It's not uncommon to hear people use the terms anxiety attack and panic attack interchangeably. While they share similar symptoms, which can include dizziness, increased heart rate, and shortness of breath, they are different conditions requiring different treatment approaches. Health care professionals use the terms to refer to specific symptoms and disorders.
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Anxiety is a normal response to danger. The automatic fight-or-flight response is activated when you feel pressured, threatened, or are facing a stressful situation, such as an exam, job interview, or a first date.
It is your body's built-in protective response to potential danger, but it becomes an issue if your anxiety is excessive or affects your daily life.
If you experience mild to moderate anxiety, this can be helpful to stay alert and focused. It can also spur you to action and motivate you to solve problems. However, if your anxiety becomes constant or overwhelming, and your fears and worries interrupt your daily life, you may have an anxiety disorder.
There is a range of anxiety disorders that have both similar and different symptoms that vary from person to person. One person with anxiety may feel highly anxious when they think about work, while another person may feel anxious when they think of meeting and mingling with new people at a social event. Another person has a constant barrage of uncontrollable or intrusive anxious thoughts, while another is often tense and worried.
All anxiety disorders are characterized by an intense feeling of fear and worry that becomes overwhelming and difficult to control.
People who experience significant anxiety often call it an anxiety attack. Although this is not a formal diagnosis included in the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-V), it is a commonly used term.
Panic attacks, on the other hand, are a sudden surge of excessive fear or discomfort accompanied by other physical and psychological symptoms. A panic attack is an abrupt episode of intense terror when there is no apparent cause or real danger.
These attacks cause sweating, increased heart rate, and difficulty breathing. You may even feel as if you're having a heart attack.
When you worry about experiencing another panic attack or you change your behavior to avoid another attack, you can develop panic disorder. This is a fairly common mental health disorder in the US.
Panic disorder is diagnosed when someone has recurrent and unanticipated panic attacks. The DSM-V¹ adds that panic attacks reach their peak within minutes and can last up to half an hour, but they are relatively brief episodes.
When experiencing a panic attack, an individual will experience at least four separate panic symptoms.
The trademark feature of a panic disorder is that it comes with no warning or identifiable trigger. This unpredictability makes individuals who suffer from panic attacks feel a loss of control over their situation. Panic attacks can occur daily for some people and less frequently for others.
Anxiety attacks can have specific triggers, such as workplace issues, relationship problems, or health issues, while panic attacks have no specific triggers.
An anxiety attack is not a diagnosable condition in itself, while a panic attack can be a symptom of panic disorder, which is a diagnosable condition.
Panic attacks have more severe symptoms than anxiety attacks. A person experiencing a panic attack can even genuinely feel like they are about to die. For this reason, people with panic attacks are more likely to need medical attention, unlike those with anxiety attacks.
Anxiety attacks often develop gradually when a person becomes anxious, while panic attacks can happen in an instant even when a person is calm right up until that point.
How each attack starts
An anxiety attack often develops gradually and can be mild, moderate, or severe. The person suffering an anxiety attack may feel that things will turn out fine if they can find a solution to their problem.
By contrast, a panic attack can occur abruptly without warning, and cannot be prevented. It can happen at any time when an individual feels anxious, calm, or even when sleeping.
A panic attack will generally peak within a few minutes whereas an anxiety attack usually builds up and continues for a longer period.
Anxiety attacks have both physical and psychological symptoms.
Psychological symptoms include:
Feeling tense and jumpy
Thinking the worst will happen
Physical systems include:
Shaking or trembling
Frequent urination or diarrhea
Shortness of breath
Due to these physical symptoms, people with anxiety can mistake their condition for another medical illness with similar symptoms.
Symptoms of a panic attack include:
Shaking or trembling
Shortness of breath
Pounding or racing heart
Dizziness or weakness
An out-of-body feeling
Chest pain or discomfort
Tingling or numbness in the arms, feet, hands, or legs
Chills or hot flashes
Sense of unreality or dreamlike sensations
Having four or more of the above symptoms is enough to classify the condition as a panic attack.
A person experiencing a panic attack may feel an intense fear of going crazy, losing control, or even dying during the episode.
Panic attack symptoms can also be mistaken for symptoms of other diseases affecting the gastrointestinal system, nervous system, heart, or lungs. These similarities may intensify a person’s fear and anxiety during or after a panic attack. For example, they may think they are having a heart attack.
