Anxiety Attacks vs. Panic Attacks

Differences include intensity and how long the attack lasts

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You might hear the terms anxiety attack and panic attack used interchangeably as if they mean the same thing. In fact, panic and anxiety have different features, and behavioral health professionals use the terms for specific symptoms and disorders.

Panic attacks are often associated with sudden fear and anxiety with high-stress levels or excessive worrying. Some of the symptoms are similar, including a rapid heartbeat, shortness of breath, and dizziness. Each also has other symptoms that are unique. 

Everyone can experience panic attacks and anxiety, they are part of the emotional and protective responses hardwired into the human body. Its when either occurs frequently that there is cause for concern. No matter which you experience, it's important to understand their definitions, symptoms, and treatments.

Anxiety Attacks vs. Panic Attacks
Illustration by Joshua Seong. © Verywell, 2018. 

Clinical Differences

Professionals who treat mental health conditions base a diagnosis on definitions found in the "Diagnostic and Statistical Manual of Mental Disorders, 5th edition," known as the DSM-5. Though anxiety and panic attacks may feel the same at times, the subtle differences outlined in this handbook help identify each.

The DSM-5 uses the term panic attack to describe the hallmark features associated with the condition known as panic disorder. However, panic attacks may occur in other psychiatric disorders and it is possible to have a panic attack if you have no disorder.

The term “anxiety attack” is not defined in the DSM-5. Rather, "anxiety" is used to describe a core feature of several illnesses identified under the headings of anxiety disorders, obsessive-compulsive disorders, and trauma- and stressor-related disorders. Some of the most common disorders under these three headings include:

The differences between panic and anxiety are best described in terms of the intensity of the symptoms and length of time the main symptoms occur.

The in-depth definitions in the DSM-5 guide your health provider to make a diagnosis and classify your condition.

Panic Attack

A panic attack is an intense and sudden feeling of fear, terror, nervousness, or apprehension. The symptoms are often so extreme that they cause a severe disruption in your day. Panic attacks usually occur out of the blue without an obvious, immediate trigger. In some cases, they are "expected" because the fear is caused by a known stressor, such as a phobia.

Panic attack symptoms peak within 10 minutes and then subside. However, some attacks may last longer or may occur in succession, making it difficult to determine when one attack ends and another begins. Following an attack, it is not unusual to feel stressed, worried, out-of-sorts, or "keyed up" for the remainder of the day.

According to the DSM-5, a panic attack is characterized by four or more of the following symptoms:

  • Heart palpitations, pounding heart, or accelerated heart rate
  • Excessive sweating
  • Trembling or shaking
  • Sensations of shortness of breath, difficulty breathing, or smothering
  • Feeling of choking
  • Chest pain or discomfort
  • Nausea or abdominal distress
  • Feeling dizzy, unsteady, lightheaded, or faint
  • Feelings of unreality (derealization) or being detached from oneself (depersonalization)
  • Fear of losing control or going crazy
  • Fear of dying
  • Numbness or tingling sensations (paresthesias)
  • Chills or hot flashes

Anxiety

In contrast, anxiety generally intensifies over a period of time and is highly correlated with excessive worry about some potential "danger"—whether real or perceived. If the anticipation of something builds up and the high amount of stress reaches a level where it becomes overwhelming, it may feel like an "attack."

The symptoms of anxiety may include:

  • Muscle tension
  • Disturbed sleep
  • Difficulty concentrating
  • Fatigue
  • Restlessness
  • Irritability
  • Increased startle response
  • Increased heart rate
  • Shortness of breath
  • Dizziness

While some of the symptoms of anxiety are similar to those associated with panic attacks, they are generally less intense. Unlike a panic attack, the symptoms of anxiety may be persistent and very long-lasting—days, weeks, or even months.

Treatment

Whether you’re dealing with panic, persistent anxiety, or both, effective treatment is available. Some of the most common treatment options include therapy, prescription medications, and self-help strategies. You may decide to try one or any combination of these methods.

  • Therapy can help you develop ways to manage your symptoms, work through past pain, determine your path for the future, and gain a clearer perspective that will allow for a more positive outlook.
  • Medications can assist you in reducing the most severe symptoms. They may only be needed for a short period of time to control symptoms while you work on the other strategies.
  • Self-help techniques, such as breathing exercises and desensitization, can be beneficial in allowing you to work through symptom management at your own pace.

A Word From Verywell

Anxiety and panic attacks can disrupt your everyday life. Whether you experience them or you want to understand what a friend or loved one goes through, know that help is available. Talking to your doctor about your symptoms and how often they occur is the first step to finding relief.

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