Panic Attack vs Anxiety Attack: What's the Difference?

You're in the middle of something terrifying. Heart pounding. Can't breathe. Feel like you're dying. Is it a panic attack? An anxiety attack? Does it matter?

These terms get used interchangeably, but they're actually different experiences with different implications for treatment. Understanding the distinction can help you respond more effectively and communicate better with healthcare providers.

The Key Difference

Panic attacks have a clinical definition in the DSM-5 (the diagnostic manual for mental health conditions). They're sudden, intense surges of fear that peak within minutes and involve specific physical symptoms.

Anxiety attacks aren't a clinical term at all. It's a colloquial phrase people use to describe periods of intense anxiety. There's no official definition, which means different people mean different things by it.

This isn't just semantics. Because panic attacks have a clear definition, they're what gets diagnosed, researched, and treated in clinical settings. "Anxiety attack" is descriptive but not diagnostic.

What Is a Panic Attack?

A panic attack is an abrupt surge of intense fear or discomfort that reaches a peak within minutes. During this time, four or more of the following symptoms occur:

Physical symptoms:

• Pounding heart, racing pulse
• Sweating
• Trembling or shaking
• Shortness of breath or feeling smothered
• Feelings of choking
• Chest pain or discomfort
• Nausea or stomach distress
• Dizziness, unsteadiness, or faintness
• Chills or hot flashes
• Numbness or tingling sensations

Cognitive symptoms:

• Fear of losing control or "going crazy"
• Fear of dying
• Feelings of unreality (derealization)
• Feeling detached from yourself (depersonalization)

What Panic Attacks Feel Like

People describe panic attacks as:

• "I thought I was having a heart attack"
• "I was certain I was dying"
• "I couldn't breathe, like someone was sitting on my chest"
• "Everything felt unreal, like a dream"
• "I had to escape, but I didn't know from what"
• "My hands went numb and tingly"
• "I thought I was losing my mind"

The intensity is what distinguishes panic attacks. They're not just uncomfortable; they're terrifying. Many people's first panic attack sends them to the emergency room, convinced something is seriously physically wrong.

Types of Panic Attacks

Expected (cued): You can identify a trigger. If you have a phobia of flying, you might have a panic attack when boarding a plane.

Unexpected (uncued): They come out of nowhere. You might be relaxing at home when one strikes. These are particularly distressing because there's no apparent cause.

Duration

Panic attacks peak within minutes (usually 10-20) and typically last no more than 20-30 minutes total. The intense phase is brief, though you may feel shaky and exhausted for hours afterward.

What Is an "Anxiety Attack"?

Since there's no clinical definition, "anxiety attack" tends to mean different things:

Some people use it to describe intense anxiety that builds up over time. Worry and tension increase until they become overwhelming. This might last hours or days.

Others use it interchangeably with panic attack. They're describing the same experience but using different words.

Some use it for sub-threshold panic. Intense anxiety with some panic-like symptoms but fewer than four or not quite meeting the clinical threshold.

What It Might Feel Like

What people typically mean by "anxiety attack":

• Building worry that becomes overwhelming
• Racing thoughts you can't stop
• Muscle tension and restlessness
• Difficulty concentrating
• Sleep disruption
• Physical symptoms (stomach upset, headache, tension)
• Sense of dread
• Irritability or being on edge

The key difference: this builds gradually rather than surging suddenly. It's often tied to identifiable stressors (even if the response is disproportionate). And it doesn't typically include the "I'm dying" terror of a true panic attack.

Comparison Table

| Feature | Panic Attack | "Anxiety Attack" | |---------|-------------|------------------| | Clinical term | Yes (DSM-5) | No (colloquial) | | Onset | Sudden, abrupt | Gradual build | | Peak | Within minutes | Varies | | Duration | 10-30 minutes (intense phase) | Hours to days | | Intensity | Extreme, terrifying | Moderate to severe | | Trigger | May or may not be identifiable | Usually identifiable | | Physical symptoms | Severe, prominent | Present but less severe | | Fear of dying | Common | Less common | | Post-episode | Exhausted, shaky | Drained, worried |

Why Does the Distinction Matter?

For Diagnosis

Panic disorder specifically requires recurrent unexpected panic attacks plus ongoing worry about having more attacks or significant behavior changes because of them.

If you tell a doctor you're having "anxiety attacks," they might not know whether you mean clinical panic attacks. Being specific about your symptoms helps you get accurate diagnosis.

For Treatment

Panic attacks and generalized anxiety respond to some similar treatments (SSRIs, therapy) but also have specific interventions:

Panic-specific treatments:

• Learning that panic attacks aren't dangerous
• Interoceptive exposure (deliberately triggering sensations)
• Panic-focused CBT
• Addressing avoidance behaviors

Anxiety-specific treatments:

• Managing chronic worry
• Addressing multiple worry domains
• Building distress tolerance over time
• Relaxation and stress management

Knowing what you're actually experiencing helps match you to the most effective approach.

