As part of our body’s natural response to protect ourselves from dangerous or stressful situations, it’s normal — and healthy — to experience the occasional bout of anxiety.
“If we use it well, anxiety can provide us with valuable information,” says Wendy Suzuki, professor of neural science and psychology at New York University and author of “Good Anxiety: Harnessing the Power of the Most Misunderstood Emotion.”
But according to the Anxiety & Depression Association of America, 40 million adults in the U.S., or 19.1% of the population ages 18 and older, are diagnosed with clinical levels of anxiety, ranging from generalized anxiety or social anxiety disorder to panic disorder and phobia-related disorders.
While people commonly refer to “panic attacks” and “anxiety attacks” interchangeably, the two conditions are actually not the same. They share several similar symptoms, but they are — in fact — clinically different.
So, how can you tell if you’re having a panic attack or intense symptoms of anxiety?
[SEE: Best Ways to Practice Self-Care.]
Difference Between a Panic Attack vs. Anxiety Attack
Panic disorder falls under the umbrella of anxiety disorders, which can cause confusion when differentiating between a panic attack and anxiety. The two are often used synonymously but only panic attacks are officially recognized as a diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), the American Psychiatric Association’s professional guide to the diagnosis of mental disorders.
Panic attack
Panic attacks are defined in the DSM-5 as a set of four or more symptoms — for example, sweating, shaking, shortness of breath or a feeling of choking — that start suddenly and usually last 5 to 20 minutes, whereas anxiety can last for months. People who experience panic attacks don’t necessarily have or develop panic disorder, and frequency can vary from daily episodes to only a few per year.
“Panic attacks are not ‘diagnosed’ on their own, per se. They often present as a component of a panic-related disorder, like panic disorder or agoraphobia,” explains Dr. Chandler Chang, a clinical psychologist and founder of Therapy Lab.
Anxiety attack
Intense anxiety symptoms might feel like an “attack” when anxiety becomes disruptive to daily life. When this occurs, mental health professionals characterize it as an anxiety disorder. While those who experience anxiety are at increased risk of panic attacks, many people with anxiety do not experience them.
“An ‘anxiety attack’ is not something separately defined, but people tend to use this phrase to refer to either a panic attack or to a peak of generalized anxiety with or without those physiological signs of a ‘panic attack,'” Chang says.
Given the similarities between a panic attack and pervasive symptoms of anxiety, being able to differentiate between the two experiences can help you better navigate through challenging moments and seek out the right type of help.
[Read: Foods and Drinks Linked to Anxiety.]
Causes of Panic Attack vs. Anxiety Attack
Panic attacks can either come on unexpectedly with no obvious triggers or can be anticipated in relation to a known cause, while anxiety typically builds gradually in response to known stressors.
Both panic attacks and heightened anxiety can have similar triggers:
— Phobias.
— Work stress.
— Caffeine.
— Medication.
— Substance withdrawal.
— Reminders of traumatic experiences.
— Driving.
— Chronic pain or illness.
“Both can be caused by the mental perception of urgency and concern or anticipation of a perceived threat,” Chang says. However, “The meaning of anxiety attack tends to differ based on who is using the phrase and the context, since that phrase has not been used in the scientific literature.”
Risk factors
Panic attacks and anxiety can also have similar risk factors:
— Stressful life event, like a divorce or the death of a family member or close friend.
— Chronic stress (family issues, professional stress, financial struggles, etc.).
— Experiencing or witnessing a traumatic event as a child or adult.
— Having immediate family members who also experience chronic anxiety.
— Having a mental health condition like depression.
[READ: Does Acupuncture Work for Anxiety?]
Symptoms of Panic Attack vs. Anxiety Attack
Panic attacks and anxiety have many symptoms in common, including:
— Sweating.
— Shaking.
— Shortness of breath.
— Feeling of choking.
— Chest pain.
— Nausea.
— Dizziness.
— Depersonalization and/or derealization, which is a sense of detachment from yourself and/or the world.
— Fear of losing control.
— Fear of dying.
— Tingling.
— Chills.
