How to Tell the Difference Between a Panic Attack and an Anxiety Attack

A panic episode looks and feels different than the type of chronic worry that can bubble up and interfere with your life.

People who've had a panic attack describe the experience in no uncertain terms. It's physically debilitating and, frankly, terrifying, they say, at least until their symptoms resolve, usually minutes later. A panic attack is night and day compared with the sort of worry that nags the mind over a longer period of time.

Here's how clinical psychologists explain the differences between having a panic attack and suffering from what some people might call an anxiety attack.

There's No Such Thing as an Anxiety Attack

Well, maybe there is, but "anxiety attack" doesn't appear in the Diagnostic and Statistical Manual of Mental Disorders (DSM), the compendium of criteria clinicians use to diagnose mental illnesses. Psychologists don't have this descriptor in their vocabulary. So, really, it could mean anything, and it means different things to different people.

Some people may be using "panic attack" and "anxiety attack" interchangeably, says Lily Brown, Ph.D., director of research with the Center for the Treatment and Study of Anxiety at the University of Pennsylvania's Perelman School of Medicine in Philadelphia.

Other people might use "anxiety attack" to describe anxious feelings that don't rise to the level of panic, says Russell Hunter, PsyD, Manassas, Virginia-based clinical psychologist and author of Attacking Panic: The Power To Be Calm. "They don't get to the fear or dread," he says, but they may be feeling shaky or nervous.

Panic and Anxiety Are Triggered by Different Underlying Emotions

We all have nervous or anxious feelings from time to time. But sometimes people stress over things that haven't even happened yet, and their worries spin out of control.

Hunter sees plenty of patients dealing with extra stress in their lives and, all of a sudden, it's like "the straw that breaks the camel's back." They need a few coping skills to get over the hump.

A panic attack, by contrast, is the body's response to some imminent danger, even if there's no obvious threat to the person's physical well-being. Panic "resembles fear," Brown says.

Here's another way to differentiate those feelings. Let's say you're someone who suffers from panic attacks. If you're worried about having the next panic attack, that's "anticipatory anxiety—the worry of, Oh, no, I'm going to have a panic attack," says Brown. On the other hand, "The emotion I'm feeling when I'm having a panic attack we would think of as fear."

It's important to distinguish between the two, she says, because there are different strategies for managing fear and anxiety.

Panic Is Short-Lived, While Anxiety Tends to be Prolonged

Anyone who's ever had a panic attack can tell you what a rollercoaster of a ride it can be. It comes on suddenly, gripping its victims in extreme fear and heart-thumping, breathtaking physical distress. Minutes later, it's over. When panic attacks occur repeatedly and people's lives are gripped by fear of having the next panic episode, they may be diagnosed with panic disorder.

The experience of someone who struggles with extreme anxiety is very different. Brown cautions against using the term "anxiety attack" since anxiety symptoms are usually neither swift nor short-lived. Anxiety tends to involve low-grade symptoms that persist over a longer period of time.

"It's kind of this shadow in the background that weighs on a person," she says.

If you're constantly dogged by worries, you might be diagnosed with a generalized anxiety disorder (GAD). This mental illness is defined as excessive anxiety and worry with symptoms that are present most of the time and persist for more than 6 months. GAD is characterized by feelings such as nervousness, restlessness, fatigue, muscle tension, and difficulty concentrating and sleeping.

A person with GAD will tell you she cannot stop worrying, Brown explains. It can be almost a pathological level of worry. She might say, "Every time my child leaves the house, I have to have him call me every half hour to make sure he's OK, and if he doesn't, I get really worried and I start calling him incessantly, even calling the authorities."

Panic Speeds Up Physical Sensations, and Worry Slows Them Down

During a panic attack, a person's breathing quickens and their heart rate speeds up. The body readies to fight off an enemy.

But studies involving people with generalized anxiety disorder suggest that worry manifests in a different way. When someone experiences episodes of worry, their physiological activity is reduced, Brown says. Their heart may not race; their sweat response might be decreased.

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