Anxiety attacks vs panic attacks

While panic and anxiety attacks can produce similar physical symptoms, including an accelerated heart rate, chest pain, and shortness of breath, they are not exactly the same. Therefore, it’s important to know how to recognize a panic vs. anxiety attack and how to help someone having a panic attack.

An anxiety attack, which usually occurs in reaction to a stressor, is short-lived and marked by feelings of apprehension, restlessness, and distress. But once that stressor is removed, the anxiety attack ends. 

Even though anxiety attacks are typically short-lived, many people may live with a general level of anxiety for months. Symptoms of anxiety that can lead to anxiety attacks include muscle tension, restlessness, fatigue, and irritability.

The main difference between a panic attack and an anxiety attack is that a panic attack does not necessarily occur in reaction to a stressor. Instead, it’s an unprecedented condition that results in an intense burst of fear that can peak within minutes. It is also often accompanied by a sense of detachment from reality, as the panic attack takes over all other thoughts.

And while anxiety is often a symptom of a panic attack, other symptoms, such as chills, a pounding heartbeat, dizziness, trembling, hot flashes, and chest pain, often cause a panic attack to be mistaken for a heart attack.

Overall, the biggest distinction between panic attacks vs. anxiety attacks is the intensity and duration of the symptoms.

Causes of anxiety attacks

Specific life stressors or situations can worsen your condition and bring on anxiety attacks. Becoming aware of these triggers can help you to better prepare and manage them. Common causes may include:

• An upsetting health diagnosis in yourself or a loved one
• Excessive caffeine intake
• Financial, job, or relationship stress
• Major life events or transitions 
• Sleep deprivation
• Social anxiety

Those with a history of mental illness such as generalized anxiety, social anxiety, PTSD, or family history are more at risk for anxiety attacks.

Symptoms of an anxiety attack

The symptoms can differ in regards to a panic vs. anxiety attack. Common symptoms of an anxiety attack vary and can present as physical or mental. Symptoms include:

• Dry mouth
• Feeling irritable and angry
• Feeling “on edge”
• Feeling overwhelmed by stress and fear
• Headache and muscle tension.
• Nausea and digestive upset
• Racing thoughts
• Rapid heartbeat
• Shortness of breath
• Sweaty palms
• Trouble settling into sleep

Anxiety attack symptoms can come on gradually over a few days, and other times they may come on more suddenly.

Causes of panic attacks

Many times, panic attacks can occur out of the blue without an obvious trigger. Other times, they may be more expected if exposed to a known fear or phobia.

Other common causes of panic attacks or factors that increase the risk are:

• Brain chemistry
• Genetics or a family history
• Major stress
• Temperament that is more sensitive to stress

Initially, panic attacks may come without warning, but over time they are usually triggered by certain situations or stressors. Being aware of these known triggers can be helpful in terms of preparing for them.

Most of the time, factors that trigger panic attacks do not pose any actual danger or threat. Instead, they have often perceived fears such as the fear of giving a big presentation in front of a large audience.

Symptoms of a panic attack

A common difference between a panic and anxiety attack is the severity of symptoms. Common symptoms of a panic attack can range from mild to intense:

• Abdominal cramping
• Being out of touch with reality or detachment
• Chest pain
• Chills
• Dizziness, lightheadedness, or faintness
• Fear of loss of control or death
• Headache
• Hot flashes
• Nausea
• Numbness or tingling sensation
• Rapid, pounding heart rate
• Sense of impending doom or danger
• Shortness of breath or tightness in your throat
• Sweating
• Trembling or shaking

If you’ve suffered from a panic attack in the past, you may be more hesitant to put yourself in that same situation again. This may lead to further detachment and avoidance of certain situations if not addressed. 

How to stop a panic attack

The first step in stopping a panic attack is simply noticing the symptoms and recognizing the condition.

In addition, the following strategies can lessen the duration and severity of the attack: 

• Close your eyes: Because panic attacks are overwhelming, they can help to block out any extra stimuli. 
• Breathe deeply: A panic attack can cause hyperventilating, which can increase fear and exacerbate the attack. Focus on taking deep breaths in and out of your mouth for a count of four, letting air slowly fill and leave your chest and belly.  
• Relax your muscles: Much like deep breathing, muscle relaxation can help control your body’s response to a panic attack and therefore lessen the symptoms.  
• Use a mantra: If you experience frequent panic attacks, repeating a phrase in your mind can help relax and reassure you and provide a focal point during an attack.  
• Meditate: Brief meditations are available online and via iPhone apps. These can help provide instant relief from a panic attack.  