— Hot flashes.
“An anxiety attack might include the physical symptoms of a panic attack, or they might involve a more emotional response of acute distress, helplessness, urgency or fear,” Chang says. In some cases, a panic attack might be confused for a heart attack.
Diagnosis for Panic Attack vs. Anxiety Attack
Panic attacks are associated with two primary diagnoses: panic disorder and agoraphobia (with or without a history of panic disorder). Once an individual has experienced a panic attack, they may become hypervigilant or watchful for future panic attacks. As a result, they may begin to avoid people, situations or places that they worry might induce a panic attack.
“If this avoidance becomes pervasive and results in limits in daily life and well-being, then we might diagnose panic disorder. Similarly, when someone avoids public places for fear of a panic attack, that pervasive fear and avoidance might be labeled agoraphobia,” Chang says.
While mental health professionals can’t clinically diagnose anxiety attacks, they can diagnose anxiety disorders or symptoms, panic attacks or panic disorders. The medical evaluation for panic attacks and anxiety disorders may include blood tests, a physical exam, a psychological evaluation or a heart test, which can help your doctor rule out any other possible causes of your symptoms.
Treatments for Panic Attack vs. Anxiety Attack
If someone is having panic attacks frequently and begins to avoid situations, people or places for fear of having an episode, then they may need the professional help of a psychiatrist, psychologist and therapist.
Panic disorder and other anxiety disorders can be treated in a number of ways, often in combination, including:
— Cognitive behavioral therapy (CBT).
— Exposure therapy.
— Relaxation techniques.
— Medications.
— Lifestyle changes.
Cognitive behavioral therapy
CBT is the most researched, well-established intervention for all forms of anxiety. This type of therapy involves working with a mental health professionals who teach strategies for relaxation and mindfulness, cognitive flexibility (thinking through and challenging negative assumptions that create more anxiety) and behavioral avoidance.
Chang recommends consulting with your doctor for a CBT referral or using the Association for Behavioral and Cognitive Therapies’ directory to find effective therapy.
“The good news is that panic disorder and agoraphobia are two diagnosis labels for symptoms that often respond favorably to evidence-based treatment,” Chang says.
Exposure therapy
Avoidance of situations that could cause more anxiety can make the anxiety worse, so working with a mental health professional on exposure therapy, which involves controlled exposure to triggering situations, can also be extremely helpful.
Relaxation techniques
Relaxation techniques can help boost the effects of other interventions.
Yoga, meditation and deep breathing are three common relaxation practices that have been shown to lower heart rate, blood pressure and cortisol levels by activating your parasympathetic nervous system. For an especially soothing experience, pair your practice with aromatherapy.
Medications
If you are still struggling, a combination of therapy with medication can be particularly useful — sometimes more so than either approach alone.
These medications include:
— Anti-anxiety medications, such as benzodiazepines.
— Antidepressants, including selective serotonin uptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs).
— Beta blockers, which can help manage physical symptoms like rapid heart rate.
Lifestyle changes
Outside of therapy and medication, there are a few things you can do to help alleviate symptoms, or even prevent panic attacks and severe symptoms of anxiety before they start:
— Eat a balanced diet.
— Develop a meditation, breathwork or yoga practice.
— Join a support group for people who experience panic attacks or anxiety.
— Limit consumption of alcohol, caffeine and recreational drugs.
Bottom Line
Panic attacks and anxiety have overlapping symptoms, causes and risk factors, but knowing the difference between the two can help you find the best treatment. You should get in touch with your physician if panic- or anxiety-related symptoms are affecting your relationships or everyday activities.
“Anxiety of any form that causes problems at work, with friends and family and/or other life problems should be addressed specifically and with the support of a (mental health professional),” Chang says. “That said, a little bit of anxiety can be a useful driver of motivation, focus, energy, and drive, so I’d never recommend that someone ‘get rid of’ all their anxiety.”
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Panic Attack vs. Anxiety Attack: How to Tell the Difference originally appeared on usnews.com
Update 11/15/23: This story was previously published at an earlier date and has been updated with new information.
