Anxiety vs. panic attack: how to tell them apart

By

Walter Alejos

|

January 26, 2021

man with hands on chest telling difference between anxiety and panic attacks

People often use the words “anxiety” and “panic” interchangeably, but there’s a difference between these terms when it comes to medical diagnosis.

In terms of lived experience, the distinction between anxiety attack vs. panic can feel annoyingly semantic. Conversationally, people often use anxiety or panic attacks to describe very similar experiences.

Plus, if someone is sharing their experience of a panic attack, in most cases, it would be insensitive and unnecessary (at best) to pull out my diagnostic manual and make sure they’re using the right terminology. “I think you need to distinguish between anxiety vs. panic attack,” said no empathic listener ever.

Still, understanding the right terminology can be critical for researching effective treatment, getting the appropriate support, and feeling a greater sense of ownership over your experience.

For people with anxiety and depression, purposefully engaging in pleasurable activities can improve mental health.
People often use the words “anxiety” and “panic” interchangeably, but there’s a difference between these terms when it comes to medical diagnosis.

In terms of lived experience, the distinction between anxiety attack vs. panic can feel annoyingly semantic. Conversationally, people often use anxiety or panic attacks to describe very similar experiences.

Plus, if someone is sharing their experience of a panic attack, in most cases, it would be insensitive and unnecessary (at best) to pull out my diagnostic manual and make sure they’re using the right terminology. “I think you need to distinguish between anxiety vs. panic attack,” said no empathic listener ever.

Still, understanding the right terminology can be critical for researching effective treatment, getting the appropriate support, and feeling a greater sense of ownership over your experience.

Why do I get anxious?

Let’s start with the basics. If we look at anxiety from an evolutionary biology perspective, we can see how anxiety might help keep us safe in the face of immediate danger. Imagine you’re walking through the park and you spot a tiger. In response to this threat, your pulse quickens, your breathing accelerates, you may begin to sweat or start to feel nauseous.

These physical changes are all part of your body’s stress response system, which activates a fight or flight reaction in the face of a threat. When you encounter a stressor, like a tiger, your brain triggers the release of chemicals. These have an immediate impact on your body, preparing you to survive whatever danger is heading in your direction.

What happens during a panic attack is experientially similar. According to researchers, the difference is that a panic attack is triggered by “false alarms.” You experience a full-fledged response to acute danger in the absence of a genuine threat.

These episodes can occur seemingly out of the blue or in response to a known trigger. For instance, someone with a fear of social situations might experience panic at a big party.

How do I know if I had a panic attack?

Although the experience is relatively common—roughly 40% of people report having a panic attack at some point in their lives—it feels anything but benign. Many describe their experience of a panic attack as the most frightening thing that has ever happened to them.

The latest edition of the Diagnostic and Statistical Manual (DSM-5) offers a definition of a panic attack. It’s an abrupt and discrete experience of intense fear or acute discomfort, which peaks within 10 minutes of onset and in which at least 4 of the following symptoms are present:

  • Heart palpitations, a pounding heart, or racing heart rate
  • Sweating
  • Trembling or shaking
  • Feeling short of breath or like you’re being smothered
  • Feeling like you’re choking
  • Chest pain or discomfort
  • Feeling nauseous or having abdominal distress
  • Dizziness, lightheadedness, or faintness
  • Feeling like things aren’t real, or like you’re not real
  • Fear of losing control or going crazy
  • Sensations of tingling or numbness
  • Chills or heat sensations
  • Fear of dying

When determining whether an experience of acute anxiety is or was a panic attack, healthcare practitioners use their training and tools to rule out physical causes and substance withdrawal.

And suppose you’re with someone experiencing acute, worrisome symptoms of panic. In that case, Mental Health First Aid advises you to stay with them and seek medical help right away, unless they specifically tell you they are having a panic attack.

Because the symptoms of panic are similar to those of cardiac distress, it’s crucial to avoid making assumptions about someone else’s experience.

It’s also important to avoid assumptions because there’s no singular experience of a panic attack. Individual factors, including culture and race, can influence the symptoms that feel most salient.

