What’s the Difference Between an Anxiety Attack and a Panic Attack?

You may think of anxiety as a matter of the mind, but it can get physical. Enter anxiety and panic attacks, which can trigger symptoms like dizziness, nausea and chest pain. But is there a difference between an anxiety attack and panic attack?

Recurrent panic attacks are a characteristic symptom of a condition called panic disorder. But theoretically, anyone — with or without an anxiety disorder — can experience an occasional anxiety attack (which is really just another name for a panic attack).

Even though the symptoms are the same (more on this later), there are definite differences between these two types of acute anxiety.

Here, Dillon Hayes, MD, a board-certified psychiatrist based in NYC, explains the difference between anxiety attacks and panic attacks, plus provides tips on how to cope with anxiety spells for better mental health and wellbeing.

The defining symptom of a condition called panic disorder, panic attacks are "intense and overwhelming moments of physical and psychological stress," Dr. Hayes says.

They usually last anywhere from five minutes to a half hour, he says. And according to the National Institute of Mental Health, they can result in mental and physical symptoms like:

• Pounding or racing heart
• Sweating
• Chills
• Trembling
• Difficulty breathing
• Weakness or dizziness
• Tingly or numb hands
• Chest pain
• Stomach pain or nausea
• Overwhelming anxiety or fear
• A feeling that you're out of control
• Fear of death or impending doom

Some people also experience chest pain, which is commonly mistaken for a heart attack, Dr. Hayes says.

What makes panic attacks particularly debilitating is their unpredictability. "Although panic attacks can be triggered by specific fears and phobias, they can also occur unexpectedly and without warning," Dr. Hayes says.

This sudden and uncontrollable onset can cause a damaging domino effect where fear of the panic attacks themselves becomes a source of anxiety, he adds.

Here's the main difference between a panic attack and anxiety attack: 'Anxiety attack' is often used to describe one-off or less frequent panic attacks, "although this is not an officially recognized term," Dr. Hayes says.

In other words, the difference between anxiety and panic attacks is the frequency at which they occur.

"The existence of recurrent panic attacks is necessary to meet criteria for the diagnosis of panic disorder," Dr. Hayes says. Still, "it is possible for those with generalized anxiety disorder (GAD) and other anxiety disorders to experience an occasional panic attack."

The symptoms of anxiety attacks are similar to panic attacks and can include physical issues like shortness of breath, heart palpitations, dizziness and nausea.

The main difference between anxiety attacks and panic attacks, though, is what sparks them.

As mentioned, "panic attacks do not always have an obvious trigger and can often occur out of the blue," Dr. Hayes says. "Anxiety attacks, on the other hand, are usually associated with pre-existing sources of anxiety and worry."

For example: "Someone who feels a lot of stress about their health or finances might find themselves in a situation where their anxiety acutely escalates into an anxiety attack," he says.

"Anxiety is a normal reaction to stress," Dr. Hayes says.

But sometimes, people learn to live with anxiety in the long term, which is why it can be tricky to realize when it's become overwhelming or chronic.

And that's a problem, because "when anxiety becomes excessive and interferes with our functioning, it can evolve into a number of different disorders," Dr. Hayes says. "The most common of these is known as GAD, which is characterized by persistent and excessive fear and worry about a diverse range of topics, including work, school, finances and health."

Uncontrolled anxiety isn't the only cause of these disorders, though. "The exact causes of anxiety disorders aren't completely understood, but they likely involve a combination of genetic factors and environmental triggers such as stressful life experiences," Dr. Hayes says.

The following factors may increase your odds of developing an anxiety condition like panic disorder or GAD, per the Mayo Clinic:

• Experiencing or witnessing trauma or abuse
• Stress due to an illness, loss, work or finances
• Certain personality types
• Other mental health disorders such as depression
• A family history of anxiety disorders
• Drug or alcohol use/misuse or withdrawal

When you're experiencing an acute bout of anxiety, it can be awfully overwhelming in the moment. Here, Dr. Hayes offers a step-by-step guide for dealing with these dreadful feelings in real time.

‌1. First and foremost, sit down and stabilize yourself‌. "Because panic attacks can involve intense physical symptoms like shortness of breath, heart palpitations and dizziness, it's very important to place yourself in a position where you're not at risk of accidentally falling," Dr. Hayes says.

‌2. Focus on your breathing.‌ "Breathe deeply and deliberately, with long inhales and exhales," Dr. Hayes says. This will help reduce your arousal level and communicate a state of calmness to your body.

‌3. Remember that the feelings are temporary.‌ "It can also be very helpful to remind yourself that the panic attack will pass with time, as they have in the past," Dr. Hayes says.

But if this is your first panic attack, Dr. Hayes recommends seeking medical attention. "The first priority in these situations is to rule out a medical emergency," he says.

Predictable or not, panic attacks don't have to dictate your mental health. Here are some evidenced-based strategies to help you prevent (or better manage) acute episodes of anxiety.

You shouldn't have to deal with debilitating anxiety on your own.

"When suffering with any anxiety disorder, it's always best to work with a professional to ensure you have the correct diagnosis and an appropriate treatment plan," Dr. Hayes says.

Certain forms of talk therapy, such as cognitive behavioral therapy (CBT), are especially effective as they can give you the practical tools you need to temper the anxiety and stress that produce panic attacks.

"Therapies like CBT can help people understand and manage not only their thoughts, but also associated emotions and behaviors as well," Dr. Hayes says.

In some cases, "prescription medications such as antidepressants and anti-anxiety agents can also be useful to help alleviate distressing symptoms," Dr. Hayes says. While medicine isn't a cure for anxiety, it can provide short-term relief as you find a therapist to address your panic attacks, he adds.

"In addition to professional treatment, at-home lifestyle modifications can play a significant role in enhancing recovery and improving one's overall wellbeing," Dr. Hayes says.

Focusing on mind and body wellness is key. Eating nutritious foods, exercising regularly and getting quality sleep are a great place to start.

That's because all three have been shown to improve mood. "When these three key areas of your life are optimized, it becomes much easier to address the underlying causes of anxiety and panic disorder," Dr. Hayes says.

"Meditation and journaling can also be especially helpful, as they're both activities that help us develop the ability to be more aware of our thoughts," Dr. Hayes says. "This enhanced awareness leads to greater insight into the way our thoughts influence our emotions and behaviors, which is essential when working to overcome anxiety disorders."

And the science backs him up: A March 2014 review in ‌JAMA Internal Medicine‌ found that mindfulness-meditation programs moderately improved anxiety.

Similarly, a small December 2018 study in ‌JMIR Mental Health‌ demonstrated that journaling was associated with decreased mental distress, depressive symptoms and anxiety, along with increased wellbeing and resilience among people with various medical conditions and elevated anxiety (though larger studies are needed to further establish this link).