What’s the difference between Anxiety Attack and Panic Attack?
Often people talk about anxiety attacks and panic attacks as though they are synonymous, but they are different conditions.
DSM-5 does not recognize anxiety attacks as a separate category. Rather, anxiety is used to describe a core feature of many different anxiety disorders. The culmination of symptoms that result from being in a state of anxiety—such as restlessness, shortness of breath, increased heart rate, and difficulty concentrating—may feel like an “attack,” but are generally less intense than those experienced at the height of a panic attack. It may come on gradually. Anxiety symptoms can prevail for long periods.
Anxiety attacks are often associated with a trigger. Since the symptoms are open to interpretation, two persons with different symptoms may both indicate that they are having an “anxiety attack”. For one person, an anxiety attack might be worrying to the extent that they are unable to concentrate on anything else; for another, it might refer to sweating and shortness of breath when faced with a certain situation.
A panic attack is a sudden, intense fear, discomfort or anxiety with symptoms like rapid heart rate, sweating, shaking, shortness of breath, hot flashes, and lightheadedness—as well as a sense of impending doom, chills, nausea, abdominal pain, chest pain, headache, and numbness or tingling. Some people mistake panic attacks for heart attacks and many believe that they are dying. The symptoms are often so severe as to interfere with your daily life. Some of the symptoms of a panic attack are similar to those of an anxiety attack, including a rapid heartbeat, shortness of breath, and dizziness.
A panic attack rarely lasts for more than an hour, with most lasting for around 20 to 30 minutes. But it may last even longer, up to a few hours. Typically, panic attacks reach their peak within 10 minutes or less and then symptoms begin to subside. Unexpected panic attacks occur without an obvious cause. Expected panic attacks are cued by external stressors, such as phobias. If these attacks happen often, they are called a panic disorder.
“Anxiety attacks” are linked to numerous mental disorders, including OCD and trauma, while panic attacks mainly affect those with panic disorder.
Anxiety Attack vs Panic Attack Symptoms
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.
Distinguishing Anxiety Attack from Panic Attack
To distinguish between an anxiety attack and a panic attack, keep in mind the following:
- There is often a situation perceived as stressful or threatening in relation to anxiety. Panic attacks most often occur out of the blue without any stressor.
- Anxiety can be mild, moderate, or severe, while panic attacks are mostly severe and disruptive.
- Physical symptoms are often more intense in a panic attack than emotional symptoms, compared to an anxiety attack.
- Usually, anxiety sets in gradually, whereas panic attacks occur abruptly.
- Panic attacks typically trigger worries of another attack, leading you to avoid places or situations where you think you might be at risk of a panic attack.
Symptoms of an anxiety attack include:
- Apprehension and worry
- Chills or hot flashes
- Shortness of breath
- Chest pain
- Feeling of choking
- Dry mouth
- Trembling or shaking
- Numbness or tingling
- Feeling faint or dizzy
- Abdominal discomfort and nausea
As per DSM-5, if four or more of these symptoms are present you can characterize it as a panic attack:
- Palpitations, pounding heart, or accelerated heart rate.
- Trembling or shaking.
- Sensations of shortness of breath or smothering.
- Feelings of choking.
- Chest pain or discomfort.
- Nausea or abdominal distress.
- Feeling dizzy, unsteady, light-headed, or faint.
- Chills or heat sensations.
- Paresthesias (numbness or tingling sensations).
- Derealization (feelings of unreality) or depersonalization (being detached from oneself).
- Fear of losing control or “going crazy.”
- Fear of dying.
- Culture-specific symptoms (e.g., tinnitus, neck soreness, headache, uncontrollable screaming or crying) may be seen. Such symptoms should not count as one of the four required symptoms.
Anxiety Attack vs Panic Attack Risk Factors and Causes
Panic and anxiety attacks may feel similar as they share a lot of symptoms. You can experience them both at the same time. For example, you might be anxious about a potentially stressful situation (say, an important presentation at work), and when the situation arrives, the anxiety may culminate in a panic attack.
Anxiety attacks can be triggered by:
- Stress at work
- Social stressors
- Too much caffeine or nicotine intake
- Withdrawal from alcohol or drugs
- Chronic illness or chronic pain
- Certain medications or supplements
- Excessive fears of objects or situations
- Memories of past trauma
The cause of panic attacks is not clear. But the body has a natural fight-or-flight response when you are under stress or in danger. It gives you a burst of energy by speeding up your heart and making you breathe faster. Thus, it gets you ready to either cope with or run away from danger. A panic attack occurs when this response happens even when there is no danger. Some people are more sensitive. Panic attacks are more likely if you have a family history of panic disorder, depression or bipolar disorder. Childhood experience of sexual or physical abuse, smoking, and interpersonal stressors in the months before the first panic are also risk factors. They sometimes happen with no clear cause.
Panic attacks may also be brought on by:
- Prolonged exposure to high levels of stress
- Phobias, such as agoraphobia (fear of crowded or open spaces), claustrophobia (fear of small spaces), and acrophobia (fear of heights)
- Problems with thyroid (hyperthyroidism), heart or breathing (asthma)
- Depression or another mood disorder
- Alcohol or drug abuse
- Using too much nicotine or too much caffeine
- Taking certain medicines, such as those used to treat asthma and heart problems
Anxiety Attack vs Panic Attack Treatment
- Anti-anxiety drugs
- Selective serotonin reuptake inhibitors (SSRIs)such as fluoxetine (Prozac), paroxetine (Paxil, Pexeva) and sertraline (Zoloft). SSRI depressants are usually the first choice because they are very effective and carry low risk of any serious side effects.
- Serotonin and norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine (Effexor).
- Benzodiazepines such as alprazolam (Xanax) and clonazepam (Klonopin).
Cognitive-behavioral therapy (CBT) is found to be very effective. During CBT, the therapist will teach you and make you undergo relaxation training, restructuring your thoughts and behaviors, mindfulness, exposure treatment, and stress reduction. Improvement can occur within weeks, and symptoms often decrease significantly or go away completely within several months.
Lifestyle and Home Remedies
- Reduce and manage sources of stress in your life.
- Practice Deep Breathing
- Use Relaxation Techniques
- Repeat a Mantra
- Practice yoga or meditation, such as mindfulness
- Learn how to identify and stop negative thoughts.
- Get regular, moderate exercise.
- Eat a balanced diet.
- Join a support group for people with anxiety or panic attacks.
- Limit your consumption of alcohol, drugs, and caffeine.