Learn more about how racial trauma can lead to stress.

Panic vs. anxiety

The main difference between anxiety and panic is the proximity of threat. Anxiety tells us “there’s danger coming,” while panic tells us, “the danger is here! Stay on high alert.”

While you might have low-grade anxiety and manage to complete a task or show up for others, panic is more acute. Because the threat feels immediate, all your energy goes towards responding to the threat. Another way this shows up is the length of onset. While anxiety can build slowly, panic usually erupts within minutes, and though it may not last as long, it can feel extremely intense.

Try mindful breathing for anxiety right now.

Panic attack vs. anxiety attack

Now that we’ve cleared up the distinction between anxiety and panic in terms of experience, let’s look at the difference between a panic attack and an anxiety attack. Though it’s not uncommon to use either the term anxiety attack or panic attack to describe a similar experience, one significant difference is that “anxiety attack” isn’t a clinical term.

The chances are that if you call up a therapist or physician to seek help for anxiety attacks, they’d know what you meant. The terms are often used interchangeably, which can cause unnecessary confusion, especially if you’re experiencing difficulty and want to find help.

To sum up, a panic attack has a clinical definition and specific diagnostic criteria. So what is an “anxiety attack”? While it might be someone’s chosen terminology, anxiety attack isn’t a clinical term.

Learn tools to stop panic attacks that work anytime, anywhere.

Panic disorder vs. anxiety disorder

Both panic and anxiety exist on a continuum. At lower levels of severity, these are human experiences that many overcome or manage without clinical support.

For example, you may feel “panicky” before a big presentation. As you stand in front of the crowd, your knees shake, and you notice that your body feels warm. But as you begin to speak, you focus on a few members of the audience, and your panic subsides.

Neither anxiety nor panic is considered a “disorder” unless it significantly interferes with your wellbeing, work, or meaningful relationships.

According to the DSM, panic disorder is characterized by recurrent, unexpected panic attacks that lead to at least a month of worry or a change in behavior related to the episodes.

40% of the population reports experiencing a panic attack at some point in time. 8 – 10% of the population reports the occasional panic attack, and of that group, 5% develop panic disorder. It may be reassuring to know that recurrence is not inevitable.

The critical distinction between panic disorder and anxiety disorder is hierarchy. Just like rain boots are a type of shoe, panic disorder is a type of anxiety disorder.

Getting the support you need

Understanding the difference between anxiety and panic attacks may feel important for your health journey, or it may not. The most important thing is that you get the support you need.

Whether you’ve experienced a single panic attack or think you may have a panic or anxiety disorder, it’s never too early to seek treatment. Visit Lemonaid to learn how to get anxiety treatment online.

Takeaway

  • Anxiety is a protective mechanism aimed at keeping us safe in the face of danger.
  • But in a panic attack, the response happens in connection with a “false alarm.”
  • The main difference between anxiety and panic is the proximity of threat. Anxiety tells us “there’s danger coming,” while panic tells us, “the danger is here.”
  • “Panic attack” is a clinical term, while “anxiety attack” is not, and panic disorder is a type of anxiety disorder.
  1. The American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
  2. Barrera (2010). The Experience of Panic Symptoms across Racial Groups in a Student Samplehttps://doi.org/10.1016/j.janxdis.2010.06.010
  3. Lilienfeld & Arkowitz (2008). Why Do We Panic? A better understanding of the path from stress to anxiety to full-blown panic disorder offers soothing news for sufferershttps://www.scientificamerican.com/article/why-do-we-panic/
  4. Otto et al. (2012). Five sessions and counting: considering ultra-brief treatment for panic disorderhttps://pubmed.ncbi.nlm.nih.gov/22730311/
  5. Smits et al. (2019). Personalized Exposure Therapy: A Person-Centered Transdiagnostic Approach. https://www.oxfordclinicalpsych.com/view/10.1093/med-psych/9780190602451.001.0001/med-9780190602451-appendix-1.
  6. Taylor (2006). Panic Disorder. http://www.jstor.org/stable/25456719

By

Walter Alejos

|

January 26, 2021