Anxiety disorders represent a category of mental health disorders, which can include generalized anxiety disorder or panic disorder. Nearly all anxiety disorders can manifest with panic attacks, but they don’t have to. Panic attacks happen without warning and have no known triggers or causes, which makes them more likely to induce subsequent anticipatory anxiety in individuals who have had one.
Anxiety disorders are mental health disorders severe enough to impede daily activities like relationships or job performance.
But individuals can simply experience acute anxiety from temporary life challenges, changes, or stressful circumstances like:
- A death in the family
- Divorce
- Having a new baby
- Moving
- Changing jobs
- Losing a job
- Financial strain
- Homelessness
- Caring for an elderly parent
- Caring for a developmentally challenged child
- Getting into an accident
These acute anxiety-inducing situations can lead to an anxiety attack, which results from known causes and triggers.
This article will review the difference between anxiety and panic attacks and the implications for treatment, as well as key symptoms, physiological responses, triggers, and prevalence.
Panic attack vs anxiety attack: What are they?
Panic disorder is a mental health disorder that falls under the umbrella of anxiety disorders. Its main symptom is repeated panic attacks, which are regularly accompanied by symptoms like:
- Fear of losing control
- Anticipatory anxiety
- Behavioral changes because of the attacks
Anxiety attacks are manifestations of anxiety-related symptoms. These symptoms might be acute or chronic, based on the cause. An anxiety attack might have some similar feelings to a panic attack, but for many people, anxiety attacks can come with unexpectedly high stress and be controlled when that stress is controlled.
Key symptoms of anxiety attack vs panic attack
With a panic attack, you will experience at least four of the primary symptoms. Symptoms of a panic attack can include:
- Dizziness
- Difficulty breathing
- Trembling
- Sweating
- Nausea
- Chills
- Hot flashes
- Feeling as though you are choking
- Tingling in the extremities
- Cold fingers, toes, and nose
- An out-of-body experience
- Shaking
- Abdominal issues
- Palpitations
- Chest pain
- Fear of dying
The feelings can be so extreme that many people mistake a panic attack for a heart attack, but it’s important to understand that panic attacks are not life-threatening and do not require emergency medical care.
An anxiety attack can have many different symptoms. It’s not always easy to recognize these symptoms because they can be physical, mental, or behavioral.
You don’t need a specific number of symptoms or a specific type of symptom, but rather, one anxiety attack might have a headache and shaking while another might have the inability to relax with difficulty concentrating, and yet another might have a racing heart, sweatiness, and feeling tearful as their primary symptoms.
With an anxiety attack, you might feel symptoms like the following:
- Headaches
- Loss of appetite
- Breathlessness
- Shaking
- Dizziness
- Chest pain
- Racing heart
- Feeling tearful
- Difficulty concentrating
- Being unable to sleep
- Worrying about the future or past
- Feeling unable to relax
- Not being able to look after yourself
- Fear of trying new things
- Compulsive behavior like regularly checking things
Physiological responses for a panic attack vs. anxiety attack
Panic attacks
Panic responses, at a physiological and biological level, are natural responses when there is a nearby predatory threat or something that might threaten your life. It is designed to activate the fight, flight, or flee response.
However, panic attacks have the same level of intense fear, and they arouse sympathetic activity in the amygdala without any actual danger being present.
So what physiologic responses actually happen for a panic attack vs. anxiety attack?
In the limbic system of your brain, where your emotions are processed, the amygdala gets activated because it senses a threat even though that threat isn’t really there. The brain will respond just as intensely to potential threats as it does to legitimate threats.
The amygdala sends messages to your bones to release stress responses through osteocalcin. Once these responses flood your system, your body increases adrenaline, a hormone that is responsible for boosting blood sugar and heart rate. It’s this increase in adrenaline that causes things like sweating, shaking, coldness in your extremities, and that clavicular hyperventilation where you aren’t taking deep breaths but instead of breathing from your clavicle.
The adrenaline changes your breathing to shallow, clavicular breathing in order to take in more oxygen so that you can sharpen your senses and have the energy you need when facing a difficult situation.
Hypothalamic-pituitary-adrenal axis dysfunction
Potential causes from some neuroendocrinological studies have found that hypothalamic pituitary adrenal axis dysfunction can exacerbate panic attacks in individuals with a panic disorder. However, this dysfunction develops after an individual has already experienced at least one panic attack because it is associated with secondary anticipatory anxiety and distress that comes from secondary symptoms.
Amygdala
Additional research has explored the physiological responses to a panic attack as it relates to the amygdala. The amygdala is a part of the brain responsible for processing fear, and it sends output to other parts of the brain, including the hypothalamus, when a fear response needs to be activated.
This fear response can trigger the release of hormones within the bones as well as a constriction of the blood vessels and a halt to unnecessary bodily processes, all in preparation for the fight or flight response.
Structural neuroimaging studies have found that individuals with panic disorder have structural alterations to the amygdala. In particular, a statistically significant number of patients with panic disorder who experienced regular panic attacks had a reduction in amygdala volume greater in the right amygdala than in the left. The deficit in the right amygdala is important because the right hemisphere processes emotions like fear and other negative emotions.
