills.”
- Seek positive behaviors: During a panic attack, finding the best coping skills can be challenging, but each person should have a few “go-to” skills. Calling a friend, performing a relaxation technique, listening to a favorite song, listing the 50 states, or exercising are all wonderful ideas, but each person may respond best to a different behavior, so continue experimenting.
- Avoid negative behaviors: Seeking positive behaviors is important, but avoiding the negatives is essential since a few unhealthy coping skills can undo all the positives. Using drugs, drinking alcohol, or engaging in any other problematic behaviors may improve symptoms in the short-term, but only create more issues in the future.
Stopping anxiety or a panic attack is very complicated, but these skills can help improve the situation, so this experience and the next can be better.
Long Term Treatment for People with Anxiety Attacks & Panic Attacks
People with anxiety or panic attacks may breathe a sigh of relief when symptoms lift, but during these times, one must commit to long-term treatments like therapy, medication, and lifestyle changes to prevent future attacks. With a combination of professional and at-home treatments, a person can achieve the symptom relief they seek.
With its limited risks and high rewards, therapy or counseling for anxiety and panic attacks are a great first choice. One of the most successful and frequently-recommended forms of therapy is called cognitive behavioral therapy (CBT).4
CBT helps teach the person a new way of thinking and behaving to target symptoms of anxiety and panic disorder. Once a person can find new ways to respond to the onset of anxiety, the attacks will improve.4
CBT can also help people:
- Better identify the triggers of their symptoms
- Plan clear and simple responses to symptoms
- Address and resolve underlying issues feeding into anxiety and panic
- Learn relaxation techniques to be used during calm periods to lower stress levels
- Differentiate between positive and negative coping skills
- Improve their communication skills to limit conflicts
At times, CBT can be uncomfortable as exposure, either real or imaginary, to sources of anxiety is common practice. A person who experiences panic at the sight of spiders may be asked to imagine, see, or even touch a spider to reduce symptoms. Though the process may create periods of worsening symptoms, in time, it will desensitize the person, so they no longer experience strong reactions to the trigger.5
People who do not get the desired relief from therapy alone may explore medication options for anxiety and panic. For anxiety and related symptoms, there are two main options—benzodiazepines and antidepressants.4
Benzodiazepines are a group of sedative medications known for their ability to decrease panic and anxiety symptoms quickly. These substances are effective, but they are only recommended for short-term use because they can result in tolerance and physical dependence, even when used as prescribed. Examples of this medication include Xanax, Ativan, and Klonopin. These medications are less problematic for misuse when they are taken infrequently than when they are used regularly to try to treat more constant forms of anxiety.
Antidepressants, like selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), can help with anxiety as well as depression. They take longer to work compared to benzodiazepines, but they carry no addictive potential. Some examples include Zoloft, Lexapro, Prozac, and Effexor. They are taken every day, not just in times of anxiety or panic.
Beta-blockers are another class of medications used to address anxiety and panic. These medications help slow a rapid heart rate, which can be a helpful way to lower the physical symptoms of anxiety. Examples include metoprolol and nadolol.4
Medications come with a risk of side effects, so each person should communicate with their prescriber any time a side effect arises or worsens. If the side effect becomes worse than the anxious symptoms, a medication change is warranted. Always consult with the professional before changing the way you take a medication as adjusting or stopping the dose could result in unwanted effects.
Lifestyle changes are often small, but their impact on anxiety and panic can be significant. Even better, these adjustments are often free. Even if they do not improve anxiety, they can improve a person’s overall mental and physical health.
Some simple lifestyle changes include:6
- Increasing physical activity: It may not be convenient, always fun, or enticing, but exercise is a wonderful coping skill for so many problems plaguing people. Exercise can have a similar effect on the brain as medications without the risk of side effects. People with anxious symptoms could respond especially well to yoga or tai chi, but an easy walking program may be the best place to begin.
- Shifting your diet: What you eat affects how you feel. Cutting out or back on caffeine could have an immediate impact on anxiety. Meanwhile, try to eat balanced meals, drink enough water, and look for ways to boost your digestive health.
- Improving the quality and quantity of sleep: Anxiety and panic can severely disrupt sleep, which is why people need to prioritize it. Set aside time for sleep and limit distractions like TVs and phones for a restful night.
- Reducing stress: Nearly everyone experiences stress, but people with anxiety and panic need to honestly review their stress reduction efforts. Are actions helping or hurting the cause? If stress is too overwhelming, consider consulting with professionals for new strategies.
- Increasing social support: Friends, family members, coworkers, religious officials, and countless others can all help reduce the burden of anxiety. Be sure to seek out the supportive people and beware of those who do not seem to have your best interests in mind.
With a balanced approach to lifestyle changes, your whole self will be happier and healthier.
Additional Resources for Panic & Anxiety Attacks
Fantastic organizations are working daily to help those dealing with high levels of anxiety and panic attacks achieve the symptoms relief they seek.
Some notable groups include: