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.
Panic Attack Symptoms
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.
Mental & Emotional Symptoms
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
Physical Symptoms
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.
Panic Attacks & Panic Disorder
Panic disorder is the mental health diagnosis given to people with recurrent panic attacks. Not all people who experience panic attacks will have panic disorder, but all people with panic disorder will have panic attacks.
Anxiety Attack Symptoms
Whereas panic attacks have a distinct set of symptoms outlined by groups like the APA, anxiety attacks are not a diagnosable condition, so symptoms are defined less rigidly.
Mental & Emotional Symptoms
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
- Nervousness
- Feeling restless
- Poor concentration and focus
- Fear that a situation will turn out badly
- Being irritable or moody
Physical Symptoms
Anxiety has the ability to affect someone’s physical health as well. An anxiety attack can influence someone’s physical health with:1,2
- 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
- Feeling 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.
The Difference Between Anxiety Attack and Panic Attack
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
The key differences between anxiety attacks versus panic attacks involve: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 put, 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 obvious beginning and end. A person could be feeling fine one minute, have a panic attack start suddenly, and then feel it end shortly after the initial symptoms. Anxiety usually ebbs and flows more gradually without a clear start and finish.
Activation in the Brain
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.
Triggers
The triggers of anxiety attacks tend to be less intense and less frightening than the triggers of panic attacks. For example, being confronted by a small dog could trigger anxiety, but having a pack of aggressive dogs running towards you could trigger a panic attack.2
Outward Appearance
People experiencing an anxiety attack might be able to experience the symptoms without anyone noticing. The same may not be true of panic attacks. Due to the intensity and sensations of a panic attack, they will likely be more obvious and apparent to others.
Can Both Anxiety & Panic Attacks Occur at the Same Time?
Yes, 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 the 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.
What Causes Anxiety & Panic Attacks?
Any person, place, thing, or situation that makes someone feel endangered could trigger anxiety, and potentially a panic attack.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.
Some of the most common causes of panic attacks and 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
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.
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 responses.
Strategies that can help during a panic attack or anxiety attack are:3
Notice the Symptoms Early
Prevention is always the best course of action, but if symptoms are already happening, 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.
Call It Discomfort, Not Danger
Anxiety is scary, and panic attacks are even 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 Ways to Cope
During a panic attack, finding the most helpful coping mechanisms 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 different behaviors, so continue experimenting.
Avoid Substances & 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.
Diagnosing a Panic Attack Vs. Anxiety Attack
Since an anxiety attack is not an official diagnosis, no professional will offer this label. On the other hand, panic attacks are an important part of mental health conditions like phobias, agoraphobia, and panic disorder. A professional like a primary care physician or a licensed therapist may offer this diagnosis when anxiety symptoms are present.
Treatment for Anxiety & Panic Attacks
It’s important to commit to long-term treatments for panic attacks like therapy, medication, and lifestyle changes to prevent future problems. With a combination of professional treatments and at-home remedies, a person can find relief from their anxiety.
Therapy
With its limited risks and high rewards, therapy for anxiety and panic attacks is a great first choice. One of the most successful and frequently-recommended forms of therapy is 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
At times, CBT can be uncomfortable as exposure to the 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
Medication
People who do not get the desired relief from therapy alone may explore medication options for anxiety and panic disorder. For anxiety and related symptoms, there are two main options—benzodiazepines and antidepressants.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 should be made. Always consult with the professional before changing the way you take medication as adjusting or stopping the dose could result in unwanted effects.
Lifestyle Changes
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.
For Further Reading
Anxiety Attack vs Panic Attack Infographics