Research found that the right amygdala is involved in processing acquired fear, and the left is involved in processing innate fear.
Anxiety attack
An anxiety attack happens when you feel tension, and it causes physical changes like an increase in your blood pressure. Physiologically, these changes are the same as the amygdala response to a panic attack, but they may not be as severe, and the symptoms can remain for prolonged periods of time.
Anxiety attack vs. panic attack: Duration
The average panic attack develops very suddenly, and this contributes to some of the main accompanying symptoms like anticipatory anxiety, as individuals are never quite sure when the next attack will happen.
Research shows that the average panic attack reaches its peak within 10 minutes.
Despite the fact that a panic attack will typically pass over the course of several minutes, some people experience lingering effects for up to a few hours after the fact. It’s not uncommon to feel exhausted afterward because of the increased adrenaline and fear response.
The feeling of being drained and exhausted comes from the immediate change in hormones, flushing through your blood vessels as they expand, and the reactivation of all the other non-essential bodily functions that may have been paused during your panic attack.
The average anxiety attack manifests slowly, building based on the physiological response to the fear source. These feelings can last anywhere from several minutes to several weeks.
Difference between anxiety attack and panic attack: Triggers
Anxiety that is very intense and prolonged is considered an anxiety attack, and this condition is triggered by prolonged stress exposure. This means that understanding what it is that triggers you is an essential part of reducing your anxiety attack frequency, severity, and symptoms.
Unfortunately, panic attacks can be random. Your body senses a threat that doesn’t exist, and adrenaline levels can spike by 2.5 times your normal rate.
Because panic attacks come on unexpectedly, it’s next to impossible for people with a panic disorder or another type of anxiety disorder that presents alongside panic attacks to recognize or control triggers in their environment. This makes it even more important to have quick tips to stop or control the severity of the panic attack symptoms.
Physical changes for panic attacks
One important thing to note is that while panic attacks don’t have known triggers or causes, people with panic disorders can learn to recognize the physical changes, which typically start around 1 hour before the panic attack itself.
Tip: If you struggle with panic attacks, wearing devices that monitor your heart activity, your temperature, your breathing, or your sweating can help you determine when a panic attack is about to happen.
For example:
Lower than normal carbon dioxide levels are often associated with the clavicular breathing and hyperventilation that comes from panic attacks. This particular symptom can begin about 45 minutes prior to the panic attack, so if you can measure your breathing, you can see when you are taking faster breaths than normal and determine whether that’s because you just finished a run or whether it’s because a panic attack is about to happen.
Things like Apple watches can help you monitor your resting pulse when you are just sitting and working throughout the day. This should be between 70 and 90 beats per minute. But if you check and you are doing something that is not strenuous but you notice your heart rate has climbed well above 90, it could indicate an impending panic attack, and you can take preventative measures.
You can also monitor your temperature. The average temperature is around 98.7°, but if, for no external reasons, you notice your temperature rising significantly, it could also be a reflection of an upcoming panic attack as the increased blood flow and adrenaline will raise your body temperature.
Difference between anxiety and panic attacks: Prevalence
According to the DSM, roughly 4.52% of the population in the US struggles with panic disorder and subsequent panic attacks.
Nearly 31% of the population struggle with some kind of anxiety disorder across the United States, but anxiety attacks can happen regardless of whether an individual has an actual anxiety disorder.
Are panic attacks and anxiety attacks the same?
Many of the anxiety vs. panic attack symptoms are the same: people feel dizzy and nervous, they sweat or shake, and get some abdominal distress. This can lead to the two being confused and misinterpreted.
Note: Panic attacks and anxiety attacks are not the same.
- Panic attacks have no known trigger or cause, and they represent a physiological response to a perceived threat that doesn’t exist.
- Anxiety attacks can have several causes and triggers, which can be determined by the individual, and the symptoms of an anxiety attack represent a stress response to the cause or trigger.
- Panic attacks are often associated with a panic disorder or other anxiety disorder so they need to be managed through techniques like cognitive behavioral therapy and possibly through medication.
- Anxiety attacks can happen in individuals who don’t have an anxiety disorder but instead are going through short-term situations that are very stressful or distressing.
How to stop panic and anxiety attacks: Tips
Short term
In order to stop panic and anxiety attacks at the moment, you can practice mindfulness and CBT coping strategies:
For a panic attack:
- Take your pointer and thumb from one hand and gently massage the area of skin between the pointer and thumb on the other hand. This can bring your focus back to the present, particularly if you are experiencing an out-of-body situation or have problems focusing.
- Close your eyes and remind yourself:
- What your name is
- Where you are
- What you were just doing
- That you have a disorder or are experiencing an attack
- That you can control the symptoms by breathing
- That you are safe
- Use square breathing to change your symptoms. During a panic attack or anxiety attack, your amygdala response will cause your blood vessels to constrict and limit the amount of carbon dioxide getting to your brain. You can change this by practicing deep breathing exercises that force your body to maintain carbon dioxide and flush it back into the brain.