For Your Understanding

If you're having panic attacks, understanding they have a clear physiological mechanism can be reassuring. Your body is misfiring a false alarm. It's terrifying but not dangerous. This knowledge itself can reduce the fear that feeds panic.

If you're having prolonged periods of intense anxiety, understanding that as distinct from panic helps you address the actual pattern (chronic worry, sustained stress response) rather than waiting for discrete attacks.

What Causes Each?

Panic Attack Causes

Biological factors: Panic attacks involve the amygdala (threat detection center) and the sympathetic nervous system. There may be genetic predisposition.

The "false alarm" model: Your brain's alarm system fires when there's no actual threat. The alarm itself is so intense that it becomes the threat, creating a feedback loop.

Triggers: Can include caffeine, certain substances, physical sensations (exercise, heat), or nothing identifiable.

Panic disorder develops when fear of panic attacks creates avoidance and ongoing anxiety, which paradoxically increases vulnerability to more attacks.

Anxiety Build-Up Causes

Chronic stress: Ongoing work pressure, relationship issues, health concerns.

Worry patterns: Rumination and catastrophizing that escalate over time.

Lack of coping resources: Not enough sleep, exercise, social support, or healthy outlets.

Avoidance: Not addressing anxiety-provoking situations, letting worry build.

General anxiety disorder (GAD): Some people have a biological tendency toward chronic worry.

How to Respond

During a Panic Attack

Remind yourself: "This is a panic attack. It's my body's false alarm. It's terrifying but not dangerous. It will pass."

Don't fight it: Resistance often makes panic worse. Allow the sensations to be there.

Breathe slowly: Panic involves hyperventilation. Slow, controlled breathing helps: breathe in for 4 counts, hold for 4, out for 6.

Ground yourself: Name 5 things you see, 4 you hear, 3 you touch. This interrupts the panic spiral.

Don't escape (if possible): Leaving reinforces that the situation is dangerous. Staying shows your brain it's safe.

Wait it out: It will peak and pass, usually within 20-30 minutes.

During Intense Anxiety Build-Up

Identify triggers: What's driving this? Even if you can't fix it, naming it helps.

Break the worry cycle: Write down worries, schedule "worry time," challenge catastrophic thoughts.

Move your body: Exercise burns off stress hormones. Even a walk helps.

Connect with someone: Talk through what you're feeling.

Address the basics: Are you sleeping? Eating? Getting outside?

Problem-solve what's controllable: If anxiety is about something specific, take one small action.

When to Get Help

Seek professional help if:

• Panic attacks are recurrent
• You're avoiding situations because of fear of panic
• Anxiety is interfering with work, relationships, or daily functioning
• You're using alcohol or substances to cope
• You're having thoughts of self-harm
• Symptoms have persisted for weeks or months
• Self-help strategies aren't working

Both panic attacks and intense anxiety are highly treatable. CBT is particularly effective for panic disorder. Various approaches help with generalized anxiety. Medication is an option for either.

What Doesn't Help

Avoidance: Whether avoiding situations that might trigger panic or avoiding anxiety-provoking tasks, avoidance maintains the problem.

Overbreathing: Taking deep breaths sounds helpful but can increase hyperventilation during panic. Slow, controlled breathing is different.

Seeking constant reassurance: This provides temporary relief but prevents you from learning you can cope.

Fighting the feelings: Battling against anxiety often intensifies it.

Dr. Google: Checking symptoms repeatedly increases anxiety.

Living With Either

Whether you experience panic attacks, intense anxiety episodes, or both, here are general principles:

Understand your pattern: Keep a log. What happens? When? What helps? This information aids treatment.

Build baseline coping: Regular exercise, adequate sleep, limited caffeine, social connection. These reduce vulnerability to both.

Develop in-the-moment skills: Breathing techniques, grounding, self-talk. Practice when calm so they're available when needed.

Address avoidance: Gradually face what you're avoiding. Exposure is the most effective treatment for anxiety.

Get professional support: These conditions are common and treatable. You don't have to figure it out alone.

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Whether it's panic surging out of nowhere or anxiety building to overwhelm, ILTY is there. Talk through what you're experiencing, learn what might help, and get support getting through the moment. No judgment. No toxic positivity. Just real help.

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Related Reading

• The Complete Anxiety Guide: Understanding anxiety in all its forms.
• 2am Anxiety: When Your Brain Won't Shut Up: Managing nighttime anxiety.
• Morning Anxiety: Why You Wake Up Worried: When anxiety hits first thing.