Panic attacks have no known external triggers, while anxiety attacks can be triggered by an identifiable source of stress. The following common factors may play a role in both types of attacks:
Withdrawal from alcohol or drugs
Medication and supplements
A stressful job
Chronic diseases, such as irritable bowel syndrome, heart disease, asthma, and diabetes
Phobias, including acrophobia (fear of heights), agoraphobia (fear of crowded or open spaces), and claustrophobia (fear of small spaces)
Traumatic memories or triggers
There are a number of factors that can increase the risk of developing anxiety or panic attacks:
Stress due to an illness
Other mental health disorders
Drugs and alcohol
Background of having experienced similar attacks in the past
When you feel like an anxiety or panic attack coming on, you can try the following techniques to calm yourself:
When you feel like your breathing rate is increasing, focus your attention on each exhale and inhale. Feel your stomach fill with air when inhaling and count down from four when exhaling. Repeat until your breathing slows.
Mindfulness-based interventions help to treat anxiety and panic disorders by grounding thoughts in the present. You can practice it by observing sensations and thoughts without reacting to them.
Acknowledge your situation
Anxiety and panic attacks can be incredibly frightening. Recognize, accept, and remind yourself that what you are experiencing will pass.
Relaxation techniques such as aromatherapy, guided therapy, and muscle relaxation can help manage anxiety or panic attacks. If you experience symptoms of either condition, try something that you find relaxing.
Some lifestyle changes can help prevent anxiety attacks and panic attacks or reduce the severity of symptoms when an attack occurs, including:
Eat a balanced diet
Get regular and moderate exercise
Join a support group for people with anxiety or panic attacks
Learn how to detect and stop negative thoughts
Reduce your consumption of caffeine, alcohol, and other drugs
Doctors cannot formally diagnose anxiety attacks, but they can examine your symptoms to determine whether you have an anxiety disorder. A panic attack can be diagnosed using the DSM-V.
Look out for the following symptoms which suggest you need to see a doctor:
Fear of leaving your house (agoraphobia)
Chronic anxiety that interrupts your daily life
Panic attack symptoms lasting more than 15 minutes
Worrying that interferes with your relationship, work, or other aspects of life
You think your anxiety could be due to a physical health problem
You have suicidal thoughts or behaviors
Tests to diagnose anxiety attacks and panic attacks include:
A physical exam
A psychological evaluation or questionnaire
A heart test, such as an electrocardiogram
Once a doctor has diagnosed you with panic attacks, they will develop a treatment plan to help lower the frequency and intensity of the panic attacks so they do not interfere with your daily activities.
Psychotherapy and medication are the two main treatment options. Your doctor may recommend one or both, depending on your history, preference, and the severity of the panic disorder.
Anxiety attacks can also be managed through therapy and medication, depending on their severity and whether you have an anxiety disorder.
Psychotherapy is an effective choice for treating both anxiety and panic attacks that helps you to understand and cope with these conditions.
Cognitive behavioral therapy (CBT) is a form of psychotherapy that can help you rewire your brain to learn that the symptoms of anxiety and panic attacks are not dangerous. Therapists help patients to gradually recreate symptoms of these attacks in a safe and repeated manner, and once they no longer feel threatening, the attacks start to resolve.
It takes time and effort to see results, but with consistent treatment, you can overcome your fear of a situation you used to avoid for fear it would trigger another attack. Attacks can reduce within weeks and go away after several months. Occasional maintenance visits can then help keep attacks under control or treat recurrent episodes.
Medication can help to reduce symptoms of both anxiety and panic attacks. Several types of medication that effectively manage symptoms include:
Selective serotonin reuptake inhibitors (SSRIs) – A class of drugs including paroxetine (Paxil, Pexeva), sertraline (Zoloft), and fluoxetine (Prozac) which are safe and effective with a low risk of adverse effects.
Serotonin and norepinephrine reuptake inhibitors (SNRIs) – Another class of antidepressant drugs² including medication such as venlafaxine (Effexor XR).
Your doctor can also recommend benzodiazepines, such as lorazepam and diazepam (Valium). These are sedatives but are typically only prescribed for short-term use as they can cause physical or mental dependency issues where the patient becomes reliant on them.
If a certain drug does not work well for you, your doctor can consider switching to a different one or combining particular medications to boost their effectiveness. Note that it can take time before you see any improvements in your symptoms.
There is also a minor risk of adverse side effects from medications, and some are not recommended in some situations, e.g., pregnancy. Talk to your doctor about potential risks.
While the symptoms of anxiety and panic attacks can overlap, they are distinct episodes with key differences.
Panic attacks are unpredictable, intense with more severe physical symptoms, and can be diagnosed using the DSM-V.
An anxiety attack is when someone feels very anxious, often from an identifiable trigger or stressor. It is not formally diagnosed but it can indicate that you have an anxiety disorder.
If you have panic or anxiety-related symptoms that affect your everyday life, it is time you consider visiting your doctor for assistance.