Anxiety Attack vs. Panic Attack: How to Tell the Difference

These two conditions have similarities but are extremely different in terms of intensity and how long they last. Here's how to tell the difference.

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If you’ve ever been unlucky enough to suffer a panic attack or an anxiety attack, you know how traumatic they can be. About 4.7 percent of the U.S. population will have a panic attack at some point in their lives. Many more will experience feelings of intense anxiety—around 40 million adults in any given year. Here’s how you can tell one from the other.

Anxiety attack vs. panic attack

One of the main things to know about a panic attack is that it’s a symptom of a panic disorder and it strikes out of the blue, according to the therapist’s bible of mental health: The “Diagnostic and Statistical Manual of Mental Disorders, 5th edition” (a.k.a. the DSM 5). The physical symptoms can include a racing heart rate, sweating, nausea, chest pain, dizziness, and dilated pupils. People will often feel a sense of doom, impending death, or a loss of control.

With an anxiety attack—which doesn’t have a distinct classification in the DSM-5—people will have symptoms like trouble sleeping, muscle tension, irritability, nausea, sweating, and difficulty concentrating—they just won’t be as intense, says Todd Farchione, PhD, a research associate professor of Psychological and Brain Sciences at Boston University.

The physiology of panic attacks vs. anxiety attacks

“A panic attack is the result of activation of the fear system—the sympathetic nervous system,” says Farchione. “It’s just happening at a time when there’s not anything external to be afraid of, which is what is so disconcerting about it.” In a panic attack, he says, the body floods with adrenaline, activating the part of the brain that handles emotion—the amygdala. This adrenal surge triggers the physical and emotional symptoms of a panic attack. When the surge subsides, your body and emotional state return to normal.

Anxiety attacks are similar, but just not as intense, says Farchione. “In anxiety, you see the release of the stress hormone cortisol, but it’s not the same as you get in a panic reaction,” says Farchione. He gives an example: “If you were in a jungle that you knew had dangerous animals in it, you might be on guard to every sound and movement,” he says. That’s anxiety. But when a lion jumps out of the jungle and charges toward you—that’s what a panic attack feels like.

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Timing in panic attacks and anxiety attacks

A panic attack generally lasts five to 30 minutes and then often ends as abruptly as it began. “You can’t maintain a fear reaction for, say, five hours—that’s not really possible from a physical standpoint,” says Farchione. Sometimes, though, after a panic attack, there might be “little aftershocks,” often focused on concern about another panic attack. These are 10 signs you may be having a panic attack.

“But you can maintain a state of pretty high anxiety for five hours,” he says. Some types of anxiety attacks—worrying about a job interview, say—come and go. But in the case of anxiety disorders, it can be chronic and disabling, according to WebMD. See these tips for understanding managing anxiety disorders.

Easing a panic attack vs. an anxiety attack

Because panic attacks share many symptoms with heart attacks, the first one can be truly terrifying. The first thing to do is rule out an actual cardiac event. Learn how to tell the difference between a panic attack and a heart attack. Once a doctor has made sure your heart is OK, try practicing a soft distraction, says Farchione: “The tendency when in that physical state is to watch it very intensely. People think, It’s not going away yet, it’s not going away,” says Farchione. Instead, do something routine instead, like getting a bite to eat. “Gently shifting your attention to something other than the panic can be helpful,” he adds.

With anxiety, learning relaxation techniques may be helpful, according to Psychology Today. Deep breathing, yoga, tai chi, or other calming exercises may help distract you from worry. These are some other tricks for calming a panic attack.

Anxiety can lead to a panic attack

Though technically panic attacks come from out of the blue, they occur to sufferers in all the different anxiety disorders. “You can think yourself into a panic attack,” says Farchione. “If I’ve made a mistake at work and I have the thought, I’m going to lose my job, and I truly believe that’s the case, my body might react as if there’s a threat—simply because I think there is.” This kind of “anticipatory anxiety” can set the conditions for a panic attack. Here are some other triggers of panic attacks.

People don’t get help for anxiety

Though anxiety disorders are “highly treatable,” according to the ADAA, “only 37 percent of those suffering receive treatment.” This means they are not only battling the symptoms, reports the Mayo Clinic, but they put themselves at risk for ailments like headaches, migraines, high blood pressure, and heart problems. These are 9 signs that you might have an anxiety disorder.

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What causes anxiety and panic attacks?

The Mayo Clinic reports that while the causes of panic attacks are murky, there are factors that can predispose you, such as your genetics, personal temperament, and major life stresses. Other risk factors include being female (the National Institute of Mental Health says women are about 23 percent more likely to have an anxiety disorder), a traumatic life event, major life changes, and a history of childhood abuse. The causes of anxiety are the same mysterious mix of genetics, brain chemistry, and life experience, according to WebMD.

Ways to manage anxiety attacks and panic attacks

Anxiety disorders are the most common mental illness in the United States, according to the Anxiety and Depression Association of America (ADAA). They hit 40 million people over the age of 18. The National Institute for Mental Health counts five major types of anxiety disorders—generalized anxiety disorder, obsessive-compulsive disorder, post-traumatic stress disorder, social anxiety disorder, and panic disorder (recurrent panic attacks that lead to fear of more attacks).  Learn 9 ways crisis counselors recommend dealing with anxiety.

Though each type of anxiety requires its own treatment path, many may respond to steps that include the following, according to the ADAA:

  • Accepting a certain lack of control
  • Learning your stress and anxiety triggers
  • Daily exercise, adequate sleep, and balanced meals
  • Taking breaths and breaks
  • Helping others through service
  • Talking to a therapist

Treatment for recurring panic attacks

If you’re having frequent panic attacks, the first line of treatment is cognitive behavioral therapy, says Farchione. This approach helps you change how you think and respond to your thoughts. Other therapeutic approaches might include benzodiazepines medications such as Ativan or Xanax or Klonopin. Many people who have recurrent attacks tend to avoid experiences and places that might cause anxiety—or even just remind the person of a panic attack. But therapy for panic attacks aims to expose people slowly to their fears. “To resolve it you would reduce the patterns of avoidance,” says Farchione. “You would want to broaden your life.”

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