Panic Attack vs. Anxiety Attack Explained

You were fine a minute ago. Now, your heart is racing, your hands and feet have gone numb, and you feel like you can’t get enough air. You’re stressed out.

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So, are you having a panic attack or an anxiety attack? Or are they the same thing?

Clinical psychologist Regina Josell, PsyD, explains what’s going on when your body goes haywire — and how to get back to a place of calm.

Panic attack vs. anxiety attack

Panic attack symptoms vs. anxiety symptoms

A lot of people use the terms “panic attack” and “anxiety attack” interchangeably, but panic attacks and anxiety attacks are slightly different beasts.

The main difference is that certain stressors often trigger anxiety, and they may build up gradually. In contrast, panic attacks typically happen unexpectedly and suddenly.

Panic attacks

Panic attacks are intense attacks of fear and uneasiness that may occur without warning. A key factor in panic disorder, they often occur in response to a stressful event. For example, if you have a phobia of flying, getting on an airplane could trigger a panic attack.

But sometimes, they strike for no apparent reason.

“The body’s fight-or-flight response gets triggered when it shouldn’t,” says Dr. Josell. “The body thinks it’s in danger, but it’s not.”

Panic attacks are scary, but they’re not dangerous and usually last just 15 to 20 minutes. (Though that feels like a long time when you’re in the middle of one.)

Causes

We don’t know exactly what causes a panic attack. It may have something to do with your amygdala, the part of your brain that deals with emotions. An imbalance of hormones like cortisol and serotonin may also cause them.

Certain factors can also contribute to panic attacks, such as:

A family history of anxiety disorders
A personal history of anxiety disorders
Negative or traumatic childhood experiences

Symptoms

By definition, a panic attack features four or more of these symptoms:

Increased heart rate
Chest pain or discomfort
Sweating
Trembling or shaking
Feeling that you might be choking
Dizziness
Chills or overheating
Nausea
Fear that you’re dying
Numbness
Feeling that what’s happening around you isn’t real

Unfortunately, if you have one panic attack, it’s common to have another. People often become so worried about it happening again that it becomes a self-fulfilling prophecy, shares Dr. Josell.

“People sometimes start to avoid certain situations or places where they had a panic attack before,” she says. “They might even avoid leaving home.”

Treatment

To tackle panic attacks, mental health professionals often use a technique known as cognitive restructuring. You learn to identify and change the thoughts that go hand-in-hand with panic triggers.

“Once you learn to manage those thoughts instead of dreading them, it tends to reduce both the intensity and frequency of the panic attacks,” Dr. Josell says.

There are some strategies you can try at home to help, like:

Label it. Learning about panic attacks and recognizing the symptoms can help you keep it together if you have another. “It helps if you can say to yourself, ‘This is a panic attack, it’s not going to kill me, it will be uncomfortable — but it will end,’” says Dr. Josell.
Keep track. Log your panic attacks, including when and where they happen, how long they last and anything that might have triggered them. If you can identify a particular trigger, you can find specific ways to manage that trigger. Tracking also helps you see if your current strategy for dealing with panic attacks is working. “When people see their panic attacks are happening less often, or lasting for a shorter time, it gives them confidence — and that helps them get better,” Dr. Josell notes.
Remember to breathe. Deep breathing exercises, like box breathing, can help dial down your body’s panic response, helping your breath and heart rate return to normal.
Distract yourself. “The more you focus on your panic, the worse it gets,” Dr. Josell says. “So, wash your face, brush your teeth, pet the dog, smell something pleasant — using your other senses, like smell and touch, can be helpful.”

Anxiety attacks

An anxiety attack isn’t technically a thing, at least not according to medical terminology. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision — DSM-5-TR, the current gold standard for the diagnosis of mental illness, doesn’t recognize or define an anxiety attack.

In most cases, an anxiety attack is used as a layperson’s term for a panic attack.

But anxiety is a typical human emotion. You might have big nerves before a big test, feel super-stressed before a work presentation or notice fear before a medical exam. Anxiety is unpleasant in the moment, but it can also motivate us and protect us from threats.

“Everybody experiences anxiety,” says Dr. Josell.

Causes

We don’t know the exact cause of generalized anxiety disorder (GAD), a constant fear of feeling overwhelmed. But certain factors can contribute to it, like:

How your brain manages stress
A family history of GAD
Stressful or challenging life experiences

Symptoms

When you have GAD, you tend to have trouble managing your worries. You may worry excessively about everyday things, like a work presentation.

That constant worry can result in physical symptoms, such as:

Fatigue
Headaches
Heart palpitations
Muscle tension
Shortness of breath
Sweating

Treatment

If you think you have GAD, talk to a healthcare provider. They may recommend talk therapy, like cognitive behavioral therapy (CBT), or medication. Often, it’s a combination of both.

Key takeaways

Anxiety happens over a prolonged time of worrying, while panic attacks tend to come on unexpectedly. But both are treatable.

Mental health professionals can help you find ways to manage anxiety, as well as treat panic attacks and panic disorder. And if you feel like panic attacks are controlling you, flip the script and start controlling them instead.

“If panic attacks are interfering with your daily life, it’s a good time to get help,” encourages Dr. Josell.