Panic Attacks vs Anxiety Attacks – What’s the Difference?

Panic attacks are sudden episodes of intense fear or discomfort that peak within minutes, often accompanied by severe physical symptoms such as chest pain, heart palpitations, shortness of breath, and a fear of losing control or dying. These attacks are typically unexpected and can occur without a clear trigger.

Anxiety attacks, on the other hand, involve a gradual build-up of anxiety that can last for an extended period. They are characterised by excessive worry, heightened nervousness, and physical symptoms similar to panic attacks, such as difficulty breathing and heart palpitations. Unlike panic attacks, anxiety attacks are usually triggered by specific stressors or situations.

Understanding the differences between panic attacks and anxiety attacks is crucial for accurate diagnosis and effective treatment. Although they share some symptoms, the underlying causes, triggers, and treatment strategies can differ significantly. Misidentification can lead to ineffective treatments and prolonged distress for individuals suffering from these conditions.

Panic attacks are intense episodes of sudden fear or discomfort that escalate rapidly, peaking within minutes. These attacks often occur unexpectedly and can be extremely debilitating. Panic attacks can happen without any obvious trigger, differentiating them from anxiety attacks, which are usually linked to specific stressors.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), a panic attack involves experiencing four or more of the following symptoms:

• Palpitations, pounding heart, or accelerated heart rate
• Sweating
• Trembling or shaking
• Sensations of shortness of breath or smothering
• Feelings of choking
• Chest pain or discomfort
• Nausea or abdominal distress
• Feeling dizzy, unsteady, lightheaded, or faint
• Chills or heat sensations
• Paresthesias (numbness or tingling sensations)
• Derealisation (feelings of unreality) or depersonalisation (being detached from oneself)
• Fear of losing control or “going crazy”
• Fear of dying

Chest Pain: Many individuals report severe chest pain during a panic attack, which can often be mistaken for a heart attack.

Heart Palpitations: A rapid or irregular heartbeat is a common symptom that adds to the fear and discomfort.

Difficulty Breathing: Shortness of breath or a feeling of being unable to breathe properly is frequently reported, contributing to the intense fear experienced during the attack.

Intense Fear: A hallmark of panic attacks is the overwhelming sense of fear or dread, often with no apparent reason.
Fear of Losing Control: Individuals often fear they are losing control or “going crazy” during an attack, which can exacerbate the overall distress.

Panic attacks typically last for about 10 to 20 minutes, but the duration can vary. Some attacks may last only a few minutes, while others can persist for over an hour. The frequency of panic attacks can also vary widely; some individuals may experience them rarely, while others may have frequent panic attacks that significantly interfere with their daily lives.

Understanding these aspects of panic attacks is crucial for recognising and differentiating them from anxiety attacks. Accurate identification by a mental health professional can lead to more effective management and treatment, improving the individual’s quality of life and mental health condition.

Anxiety attacks are characterised by a gradual increase in anxiety and distress over a period. Unlike panic attacks, which occur suddenly and intensely, anxiety attacks often develop in response to specific stressors or perceived threats. They can last for an extended time, sometimes hours or even days, and involve a persistent sense of worry and dread.

Anxiety attacks share many physical symptoms with panic attacks, including:

Heart Palpitations: A rapid or irregular heartbeat is common during anxiety attacks, contributing to a sense of unease.

Difficulty Breathing: Shortness of breath or a feeling of being unable to breathe properly can occur, though typically less severe than in panic attacks.

Chest Pain: Discomfort or tightness in the chest, though usually milder compared to panic attacks.

Excessive Worry: A hallmark of anxiety attacks, excessive and persistent worry can dominate the individual’s thoughts and physical state.

Intense Fear: Similar to panic attacks, anxiety attacks involve a significant amount of fear, though it is more chronic and less acute.

Perceived Threat: Individuals often feel a continuous sense of impending doom or danger, which is less immediate than the intense fear experienced during panic attacks.

Duration: Anxiety attacks typically last much longer than panic attacks. While a panic attack peaks within minutes and subsides within an hour, anxiety attacks can persist for hours or even days.

Frequency: Anxiety attacks can be more frequent and prolonged, often occurring in response to ongoing stressors or as part of a generalised anxiety disorder. In contrast, panic attacks are often unexpected and episodic, with varying frequency.

Understanding these distinctions is essential for accurately diagnosing and treating anxiety attacks, helping individuals manage their symptoms and improve their overall mental health.

Heart Palpitations

Panic Attacks: Heart palpitations are often intense and can feel like the heart is racing, pounding, or skipping beats. This symptom usually peaks quickly and adds to the overwhelming fear experienced during a panic attack.

