You might hear people say that they're having a panic attack or an anxiety attack — and this very well could be the case. But, these are also terms that are thrown around often without understanding what exactly the symptoms are (and, that's understandable!). Chances are, you might be mixing up what you believe to be a panic attack for anxiety or, even, vice versa.
Psychologist Amanda Spray, PhD, clinical associate professor in NYU Langone Health's Department of Psychiatry, told POPSUGAR that anxiety attacks are used a lot in media and pop culture. However, while panic attacks are in the Diagnostic and Statistical Manual (DSM-5) — what mental health professionals use to diagnose conditions and, for psychiatrists specifically, to prescribe treatment — anxiety attacks aren't. It doesn't mean anxiety is any less legitimate; it just means anxiety attacks are not technically a diagnosable.
The bottom line though, is that someone is feeling overwhelmingly distressed in some way. That being said, there are differences between a panic attack and what people would consider to be an anxiety attack. Both Dr. Spray and Vania Manipod, DO, psychiatrist in private practice in Southern California, agreed that, for a panic attack, it's as though there's no actual trigger in the moment; you typically don't see it coming. As Dr. Spray put it, it's experiencing a "sudden rush of physical sensations that people describe as coming out of nowhere." Let's take a look at the symptoms.
Panic Attack Symptoms
The following symptoms for panic attacks were listed in the DSM-5 or confirmed by the experts we spoke to. According to the DSM-5, a panic attack is an "abrupt surge of intense fear or intense discomfort that reaches a peak within minutes." During that time, four or more of the following symptoms have to occur:
- Heart palpitations, pounding or accelerated heart rate, chest pains, and shortness of breath similar to heart attack symptoms
- Chills even if you're not cold
- Trembling or shaking
- Sweating or heat sensations
- Feeling of choking
- Fear of losing control or fear of dying
- Nausea or abdominal distress
- Feeling dizzy, unsteady, or faint
- Paresthesias (numbness or tingling sensation)
- Derealisation (feelings of unreality) or depersonalization (being detached from oneself)
How Anxiety Differs From Panic Attacks
Dr. Manipod told POPSUGAR that many patients of hers use the term "anxiety attack" interchangeably with a "panic attack." Having an onset of anxiety, what one would describe as an anxiety attack, could feel the same as a panic attack, but it's not as severe and is experienced as less of a threat. It dissipates and doesn't interfere with your day, she said, calling it a "near panic attack." Again, a panic attack is more abrupt; you don't see it coming.
Here's a pretty common example you might relate to: if you're lying awake in bed at night and your mind is racing with intrusive thoughts, this can trigger physical symptoms in some people, Dr. Spray said. It could feel as though you are panicking, but a panic attack doesn't necessarily occur. These anxious thoughts, though, she explained, are definitely worth addressing, and can be treated with cognitive behavioural therapy, which "helps you to make this connection between your thoughts, your feelings, and your behaviours."
Panic Attacks vs. Panic Disorders
It's worth noting, too, that you can have anxiety without being diagnosed with an anxiety disorder. It's normal for people to experience anxiety, Dr. Manipod said, but if it interferes with your daily life, then it becomes a disorder diagnosable in the DSM-5 — and that type of anxiety disorder is diagnosed depending on where the fear stems from, whether it's social anxiety, general anxiety, or triggered by a specific phobia.
Something like generalised anxiety disorder, which is more persistent, "can be just as hard to cope with as recurrent panic attacks," Dr. Spray noted. "They just are slightly different. Generalised anxiety disorder is usually characterized by excessive worry, carrying around a lot of muscle tension, being restless, feeling fatigued, difficulty concentrating, difficulty falling asleep or sleeping." Additionally, though — and here's where going to a professional is important so that they can clarify — you might have an anxiety disorder and also get panic attacks.
The same goes for panic attacks: you can experience panic attacks without having a panic disorder. "Anytime someone gets a diagnosis of a disorder, it's because it's interfering with their daily function," Dr. Manipod clarified. So, she said, if you have a panic attack followed by consistent fear of having another one that persists for over a month, and that fear affects your life negatively, that would align more with a panic disorder.
Dr. Spray added that it's common in these cases that the person avoids different situations for fear of having another attack. She went on to clarify that you can have panic attacks in the context of other disorders. Post traumatic stress disorder is one of them, and you can have a depressive disorder with panic attacks as well, she said.
Treatment For Panic Attacks or Anxiety
Dr. Manipod said that it depends on the person, but treatment remains pretty consistent medication-wise for both anxiety and panic attacks. For most anxiety disorders, psychiatrists might prescribe antidepressants. Those are SSRIs like Prozac and Zoloft and SNRIs such as Effexor and Cymbalta. Types of psychotherapy, like cognitive behavioural therapy, are also used in order to learn how to cope in everyday life.
For panic disorders specifically, some of Dr. Manipod's patients tend to also want medication for emergency situations where coping mechanisms don't work. These medications are under the class of Benzodiazepine and work to calm you down. Due to the risk of building up a tolerance, she prefers that patients use it mostly in those emergency situations. She added, though, that there are a lot of people who have "very severe panic disorders to the point where they are constantly feeling in panic mode and do take it more frequently and regularly."
How to Stop a Panic Attack
Learn to identify it. When you feel shortness of breath or a racing heart, try to identify that what is happening doesn't mean you'll necessarily lose control. Being aware of it, Dr. Manipod said, is important in helping you come down from (and calm) any physical symptoms. You could even repeat, "I'm going to be OK," or "I'm not going to die from this," she suggested.
Take deep breaths. If you feel like you're hyperventilating and you don't control your breathing, it might worsen your physical symptoms and cause the panic attack or anxiety attack to progress. Both mental health professionals recommended deep breathing. One example of this, Dr. Spray noted, is paced breathing where your exhale is longer than your inhale.
Consider seeking help. If you're under distress and wish to speak with a mental health professional, definitely do so. Dr. Spray and Dr. Manipod were both very adamant about the positive affects that psychotherapy has on panic or anxiety attacks. You can read up on the difference between therapists, psychologists, and psychiatrists in this guide.
If you are feeling anxious or depressed and need help finding help or resources, the Anxiety and Depression Association of America (1-240-485-1001) and the National Alliance on Mental Illness (1-800-950-6264) have resources available.