Anxiety vs. panic attack
You might hear people talking about panic attacks and anxiety attacks like they’re the same thing. They’re different conditions though.
What is an anxiety attack?
The DSM-5 does not mention anxiety attacks, but it does define anxiety as a feature of a number of common psychiatric disorders.
What is a panic attack?
Panic attacks come on suddenly and involve intense and often overwhelming fear. They’re accompanied by very challenging physical symptoms, such as a racing heartbeat, shortness of breath, or nausea.
The latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) recognizes panic attacks and categorizes them as unexpected or expected.
Unexpected panic attacks occur without an obvious cause. Expected panic attacks are cued by external stressors, such as phobias.
Panic attacks can happen to anyone, but having more than one may be a sign of panic disorder.
Symptoms of anxiety include:
Anxiety is usually related to the anticipation of a stressful situation, experience, or event. It may come on gradually.
The lack of diagnostic recognition of anxiety attacks means that the signs and symptoms are open to interpretation.
That is, a person may describe having an “anxiety attack” and have symptoms that another person has never experienced despite indicating that they too have had an “anxiety attack.”
Read on to find out more about the differences between panic attacks and anxiety.
Panic and anxiety attacks may feel similar, and they share a lot of emotional and physical symptoms.
You can experience both an anxiety and a panic attack at the same time.
For instance, you might experience anxiety while worrying about a potentially stressful situation, such as an important presentation at work. When the situation arrives, anxiety may culminate in a panic attack.
|Symptoms||Anxiety attack||Panic attack|
|Emotional||apprehension and worry||✓|
|fear of dying or losing control||✓|
|a sense of detachment from the world (derealization) or oneself (depersonalization)||✓|
|Physical||heart palpitations or an accelerated heart rate||✓||✓|
|shortness of breath||✓||✓|
|tightness in the throat or feeling like you’re choking||✓||✓|
|chills or hot flashes||✓||✓|
|trembling or shaking||✓||✓|
|numbness or tingling (paresthesia)||✓||✓|
|nausea, abdominal pain, or upset stomach||✓||✓|
|feeling faint or dizzy||✓||✓|
It may be difficult to know whether what you’re experiencing is anxiety or a panic attack. Keep in mind the following:
- Anxiety is typically related to something that’s perceived as stressful or threatening. Panic attacks aren’t always cued by stressors. They most often occur out of the blue.
- Anxiety can be mild, moderate, or severe. For example, anxiety may be happening in the back of your mind as you go about your day-to-day activities. Panic attacks, on the other hand, mostly involve severe, disruptive symptoms.
- During a panic attack, the body’s autonomous fight-or-flight response takes over. Physical symptoms are often more intense than symptoms of anxiety.
- While anxiety can build gradually, panic attacks usually come on abruptly.
- Panic attacks typically trigger worries or fears related to having another attack. This may have an effect on your behavior, leading you to avoid places or situations where you think you might be at risk of a panic attack.
Unexpected panic attacks have no clear external triggers. Expected panic attacks and anxiety can be triggered by similar things. Some common triggers include:
- a stressful job
- social situations
- phobias, such as agoraphobia (fear of crowded or open spaces), claustrophobia (fear of small spaces), and acrophobia (fear of heights)
- reminders or memories of traumatic experiences
- chronic illnesses, such as heart disease, diabetes, irritable bowel syndrome, or asthma
- chronic pain
- withdrawal from drugs or alcohol
- medication and supplements
- thyroid problems
Anxiety and panic attacks have similar risk factors. These include:
- experiencing trauma or witnessing traumatic events, either as a child or as an adult
- experiencing a stressful life event, such as the death of a loved one or a divorce
- experiencing ongoing stress and worries, such as work responsibilities, conflict in your family, or financial woes
- living with a chronic health condition or life threatening illness
- having an anxious personality
- having another mental health disorder, such as depression
- having close family members who also have anxiety or panic disorders
- using drugs or consuming alcohol
People who experience anxiety are at an increased risk of experiencing panic attacks. However, having anxiety does not mean you will experience a panic attack.
