Understanding the Key Differences Between Panic Attacks and Anxiety Attacks

The term “anxiety attack” is not officially recognized in medical literature but is often used to describe emotional and physical reactions to stress. In contrast, panic attacks are sudden episodes of intense anxiety accompanied by severe emotional, cognitive, and physical symptoms.

While panic attacks frequently occur in individuals with panic disorder, anyone can experience one at some point in life.

Defining Anxiety Attacks

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) does not list anxiety attacks as a distinct diagnosis. Instead, it categorizes various anxiety disorders, such as:

• Generalized Anxiety Disorder
• Panic Disorder
• Separation Anxiety Disorder
• Agoraphobia without panic disorder history
• Social Anxiety Disorder
• Specific Phobias

Anxiety typically arises in anticipation of or response to stressful situations, developing gradually or suddenly. Common symptoms include:

• Excessive worry
• Emotional distress
• Fear

When these symptoms emerge abruptly and intensely, people might label the experience as an anxiety attack, though it may actually be a panic attack or a severe anxiety episode.

Understanding Panic Attacks

Panic attacks strike suddenly, characterized by overwhelming fear and intense physical symptoms like a rapid heartbeat, shortness of breath, and nausea.

The DSM-5-TR classifies panic attacks as either unexpected or expected. Unexpected attacks occur without an identifiable trigger, while expected attacks are linked to specific stressors, such as phobias.

Anyone can experience a panic attack, but recurrent episodes may indicate panic disorder, a mental health condition marked by repeated panic attacks.

Symptoms: Panic Attack vs. Anxiety Attack

Since anxiety attacks are not formally defined, they lack specific diagnostic criteria. Panic attacks, however, present with a combination of physical and emotional symptoms, including:

• Intense worry and apprehension
• Severe distress
• Fear of dying or losing control
• Feelings of detachment from reality (derealization) or oneself (depersonalization)
• Heart palpitations or rapid heartbeat
• Chest discomfort
• Difficulty breathing
• Throat tightness or choking sensation
• Dry mouth
• Excessive sweating
• Chills or hot flashes
• Trembling or shaking
• Numbness or tingling sensations (paresthesia)
• Nausea, stomach pain, or digestive upset
• Headaches
• Dizziness or faintness

Distinguishing a panic attack from anxiety involves considering:

• Trigger: Anxiety usually stems from perceived threats, while panic attacks often occur without warning.
• Intensity: Panic attacks are extreme and can immobilize, unlike varying anxiety levels.
• Physical Reaction: Panic triggers a strong fight-or-flight response with pronounced physical symptoms.
• Onset Speed: Panic attacks begin abruptly and can last minutes to hours.
• Impact: Panic attacks may cause fear of recurrence, influencing behavior and avoidance.

Causes of Panic and Anxiety Attacks

People experience anxiety for diverse reasons, such as facing a job interview, a first date, or unexpected personal challenges. The severity depends on emotional resilience and support.

Panic attacks can be triggered by known or unknown factors. Unexpected attacks might arise during calm moments, while expected ones are linked to specific fears, like flying.

Common contributors to anxiety and panic attacks include:

• High-pressure jobs
• Social interactions
• Phobias such as agoraphobia, claustrophobia, and acrophobia
• Traumatic memories
• Chronic illnesses like heart disease, diabetes, IBS, or asthma
• Persistent pain
• Withdrawal from alcohol or drugs
• Caffeine consumption
• Medications and supplements
• Thyroid disorders

Risk Factors for Panic and Anxiety Attacks

Anxiety and panic attacks are more likely when certain risk factors are present, including:

• Exposure to trauma or witnessing traumatic events
• Major life stressors such as bereavement or divorce
• Ongoing stressors like work pressure, family conflicts, or financial difficulties
• Chronic or life-threatening health conditions
• An anxious personality type
• Coexisting mental health disorders such as depression
• Family history of anxiety or panic disorders
• Use of illicit substances or alcohol

While anxiety disorders increase the likelihood of panic attacks, not everyone with anxiety will experience them.

Diagnosing Panic and Anxiety Attacks

Since anxiety attacks are not formally recognized, they are not diagnosed. Persistent anxiety or panic attacks may lead healthcare providers to diagnose an anxiety disorder.

Doctors assess symptoms and perform tests to exclude other conditions with similar signs, such as heart or thyroid diseases.

Diagnostic steps may include:

• Physical examination
• Blood tests
• Electrocardiogram (ECG) or EKG
• Psychological assessments or questionnaires

Learn how to differentiate between a heart attack and a panic attack for accurate diagnosis.

Treatment Options for Panic and Anxiety Attacks

Managing anxiety disorders often involves a combination of psychotherapy, lifestyle changes, and medication prescribed by mental health professionals.

Therapeutic Approaches

Effective talk therapies include:

• Cognitive Behavioral Therapy (CBT): Helps reshape negative thought patterns and develop coping strategies.
• Cognitive Therapy: Focuses on identifying and reframing unhelpful thoughts associated with anxiety.
• Exposure Therapy: Gradual, controlled exposure to anxiety triggers to reduce fear responses.
• Relaxation Techniques: Breathing exercises, guided imagery, biofeedback, and progressive muscle relaxation.

Therapies may be delivered individually, in groups, or a mix of both.

Medications

Common medications for anxiety symptoms include:

• Antidepressants such as SSRIs and SNRIs
• Beta-blockers to manage physical symptoms like rapid heartbeat
• Benzodiazepines for short-term relief of acute symptoms

Medications can have side effects, and some, like benzodiazepines, carry dependency risks. Long-term medications may take weeks to become effective.

Healthcare providers often tailor treatment plans and adjust them as needed.

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At-Home Strategies to Manage Panic and Anxiety Attacks

To ease anxiety or prepare for potential panic attacks, try these techniques:

• Deep Breathing: Slow, focused breaths can calm your nervous system. Inhale deeply, feel your abdomen rise, and exhale slowly counting to four.
• Acceptance: Acknowledge your feelings without judgment, reminding yourself that symptoms are temporary.
• Mindfulness: Stay present by observing your thoughts and sensations without reacting, which can reduce anxiety.
• Relaxation Methods: Use guided imagery, aromatherapy, or muscle relaxation to soothe your mind and body.

Healthy Lifestyle Habits

Incorporate these habits to prevent and lessen anxiety and panic attacks:

• Manage and reduce stress sources
• Identify and interrupt negative thought patterns
• Engage in regular physical activity
• Practice meditation or yoga
• Maintain a balanced, nutritious diet
• Join support groups for shared experiences
• Limit or avoid alcohol and caffeine intake

Summary

Although “anxiety attacks” is a commonly used phrase, it does not represent an official medical diagnosis. Panic attacks are recognized episodes marked by sudden, intense anxiety and significant physical and mental symptoms. These episodes can occur unexpectedly or in response to triggers.

If you experience panic attacks or persistent, severe anxiety, seeking professional medical advice is essential.

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