Anxiety Attack vs. Panic Attack. What’s the Difference?

Medically reviewed by: Wendy Rasmussen, PhD
Wednesday, October 6 2021

Nearly everyone feels anxious now and then. Money, work, relationships — anxiety is built into modern life. It’s also built into your body. It’s a protective mechanism that helps you avoid danger.  Anxiety is the nagging voice that reminds you to lock the doors and check your gas gauge.  It’s only a problem when it starts to disrupt your life. Your worries escalate until they suddenly feel unmanageable and overwhelming. There are a few differences when it comes to an anxiety attack and a panic attack. Read on to learn some of the key differences.

What is an anxiety attack?

You won’t find anxiety attacks listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the standard guide for mental health professionals. Yet these attacks are very real. They’re a natural response to a long, slow buildup of stress and worry.  Symptoms of an anxiety attack vary, depending on the degree and type of stress. Psychological symptoms predominate, but you might also have physical symptoms, such as:

  • Trouble sleeping  
  • Fatigue  
  • Tense muscles
  • Headaches
  • Fast heartbeat or breathing

As distressing as an attack can be, you can usually push through it. The attack itself isn’t harmful, but if you have persistent attacks that you struggle to manage on your own, it may be time to seek professional advice. 

What is a panic attack? 

A panic attack is a sudden surge of intense fear that strikes without warning. It can happen for no known reason. Or, it can be an out-of-proportion response to something you’re afraid of, such as spiders or small spaces. And it can occur anywhere at any time, even while you’re asleep.

A panic attack is triggered when your normal fight-or-flight response, which protects you from harm, kicks into high gear. The problem is that it’s a false alarm. Scientists think this may happen when certain parts of your brain  get their signals crossed. The reasonable part (the prefrontal cortex) doesn’t tell the fearful, primitive part (the amygdala) that there’s nothing to worry about.

Panic attacks are much more emotionally and physically intense than anxiety attacks. They’re sometimes called anxiety attacks on steroids. It’s nearly impossible to power through one. During a panic attack, you may feel you’re going crazy, having a heart attack, or even dying.  Despite this, a panic attack isn’t dangerous or life-threatening, though fear of what’s happening can make symptoms worse. 

Symptoms can include:

  • A pounding or racing heart
  • Chest pain
  • Feeling detached from the real world
  • Feeling dizzy or light-headed
  • Nausea
  • Sense of impending doom
  • Shortness of breath or a choking feeling
  • Sweating or hot flashes
  • Trembling or shaking

You probably won’t have all these symptoms. According to the DSM-5, you must have at least four to be diagnosed with a panic attack. 

Some good news: Panic attacks are usually at their worst a few minutes after they start. They last about 20 minutes on average and no more than an hour. You’re also not likely to have more than one or two in your life. 

Still, worrying about having another can take a toll. If you have repeat panic attacks, it may be time to talk to a professional. And if your symptoms last longer than an hour, get immediate emergency care.

How to manage an anxiety or panic attack

The aim with both anxiety and panic attacks is to calm the fight or flight response. Here’s how:

  • Take a breath. Breathing deep into your belly — diaphragmatic breathing — switches your body from the fight-or-flight response of the sympathetic nervous system to the Zen calm of the parasympathetic nervous system. Inhale for a count of four, hold, and exhale for a count of six. This slows down your heart rate and breathing.
  • Relax your muscles. Starting with your feet, tense each muscle in your body for a few seconds, then slowly release. 
  • Be here now. Fighting what’s happening can make your symptoms worse. Instead, accept what you experience in the moment and know it will pass.
  • Use positive self-talk. Negative mind chatter often triggers anxiety. Tell yourself that you’ve got this, no matter how frightening it feels.
  • Ask for help, if you need it. Talk to a friend, therapist, or anyone else who can help you feel calmer.

Panic and anxiety attack causes

For many people, an anxiety or panic attack is a once-in-a-lifetime event. For others, it may signal a deeper problem, such as an anxiety or panic disorder. It may also be associated with medical conditions, such as too much or too little thyroid hormone, heart disease, or taking certain medications, including asthma drugs and steroids. 

Other factors that may increase your risk include:

  • Being female. Women are more likely to have these attacks than men. The statistics may be skewed, though, because far fewer men seek treatment.
  • Genes. If a close family member has anxiety or panic attacks, you might be more likely to have them, too.
  • A traumatic event, such as a serious accident or sexual assault.
  • Childhood trauma, including psychological, sexual, or physical abuse.
  • Major life changes. A serious illness, job loss, or divorce — even happy events like a promotion or new baby — can increase the chance of anxiety or panic attacks.
  • Smoking and caffeine, alcohol, or drug use.

Anxiety or panic attack treatment

Healthy lifestyle choices are the most important thing you can do for your mental and physical well-being. Making lifestyle choices (like the ones below) can also help you manage other health conditions.

  • Try to get at least 30 minutes of exercise every day. It helps reduce stress and boosts your mood. You’ll be amazed how much better you feel.
  • Create a healthy sleep schedule and stick to it. Avoid exercise, caffeine, and screens late in the day.

You may benefit from a type of talk therapy called cognitive behavioral therapy (CBT).

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