Panic Attack or Anxiety Attack? How to Tell the Difference

By Eric Alcera, M.D.

You’re driving home after an uneventful day at work. You don’t have much on your agenda for the evening – just a nice, quiet dinner at home. Overall, it has been a day of very limited stress or disturbance.

Then, out of nowhere, discomforting feelings begin to overwhelm you. You don’t know where the feelings are coming from or how to suppress them – and, it seems they’re only intensifying by the moment. The feelings become so consuming that you need to stop driving, so you pull your car over on the side of the road.

You wonder what could be going on and how this could have happened.

Are you experiencing a panic attack? Or, is it an anxiety attack?

What is a Panic Attack?

Panic attacks and anxiety attacks differ in various ways. Let’s start by examining what a panic attack is.

In the situation mentioned above, it’s very likely the overwhelming feeling you were experiencing while driving was a panic attack. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a panic attack is defined as an abrupt onset of fear or discomfort. Panic attacks, according to the DSM-5, include at least four 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, light-headed or faint

Chills or heat sensations

Numbness or tingling sensations

Feelings of unreality or feelings of being detached from oneself

Fear of losing control

Fear of dying

It’s important to note that the symptoms of a panic attack will ramp up rather quickly, and tend to reach the height of their intensity within several minutes. Sometimes, the attack can even last as little as just seconds. At that point, the symptoms will typically begin to subside. Generally speaking, a panic attack can occur out of nowhere and does not have to be prompted by any event in particular.

Many patients who experience panic attacks describe them as debilitating, and note they feel as though they have lost control. Because of their unpredictability, sufferers can sometimes worry about when the next one might occur, and subconsciously trigger it to happen. Ultimately, panic attacks can begin to cause a significant disruption in a person’s life.

What is an Anxiety Attack?

While panic attacks are recognized in DSM-5, anxiety attacks are not. This does not mean anxiety attacks are not something that a person can experience – simply that they’re open to varying interpretations, and can be part of many diagnoses, such as post-traumatic stress disorder (PTSD), generalized anxiety disorder, and more.

Anxiety itself can also come on as a normal physiological response to a situation.

The DSM-5 definition of “anxiety,” notes that symptoms can include worry and stress and these symptoms are usually a result of a specific situation, experience or event. Anxiety, unlike the quickly-intensifying panic attack, may come on gradually or can be abrupt. The key is that it is usually triggered by a stressor.

Notable symptoms of an anxiety attack can be both emotional and physical, and include the following:

Worry

Distress

Restlessness

Fear

Chest Pain

Muscle tension

Heart palpitations

Dizziness

Headache

As mentioned, feelings of anxiety associated with a certain situation or event for some people is a normal physiologic response that is necessary for survival. If you’re walking down the street and you see a tiger walking towards you from the other direction, what’s going to happen? More than likely, your heart will begin to race and you’ll tense up. That is typical.

For others, they can have this type of reaction to something seemingly much more mundane, like running into a former friend at the grocery store. Some of the most common triggers for those suffering from anxiety disorders include being confronted with memories associated with traumatic experiences or with stressful social situations.

What Are the Primary Differences Between A Panic and An Anxiety Attack?

At the core, the differences between a panic attack and an anxiety attack are the length of the symptoms, the level of intensity and how they are triggered. While panic attacks are sudden, quick and highly intense, anxiety attacks can be either gradual build ups or abrupt, can last for hours and can be lower intensity. Likewise, while panic attacks don’t need a specific trigger and can be unprovoked, an anxiety attack most often is brought on in reaction to a specific event or trigger, as discussed above.

Are There Any Simple Tips for Preventing the Symptoms?

While regular and reoccurring symptoms of panic and anxiety should be discussed with your doctor, there are some known ways to help prevent symptoms of an impending panic or anxiety attack, including eliminating stress in your daily life where possible, incorporating healthy eating and exercise habits and making mindfulness a key component of your day – which can be done through activities like yoga and meditation.

When Should You See a Doctor?

If you’re experiencing symptoms associated with either a panic attack or an anxiety attack, it may be beneficial for you to visit a physician. A psychiatrist can help you to determine risk, cause and the best courses of treatment. Seeing a doctor is especially vital when symptoms of the attacks begin to affect your mood long-term, your sleep patterns, your appetite or any other important component of your life. If the root of the issue is not determined and treated, it may lead to additional health concerns in the future.

Dr. Eric Alcera is a psychiatrist based in Shrewsbury, NJ and specializes in child and adolescent psychiatry. He is the associate corporate medical director of Hackensack Meridian Behavioral Health Services. To learn more about Hackensack Meridian Health’s Behavioral Health Services, click here.