Anxiety Attacks: Heart palpitations in anxiety attacks are typically less severe but can be persistent, accompanying the prolonged state of worry and nervousness.

Chest Pain

Panic Attacks: Chest pain during panic attacks can be severe, mimicking the pain associated with a heart attack. This pain often contributes to the fear of dying or losing control.

Anxiety Attacks: Chest pain in anxiety attacks is usually milder and more of a persistent discomfort or tightness rather than acute pain. It often accompanies ongoing anxiety and stress.

Difficulty Breathing

Panic Attacks: Individuals experiencing a panic attack often feel like they cannot breathe, leading to hyperventilation. This intense shortness of breath can peak within minutes and is a key symptom of panic attacks.

Anxiety Attacks: Difficulty breathing in anxiety attacks tends to be less acute but can be prolonged, creating a constant sense of breathlessness or tightness in the chest.

Intense Fear

Panic Attacks: The fear experienced during a panic attack is extreme and sudden. It often feels overwhelming and can be associated with a fear of dying, losing control, or “going crazy.”

Anxiety Attacks: The fear in anxiety attacks is more chronic and related to excessive worry about future events or situations. It is less intense but more persistent.

Losing Control

Panic Attacks: A common symptom is the fear of losing control, either physically or mentally. This can include the fear of fainting, having a heart attack, or losing one’s mind.

Anxiety Attacks: While anxiety attacks involve fear, it is more related to the perceived threat and worry about future events rather than an immediate sense of losing control.

Excessive Worry

Panic Attacks: Excessive worry is not typically a primary symptom during the acute phase of a panic attack, which is more characterised by intense and immediate fear.

Anxiety Attacks: Excessive worry is a hallmark of anxiety attacks, where individuals experience ongoing and overwhelming worry about various aspects of life, contributing to prolonged anxiety states.

Panic Attacks

Impact: Panic attacks can significantly disrupt daily life due to their sudden onset and severe symptoms. Individuals may develop a fear of experiencing another attack, leading to avoidance behaviours and impacting their social, occupational, and personal lives.

Frequency: While they may not occur daily, the unpredictability and intensity of panic attacks can cause significant distress and avoidance of certain situations or places.

Anxiety Attacks

Impact: Anxiety attacks, with their prolonged duration and persistent worry, can have a continuous impact on daily life. They can affect a person’s ability to concentrate, perform tasks, and maintain relationships due to the ongoing state of anxiety.

Frequency: Anxiety attacks can be more frequent and long-lasting, often occurring in response to specific stressors or as part of a generalised anxiety disorder. This can lead to chronic stress and interfere with daily activities and overall quality of life.

Common Triggers for Panic Attacks

Unexpected Panic Attacks: Panic attacks often occur without a clear trigger, making them unexpected and unpredictable. This unpredictability can increase overall anxiety and fear of future attacks.

Stressor-Related Disorders: Stressful life events or transitions, such as divorce, job loss, or significant life changes, can trigger panic attacks. These events create high levels of stress that can precipitate an attack.

Panic Disorder: Individuals with panic disorder are prone to frequent panic attacks. The disorder itself can be a trigger, as the fear of having an attack can induce one.

Common Triggers for Anxiety Attacks

Generalised Anxiety Disorder (GAD): Individuals with GAD experience chronic anxiety and excessive worry about various aspects of life, which can trigger anxiety attacks. The persistent state of worry associated with GAD makes individuals more susceptible to anxiety attacks.

Traumatic Events: Past traumatic events, such as accidents, assaults, or natural disasters, can trigger anxiety attacks. The lingering fear and stress from these events can provoke episodes of intense anxiety when reminded of the trauma.

Specific Stressors: Situations such as financial concerns, relationship problems, or workplace stress can trigger anxiety attacks. The anticipation and worry about these specific stressors can lead to an anxiety attack.

Stressful Events: Both panic and anxiety attacks can be triggered by high-stress situations. Events like moving, changing jobs, or significant losses can create an environment of heightened stress, increasing the risk of both types of attacks.

Chronic Health Condition: Living with a chronic health condition, such as heart disease or diabetes, can increase stress levels and lead to both panic and anxiety attacks. The ongoing concern about health can be a significant risk factor.

Other Mental Health Conditions: Conditions such as depression, PTSD, and other anxiety disorders can increase the likelihood of experiencing panic or anxiety attacks. The interplay between different mental health conditions can exacerbate symptoms and trigger attacks.

