How do you know if you’re having a panic or anxiety attack?

The terms panic attack and anxiety attack are used interchangeably, but they are not the same. Key characteristics distinguish one from the other, though they have several symptoms in common.

These types of attack have different intensities and durations.

Panic attacks are generally more intense than anxiety attacks. They also come on out of the blue, while anxiety attacks are often associated with a trigger.

Symptoms of anxiety are linked to numerous mental health conditions, including obsessive-compulsive disorder and trauma, while panic attacks mainly affect those with panic disorder.

What are the signs and symptoms?

The differences between anxiety and panic attacks are best highlighted by comparing the symptoms of each condition:

Panic attack symptoms

Chest pain is a symptom of panic and anxiety attacks.

Panic attacks come on suddenly, without an obvious trigger.

Symptoms include:

a racing or pounding heartbeat

chest pain

dizziness or lightheadedness

hot flashes or chills

nausea

numbness or tingling in the extremities

shaking

shortness of breath

stomach pain

sweating

the feeling of being choked or smothered

People experiencing a panic attack may also:

feel a loss of control

feel like they are going crazy

have a sudden fear that they will die

feel detached from themselves, which is called depersonalization, and feel detached from their surroundings

Symptoms of panic tend to peak after 10 minutes, then gradually subside.

However, several panic attacks can occur in a row, making it seem like an attack is lasting for much longer.

After an attack, many people feel stressed, worried, or otherwise unusual for the rest of the day.

Anxiety attack symptoms

While panic attacks come on suddenly, symptoms of anxiety follow a period of excessive worry.

Symptoms may become more pronounced over a few minutes or hours. They are typically less intense than those of panic attacks.

Anxiety attack symptoms include:

being easily startled

chest pain

dizziness

dry mouth

fatigue

fear

irritability

loss of concentration

muscle pain

numbness or tingling in the extremities

a rapid heart rate

restlessness

shortness of breath

sleep disturbances

the feeling of being choked or smothered

worry and distress

Anxiety symptoms often last longer than the symptoms of a panic attack. They may persist for days, weeks, or months.

Differentiating between panic and anxiety attacks

Because the symptoms are so similar, it can be difficult to tell the difference between panic and anxiety attacks.

Here are some tips that can help:

Panic attacks usually occur without a trigger. Anxiety is a response to a perceived stressor or threat.

Symptoms of a panic attack are intense and disruptive. They often involve a sense of “unreality” and detachment. Anxiety symptoms vary in intensity, from mild to severe.

Panic attacks appear suddenly, while anxiety symptoms become gradually more intense over minutes, hours, or days.

Panic attacks usually subside after a few minutes, while anxiety symptoms can prevail for long periods.

What are the causes?

Pressure and stress in the workplace can trigger attacks.

Panic attacks can be expected or unexpected. Unexpected attacks have no apparent triggers.

Anxiety attacks and expected panic attacks can be triggered by:

work stresses

social stresses

driving

caffeine

withdrawal from alcohol or drugs

chronic conditions or chronic pain

medications or supplements

various phobias (excessive fears of objects or situations)

memories of past trauma

Risk factors

People are more likely to experience panic attacks if they have:

an anxious personality

another mental health issue, such as depression, bipolar disorder, or an anxiety disorder

family members with anxiety or panic disorders

a chronic medical condition, such as a thyroid disorder, diabetes, or heart disease

issues with alcohol or drug abuse

ongoing stresses in their personal or professional lives

experienced a stressful event, such as a divorce or bereavement

experienced trauma in the past

witnessed a traumatic event

Females are more likely than males to have anxiety or panic attacks.

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Diagnosis

A doctor or mental health professional can diagnose a panic attack, panic disorder, or anxiety disorder.

They base their diagnoses on definitions contained in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

These professionals cannot diagnose an anxiety attack, because it is not a clinically defined condition in the DSM-5. They can, however, recognize the symptoms of anxiety.

To diagnose any of these conditions, a doctor will discuss symptoms and life events. They may also perform a psychological evaluation to see what category, if any, the symptoms fall into.

It may be necessary to rule out physiological conditions that share similar symptoms.

To do this, a doctor may perform:

a physical examination

blood tests

heart tests, such as an electrocardiogram

What should I do during a panic or anxiety attack?

The following strategies can help:

Acknowledge what is happening

The symptoms of a panic or anxiety attack can be extremely frightening. Acknowledging the situation and remembering that symptoms will soon pass can reduce anxiety and fear.

Breathe slowly and deeply

Difficulty breathing is among the most common and alarming symptoms of these types of attack.

To slow breathing down, focus the attention on the breath. Inhale and exhale at a slow and steady rate until symptoms subside.

Count to four during each inhalation and exhalation.

Try relaxation techniques

Methods of relaxation, such as progressive muscle relaxation and guided imagery, can reduce feelings of panic and anxiety.

A person can learn these techniques online or by working with a qualified therapist.

Practice mindfulness

Mindfulness helps people to stay grounded in the present moment.

It can be especially beneficial for people with anxiety, who tend to worry about perceived and potential stressors.

Practice mindfulness by actively noticing thoughts, emotions, and sensations without judging or reacting to them.

A doctor or mental health professional can tailor treatment to help individuals deal with anxiety or panic attacks.

Home remedies

Daily exercise may help to reduce stress and anxiety.

The Anxiety and Depression Association of America recommend the following home remedies for stress and anxiety:

maintain a positive attitude

manage or reduce stressors

discover the triggers

limit alcohol and caffeine intake

eat healthful and balanced meals

sleep for 8 hours a night

exercise every day

take time out each day for enjoyable activities

practice meditation, yoga, or deep breathing

build a support network

Medical treatments

People debating whether to seek treatment often wonder:

Can therapy work?

Engaging in therapy can help to identify triggers and manage symptoms. Therapy also aims to help people to accept their pasts and work toward their futures.

One type, called cognitive behavioral therapy, may be especially helpful for people with anxiety and panic disorders.

Does medication help?

Medication can reduce symptoms in people with severe or recurrent panic or anxiety. It can be used in conjunction with therapy or as a stand-alone treatment.

A doctor may prescribe:

anti-anxiety drugs

antidepressants

benzodiazepines

Takeaway

Panic and anxiety attacks are different, but they share some symptoms.

Anxiety attacks often follow periods of prolonged worry. Panic attacks tend to occur suddenly, and the symptoms are often more intense.

Panic and anxiety can be distressing and disruptive, but self-help strategies can reduce the intensity of symptoms. Therapy and medication can prevent or reduce the number of future episodes.

The sooner a person seeks help, the better the outcome.

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