For Square Breathing:
- Exhale for a count of 4 or 6 through the mouth, and when you have pushed all of the air out of your body, pause.
- Hold the pause for the same length of time (4 to 6 seconds) before you inhale again.
- When you inhale, do so for a slow count of 4 to 6 seconds through the nose.
- Finally, wait at the top of the breath before you exhale again.
- Repeat this process until you feel your symptoms dissipate.
Try mindful meditation where you:
- Close your eyes and bring your focus on the seat/chair/ground beneath you.
- Notice the sounds of the space you are in, first those that are closest to you, then those that are farther and farther away.
- Pay attention to the temperature of the space and how the air feels against your skin.
- Notice the feel of your clothes or shoes against your body.
- Pay attention to the emotions you are feeling, letting them pass without judgment or concern.
Tip: Don’t wait until a severe panic attack or anxiety attack to use these methods. Try to make them part of your regular response to stress or even mild anxiety so that they become a habit. It takes several weeks to form a reliable habit.
Long Term
Exercise
In order to reduce anxiety and subsequently help control anxiety attacks and panic attacks, you need to exercise regularly. While the attacks might be short-lived, regular exercise can prove very useful both short and long-term.
- Regular exercise will divert you away from the anxious thoughts that might be triggering your anxiety attacks.
- Moving your body can reduce muscle tension, a major symptom of anxiety attacks.
- Improving your heart rate through exercise changes your brain chemistry, altering things like serotonin and endocannabinoids, as well as other anti-anxiety neurochemicals that can be activated during a panic attack or anxiety attack.
- Exercise can also activate the prefrontal cortex in the brain responsible for your executive function. The executive function controls your amygdala, which can decrease the way in which your body and brain are responding to real or imagined threats from anxiety or panic attacks.
- Regular exercise can help build your resilience, which prevents stressful situations from having the same effect on your overall well-being, something that can decrease the total number of anxiety attacks or panic attacks you might experience in the future.
Sleep
Research suggests that poor sleep can increase anxiety levels by up to 30%. This means you may be at a higher risk of panic attacks or anxiety attacks if you don’t sleep well, particularly if you don’t get deep sleep.
- Deep sleep gives your neurons a chance to repair themselves.
- Sleep controls your emotional and social well-being.
- Deep sleep promotes protein production, which is essential for repairing the damage caused by stress.
Sleep deprivation causes individuals to experience heightened anxiety during regular tasks and perceive a greater catastrophic outcome than they would if they were well rested. This means that you are at a much higher risk of developing a short-term anxiety attack if you don’t sleep well because you will perceive threats where they don’t exist. This can also contribute to panic attacks.
Sleep deprivation inhibits memory function, leads to cognitive struggles, disrupted hormonal balances, further adrenaline levels, and an inability to effectively cope with stress. With poor sleep quality and quantity, you will find it more challenging to use short-term coping mechanisms to deal with your anxiety levels. You will have higher resting adrenaline levels, which contribute to anxiety and panic attacks.
During deep NREM sleep, your brain waves become synchronized, and you have a significant drop in heart rate and blood pressure, which decreases your anxiety. This means that deep sleep inhibits anxiety, and the better you can sleep each night, the less anxiety you will have during the day.
Remember that the reverse is also true, such that insufficient sleep will amplify your anxiety and increase your risk of anxiety attacks during the day.
Professional Help
All of these quick tips can help you at the moment, but it’s equally important to know whether the cause of your panic attack vs. anxiety attack symptoms links to a legitimate anxiety disorder like panic disorder or generalized anxiety disorder.
For example:
Someone in the middle of a significant life transition or experiencing short-term hardship might have anxiety attacks, but they aren’t linked to a mental health disorder but rather an acute circumstance. In that case, the tips above can be useful in controlling the anxiety attack when it manifests.
Similarly, someone struggling with a significantly distressing situation or chronic stress in their lives might experience panic attacks without a panic disorder. In these cases, understanding the potential causes and the physical changes that happen can be useful in managing the severity of panic attacks and how much they interfere with daily function.
Still, if symptoms persist and these tips are not useful, it might be because the symptoms relate to a mental health disorder, in which case getting a diagnosis from a qualified professional and subsequent treatment might be your best option.
If you have a panic disorder, it’s one of the most treatable forms of anxiety disorder. You can talk to your doctor or a mental health professional about talk therapy, like cognitive behavioral therapy and anti-anxiety medications that might be useful.
The same is true of individuals with other anxiety disorders who struggle with anxiety attacks as a result of their symptoms. Don’t be afraid to reach out for professional help if your symptoms cause significant distress or daily impairment.
Summing Up
Whether you have anxiety or panic attacks, there are treatment options for both. Some commonalities can make it hard to tell the difference between a panic attack vs. anxiety attack, and they are often confused or misinterpreted.
If your symptoms are not easily manageable with at-home tips, and the symptoms of anxiety attack vs. panic attack cause great distress in your daily life, don’t be afraid to seek professional help. With anxiety, it is important to gain awareness of symptoms, durations, triggers, and prevalence and to be proactive in your management of all of it.