Reaching a diagnosis
Doctors can’t diagnose anxiety attacks, but they can diagnose:
- anxiety symptoms
- anxiety disorders
- panic attacks
- panic disorders
Your doctor will ask you about your symptoms and conduct tests to rule out other health conditions with similar symptoms, such as heart disease or thyroid problems.
To get a diagnosis, your doctor may conduct:
- a physical exam
- blood tests
- a heart test, such as an electrocardiogram (ECG or EKG)
- a psychological evaluation or questionnaire
Treatment and medication
Speak with your doctor about other treatments for anxiety and panic attacks. Here are some treatments they may discuss with you.
Counseling and psychotherapy
Talking therapies for anxiety and panic disorders can involveTrusted Source the following, often in combination.
- Cognitive-behavioral therapy (CBT) can help you see things that worry you in a new way. A counselor can help you develop strategies for managing triggers when they arise.
- Cognitive therapy can help you pinpoint, reframe, and neutralize the unhelpful thoughts that often underlie an anxiety disorder.
- Exposure therapy involves controlled exposure to situations that trigger fear and anxiety, which can help you learn to confront those fears in a new way.
- Relaxation techniques includeTrusted Source breathing exercises, guided imagery, progressive relaxation, biofeedback, and autogenic training. Your doctor can talk you through some of these.
Your doctor may suggest attending individual sessions, group sessions, or a combination of the two.
Examples of medications your doctor may prescribeTrusted Source are:
- antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs)
- beta-blockers, which can help manage some of the physical symptoms, such as a rapid heart rate
- anti-anxiety drugs, such as benzodiazepines, a sedative medication that can suppress symptoms quickly
All these drugs can have adverse effects. SSRIs and SNRIs are for long-term use, and it can take time to feel the effects. Benzodiazepines are for short-term use only, as there is a high risk of dependence.
Oftentimes, your doctor will recommend a combination of treatments. They may also need to alter your treatment plan over time.
You should speak with your doctor or another mental health professional to find out what you can do to both prevent and treat anxiety- and panic-related symptoms. Having a treatment plan and sticking to it when an attack happens can help you feel like you’re in control.
If you feel an anxiety or panic attack coming on, try the following:
- Take slow deep breaths. When you feel your breath quickening, focus your attention on each inhale and exhale. Feel your stomach fill with air as you inhale. Count down from four as you exhale. Repeat until your breathing slows.
- Recognize and accept what you’re experiencing. If you’ve already experienced an anxiety or panic attack, you know that it can be incredibly challenging. Remind yourself that the symptoms will pass and you’ll be alright.
- Practice mindfulness. Mindfulness-based interventions are increasingly used to treat anxiety and panic disorders. Mindfulness is a technique that can help you ground your thoughts in the present. You can practice mindfulness by actively observing thoughts and sensations without reacting to them.
- Use relaxation techniques. Relaxation techniques include guided imagery, aromatherapy, and muscle relaxation. If you’re experiencing symptoms of anxiety or a panic attack, try doing things that you find relaxing. Close your eyes, take a bath, or use lavender, which has relaxing effects.
The following lifestyle changes can help you prevent anxiety and panic attacks, as well as reduce the severity of symptoms when an attack occurs:
- Reduce and manage sources of stress in your life.
- Learn how to identify and stop negative thoughts.
- Get regular, moderate exercise.
- Practice meditation or yoga.
- Eat a balanced diet.
- Join a support group for people with anxiety or panic attacks.
- Limit your consumption of alcohol and caffeine as well as the use of drugs.
Panic attacks and anxiety attacks are not the same. Though these terms are often used interchangeably, only panic attacks are identified in the DSM-5.
Anxiety and panic attacks have similar symptoms, causes, and risk factors. However, panic attacks tend to be more intense and are often accompanied by more severe physical symptoms.
You should contact a healthcare professional if anxiety- or panic-related symptoms are affecting your everyday life.
Last medically reviewed on October 19, 2021