Family History: A family history of anxiety disorders or panic disorder can increase the risk of developing similar conditions. Genetics can play a role in predisposing individuals to these mental health issues.

Substance Abuse: The use of drugs and alcohol can trigger panic and anxiety attacks. Substance abuse can alter brain chemistry and exacerbate anxiety, leading to attacks.

Role of Mental Health Professionals

Psychological Evaluation: Mental health professionals conduct thorough psychological evaluations to understand the individual’s symptoms, triggers, and overall mental state. This evaluation helps in diagnosing whether the individual is experiencing panic attacks, anxiety attacks, or both.

Medical History: Gathering a detailed medical history is crucial to rule out other conditions that might mimic the symptoms of panic or anxiety attacks. This includes reviewing any past mental health issues, family history of mental disorders, and any chronic health conditions

Physical Examination and Psychological Evaluation

Physical Examination: A physical exam helps rule out physical health conditions that might cause similar symptoms, such as heart disease or respiratory issues. Blood tests, ECGs, and other tests might be conducted.

Psychological Evaluation: This involves detailed interviews, questionnaires, and self-assessment tools to diagnose the specific type of anxiety or panic disorder.

Medications

Selective Serotonin Reuptake Inhibitors (SSRIs): Commonly prescribed to treat anxiety and panic disorders due to their efficacy in regulating mood and reducing symptoms.

Serotonin Norepinephrine Reuptake Inhibitors (SNRIs): Another class of medications used to treat anxiety disorders, helping to alleviate symptoms by balancing neurotransmitters in the brain.

Therapy Options

Exposure Therapy: A type of cognitive-behavioural therapy (CBT) that helps individuals confront and reduce their fear of panic attacks through controlled exposure to anxiety-provoking situations.

Talking Therapies: Includes CBT, hypnotherapy and other forms of psychotherapy to help individuals understand and manage their anxiety, develop coping strategies, and change negative thought patterns.

Relaxation Techniques

Deep Breathing: Techniques to help calm the mind and body, reducing the intensity of panic and anxiety attacks.

Progressive Muscle Relaxation: Involves tensing and relaxing different muscle groups to reduce physical tension associated with anxiety.

Breathing Exercises: Regular practice of controlled breathing to manage stress and anxiety.

Identify Triggers: Recognising and understanding specific triggers for panic and anxiety attacks can help in developing strategies to avoid or manage them.

Reduce Symptoms: Implementing lifestyle changes such as regular exercise, a balanced diet, adequate sleep, and avoiding caffeine and alcohol can help reduce symptoms.

Manage Anxiety: Incorporating mindfulness practices, maintaining a healthy work-life balance, and engaging in activities that promote relaxation and well-being.

Definition and Characteristics of Panic Disorder

Panic disorder is characterised by recurrent, unexpected panic attacks and persistent concern about having more attacks. It often leads to behavioural changes, such as avoiding places or situations where previous attacks have occurred.

Definition and Characteristics of Anxiety Disorder

Anxiety disorders encompass various conditions, including generalised anxiety disorder (GAD), social anxiety disorder, and specific phobias. These disorders are marked by excessive, persistent worry and fear about everyday situations.

How Panic Disorder Relates to Frequent Panic Attacks

Panic disorder specifically involves frequent panic attacks and the fear of future attacks, leading to significant interference with daily life and functioning.

Differences in Treatment Approaches

Panic Disorder: Treatment often focuses on managing acute symptoms through medications (e.g., SSRIs) and CBT, particularly exposure therapy.

Anxiety Disorder: Treatment might include a broader range of therapies, including medication, CBT, and lifestyle changes, aimed at managing chronic anxiety and worry.

Immediate Coping Strategies

Deep Breathing: Practicing deep breathing exercises can help calm the mind and body during an anxiety or panic attack.

Relaxation Techniques: Techniques such as progressive muscle relaxation can provide immediate relief from symptoms.

Long-Term Management

Identify Triggers: Keeping a journal to track triggers and symptoms can help individuals understand and manage their anxiety better.

Talking Therapies: Engaging in regular psychotherapy sessions to develop coping strategies and address underlying issues.

Preventative Measures

Progressive Muscle Relaxation: Regular practice can reduce overall tension and improve stress management.

Exposure Therapy: Helps in reducing the fear of panic attacks by gradually exposing individuals to anxiety-provoking situations in a controlled manner.

While panic attacks are characterised by sudden, intense fear and physical symptoms, anxiety attacks involve prolonged worry and distress. Understanding these differences is crucial for effective diagnosis and treatment.