What are anxiety disorders?

Anxiety disorders are mental health conditions characterized by worry, anxiety, and fear severe enough to affect one’s daily activities. There are a few common symptoms:

• An inability to shut off thoughts or set aside a worry
• A stress level disproportionate to the nature of the event.
• Restlessness and irritability 

In diagnosed anxiety disorders, it is more than just the occasional worry or anxious feeling - it involves a more persistent feeling of dread or anxiety.

Different types of anxiety disorders 

According to the National Institutes of Mental Health, there are five major types of anxiety disorders. These disorders may share some similarities in symptoms but may present under different circumstances.

1. Generalized Anxiety Disorder (GAD) 

People with GAD experience excessive anxiety or worry on most days for at least six months. Common symptoms include restlessness, fatigue, difficulty concentrating, irritability, headaches, and difficulty sleeping.

These symptoms typically interfere with aspects such as personal health, work, and social interactions and can cause anxiety in many areas of daily living.  

2. Obsessive-Compulsive Disorder (OCD)

OCD is an anxiety disorder that includes unwanted worries, obsessions, or a preoccupation with negative thoughts. The person may engage in compulsive or repetitive behaviors such as hand washing, counting, checking, or cleaning in an attempt to prevent these thoughts or perceived threats from occurring.

These symptoms can interfere with all aspects of life, such as work, school, and personal relationships. 

3. Panic Disorder

This disorder is marked by recurrent unexpected panic attacks. There are also sudden periods of intense fear or a sense of losing control that comes on quickly and reaches their peak within minutes.  

4. Post-Traumatic Stress Disorder (PTSD)

This type of anxiety disorder often develops after exposure to a terrifying event.

PTSD can be triggered by military combat, a personal assault, an accident, or a disaster. Symptoms may include nightmares or unwanted memories of the trauma, fear, and avoidance of anything that brings back these memories.

5. Social phobia

Previously called Social Anxiety Disorder, the social phobia involves a general, intense fear of being watched or judged by others in social situations.

This can result in the person having difficulty making eye contact with others or establishing close connections and lead to a fear or avoidance of social situations.

Treatment for anxiety and panic attacks

Proper treatment can reduce the intensity and duration of your anxiety or panic attacks. Typically first-line treatment includes psychotherapy, otherwise known as talk therapy, and medication.

Psychotherapy aims to help you understand why anxiety and panic attacks occur and develop coping mechanisms to better manage them.

Prescription medications can also reduce symptoms if talk therapy isn’t enough. Common medications prescribed include Selective Serotonin Reuptake Inhibitors (SSRIs), Serotonin and Norepinephrine Reuptake Inhibitors, and Benzodiazepines.

Simple ways to reduce stress effectively

There are effective lifestyle changes that can improve your quality of life and help you better cope with stress-related health issues:

• A balanced diet
• A daily yoga or meditation practice
• Engage in regular exercise
• Getting a better night’s sleep
• Limiting screen time
• Practicing a healthy activity for the mind such as reading
• Reducing caffeine intake
• Spending time with loved ones

Not only are these habits helpful for adults, but also for kids with stress. 

Visit an Urgent Care for anxiety or panic attacks 

Everyone feels anxious at times, especially during difficult circumstances. It can also be difficult to determine the difference between panic attacks and anxiety attacks. It's also important to know how to handle holiday stress.

Although worry doesn’t necessarily mean you have an anxiety disorder, it’s important to see a doctor if you experience anxiety with any of the following symptoms: 

• You feel depressed and anxious at the same time or feel you’re losing control  
• Anxiety begins to affect your work and/or personal life 
• Your anxiety is causing you to abuse drugs and/or alcohol to cope. 

You may be asking yourself “can you go to the hospital for anxiety?” The answer is yes — in fact we recommend you seek immediate help. If you are suffering from chronic anxiety or panic attacks, visit a an Urgent Care near you.   

If your anxiety turns toward suicidal thoughts, call 9-1-1 immediately or contact the National Suicide Prevention Lifeline at 1-800-273-8255.

Written by Sarah Thebarge, Physician Assistant