Understanding the Difference: Panic Attacks and Anxiety Attacks | E-Counseling.com

Understanding the Difference: Panic Attacks and Anxiety Attacks

Shannon V. McHugh, PsyD
September 15, 2020
panic vs anxiety attack

Anxiety can come in many forms. Some people report that they experience rumination, or the inability to turn off their racing thoughts. Others say they feel “on edge” or jittery. And still others experience symptoms that are best described as attacks to their body and their mind. Symptoms such as heart racing, sweating, chest pain, shortness of breath, choking sensation, hot flashes or chills, trembling or shaking, numbness or tingling in their body, nausea, headache, or feeling dizzy or faint take over a person’s nervous system, causing severe distress.

Experiencing an attack such as this can make a person feel like they are out of control. People label these experiences as one of two things: anxiety attacks or panic attacks. Some may assume that anxiety and panic attacks are the same thing, but in fact there are some differences between the two.

What’s the Difference?

Mental health professionals often look to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to assess whether someone meets the criteria for a particular diagnosable mental health condition. Anxiety attacks are not listed in the DSM-5, but the symptoms mentioned in the paragraph are identified as symptoms of anxiety as a whole. This may be because there can be so much discrepancy between what two people consider to be an “anxiety attack.”

For the most part, the symptoms that come along with anxiety do not necessarily always feel like an “attack”; rather they can slowly build, and the consistent worry and fear associated with anxiety can eventually lead to panic attacks, but they do not always.

One of the key differences many mental health professionals make between anxiety and panic attacks is that anxiety is usually caused by a trigger of some kind, whereas panic attacks may be more unpredictable.

When people feel threatened or worried about something, being presented with what frightens them can cause them to experience symptoms of distress that some would identify as an anxiety attack.

Anxiety attacks can develop slowly over time and vary in severity from minimal to severe depending on the circumstances. While a person with anxiety may feel all the markers of what would be considered a panic attack (like the symptoms mentioned in the first paragraph), they usually don’t experience markers of feeling like they are dying, nor do they experience symptoms of feeling like they are outside of their body or not really themselves (also called depersonalization).

Panic attacks, however, do involve symptoms of feeling like you are dying, having a heart attack, or losing control of your mind and body. They also can cause a person to have an out-of-body experience or a sense of detachment from the world (derealization). The DSM-5 describes panic attacks as “discrete periods of sudden onset of intense fear or terror, often associated with feelings of impending doom.”

A key aspect of panic attacks, and the main difference between panic and anxiety attacks, is that the trigger is difficult to identify. They can occur at random times, are unpredictable, and can prevent a person from being able to control their body or mind.

The sudden development of these symptoms causes a person to feel significant distress, particularly because they weren’t expecting it. As a result, panic attacks often leave a person feeling excessively worried that they could happen again. The DSM-5 does not have diagnostic criteria for a “panic attack” itself but does discuss the symptoms and relate them to various mental conditions. The DSM-5 does indicate that if someone experiences consistent panic attacks, they may have a panic disorder, which suggest that someone experiences an inability to control the symptoms of panic attacks.

The manual describes that panic attacks can be either unexpected or expected; they are usually identified as being experiences that happen “out of the blue” and without a reason, though people with severe fears or worries can be triggered to experience such severe anxiety that it causes a panic attack in expected situations.

Let’s say that someone has a phobia or an intense fear of snakes and they end up in a situation where they see a snake. In this situation, a person may be so severely anxious or scared that it triggers a panic attack where they end up feeling like they are about to die or are outside of their own mind and body.

In these types of situations, the body’s fight-or-flight responses kick in, causing a person to experience the symptoms of a panic attack. This is different than feeling anxious, as it is much more severe and causes an increase in worry and fear as a result of the physiological symptoms taking control of their body.

What Causes Anxiety Attacks and Panic Attacks?

Anxiety can present itself in different people for different reasons, but symptoms of anxiety and panic usually arise due to a person not being able to control their worries or stress levels. People struggling with occupational or social stresses who are unable to relax or calm down can often feel triggered by symptoms of anxiety which can lead to panic attacks.

People with medical conditions or alcohol or drug addictions may experience anxiety or panic symptoms as a result of chemical changes in their body. A history of traumatic experiences can also cause people to begin to experience symptoms of anxiety or panic because their bodies and brains have developed maladaptive ways to cope with the trauma.

What to do During an Anxiety or Panic Attack

Whether you are experiencing symptoms of anxiety or an actual panic attack, the most important thing is to find ways to relax and stay in the present moment. A main reason why anxiety can brew and escalate is because a person’s thoughts are stuck in the “what-if’s” of life; when your mind is focused on either the past or the future, you are not able to stay in the present moment and can end up losing control of your functioning, both mentally and physically.

Here are some tips for managing symptoms of anxiety and panic attacks that may help to lessen the intensity:

Acceptance

The first step is to acknowledge that the symptoms you’re experiencing are either anxiety or panic and to remind yourself that they will pass. The mantra “no feeling is final” can be important to remember, as it can be hard to think about the fact that feelings of anxiety or panic are temporary.

Verbalizing statements like “I’m experiencing anxiety” or “this is a panic attack” may help to reduce the fear that you are experiencing a medical emergency that you cannot control. People often report feeling like they are having a heart attack when they experience panic symptoms, so remembering that this is a common feeling can help to reduce feelings of terror regarding your physical health.

Mindfulness

Exercises that help you redirect your thoughts to the present moment are critical. Here are some quick tips you can follow anywhere to help reduce feelings of panic and the mind-racing that comes along with it:

Use your five senses to bring yourself back to the room you’re in: identify things you see, feel, hear, smell, and taste in the room.

  • Notice every color that you see in the room around you.
  • Count items you notice around you.
  • Light a candle or find another way to add scents to the room to help relax you.
  • Breathing

Connecting to your breath is so important during panic attacks or anxiety attacks because it is the way to help clean out your body and provide you with a calmer outlook. Deep, diaphragmatic breaths or “belly breaths” can help you focus on your body’s functioning in a healthy way and reduce thoughts of things that are out of your control.

Relaxation

Tensing and relaxing your muscles, listening to calming music, or taking a warm bath or shower are just some of the ways you can redirect your thoughts back to a place of relaxation to get back in control when experiencing panic or anxiety.

Seek Support

Checking in with a trusted family member or friend can often help you through anxiety. It may also be advisable to seek professional support from a mental health professional who can provide you with medical and psychological support and tools to help reduce symptoms of anxiety or panic attacks.

Shannon V. McHugh, PsyD

Dr. Shannon McHugh is a Licensed Clinical and Forensic Psychologist in Los Angeles, California. She specializes in assessment and treatment of children, adolescents, and adults who have developmental and social delays, behavioral difficulties, and those who have experienced traumatic events

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