Panic Attack vs. Anxiety Attack: What's the Difference (and How Do You Treat Them)?

Whether or not you’re an anxious person, you’re probably familiar with the terms ‘panic attack’ and ‘anxiety attack.’ On TV shows or movies or in random conversations, they’re often used interchangeably. That’s inaccurate, though; panic attacks and anxiety attacks are not the same thing. We caught up with Julia LaFauci, LCSW at Humantold, a New York-based provider of psychotherapy services, for the real differences between the two, including how to treat each one. 

LaFauci tells us that panic attacks are defined by the Diagnostic and Statistical Manual (DSM-5), a standard clinical tool for assessment and diagnosis of mental disorders, as “Abrupt surges of intense fear or discomfort that reach a peak within minutes and are accompanied by physical and/or cognitive symptoms.” She adds, “Panic attacks are not considered a stand-alone mental health disorder by the DSM-5, but are often seen in the presence of other anxiety disorders like generalized anxiety disorder, panic disorder or specific phobias.” Still, panic attacks can happen suddenly to anyone—regardless of diagnosis—without clear reason. “For some, a panic attack is an expected physiological response to feared objects or situations,” she explains. “A common example of this is a fear of flying or fear of small enclosed spaces.”

The physical symptoms of a panic attack can include palpitations, heart pounding, sweating, trembling or shaking, shortness of breath, chest pain or discomfort, nausea, dizziness, chills or heat sensations, numbness or tingling. The cognitive symptoms sometimes include something called derealization, which LaFauci defines as “a sense of detachment from reality, or depersonalization, which is commonly described as an ‘out of body experience.’” 

Unlike panic attacks, the term anxiety attack is not recognized as a clinical term by the DSM-5. LaFauci explains that the tendency to use it interchangeably with panic attack is likely due to overlap of symptoms between the two. “Both can cause shortness of breath and an increase in heart rate,” she notes.  The difference is that anxiety doesn’t often show itself as suddenly as the term anxiety attack suggests. “The word attack connotes a sudden impairment, which is generally not the case for anxiety disorder. A clinical diagnosis of generalized anxiety disorder is made after at least six months of chronic, daily feelings of worry that may be disproportionate to the likelihood or impact of the event. The worry is difficult to control and can have a negative effect on the ability to manage work, relationships, or school.” Anxiety, she tells us, is linked with persistent symptoms of fatigue, irritability, muscle aches or tension, difficulty sleeping, feeling on edge and difficulty concentrating on tasks.

“The treatment for anxiety and panic attacks might look very similar and include a combination of approaches,” LaFauci tells us. “Many will seek out psychotherapy to better understand how to manage symptoms, identify specific triggers and implement coping strategies. While the symptoms may not be eliminated in their entirety, the goal of therapy is to minimize their impact on daily functioning.”

For acute panic attack situations, medication prescribed by a doctor may be taken and can help reduce feelings of anxiety when taken over an extended period of time. She adds that medications for anxiety and panic attacks are most effective when paired with psychotherapy.

Other non-pharmacological interventions can include meditation, mindfulness exercises, and deep breathing techniques. “A simple, easy technique that I like to teach my clients is the '4-7-8' breathing method, which can help in an acute panic attack or even when anxiety is keeping you awake at night.” Here’s how it works:Take a deep breath through the nose for four counts, hold it for seven counts, and very slowly exhale through the mouth for eight counts. “It slows your heart rate down from the deep breaths and provides a distraction from intense thoughts or feelings in that moment,” LaFauci explains. Beyond that, she recommends simple lifestyle changes like more sleep, increasing physical activity and reducing caffeine or alcohol intake to help with symptoms. 

So basically, while they aren't worlds apart—and their treatments are often quite similar—panic attacks and anxiety attacks are, in fact, different things. Just something to keep in mind the next time you or someone you know use either term.