What is the difference between an anxiety attack and a panic attack?

The terms “anxiety attack” and “panic attack” are used interchangeably in popular culture, but they have very specific and different meanings to psychiatrists, so I’d like you to know what the difference is too. It’s important to know whether you are having and anxiety attack or a panic attack because it will affect the type of treatment that you are likely to respond to (as I’ll discuss at the end of this article).

An anxiety attack is when something bad happens to you or you’re thinking about something bad and you get really anxious. You can get so anxious that you might even have some physical symptoms. For example, you might get shaky, your heart might race, or you might get short of breath. An anxiety attack can last anywhere from a few minutes to a few days. The main feature of an anxiety attack is that you are worrying about something in your LIFE (for example, relationships, work, school, money).

A panic attack on the other hand comes on all of a sudden, out of the blue for no reason at all, and it’s all about your BODY or your MIND. You suddenly feel like you must be having a heart attack (or a stroke, or passing out, or choking, or vomiting, or going crazy, or losing all control) because your heart is racing, you’re short of breath, you may have nausea or tightness in your throat, and you’re shaking. A panic attack comes on within ten minutes, but can last anywhere from a few minutes to a few hours. The main feature of a panic attack is that you are worrying about your BODY or your MIND right then and there, rather than worrying about something in your life. Most people with panic attacks have gone to an emergency room at least once to make sure nothing physical was going on.

Some people actually have anxiety attacks that turn into panic attacks. For example, they will start to worry about something stressful in their lives, but then once they get worked up enough, they will start to worry about what’s going on in their bodies or their minds instead. The treatment for a panic attacks that are triggered by anxiety attacks is the same as that used for panic disorder.

As I mentioned before, the distinction between anxiety attacks and panic attacks is important because it will change the type of treatment you are likely to respond to. For one thing, if you have panic attacks, then antidepressants should only be started at very low doses initially because otherwise they can trigger an increase in your panic attacks (i.e. because you are very sensitive to your body). In contrast, with anxiety attacks, you can usually be started at a normal dose of antidepressants right away (and yes, antidepressants work great for anxiety, even if you are not depressed!). Benzodiazepines (such as Xanax, Klonopin, Ativan, and Valium) will work well for both panic attacks and anxiety attacks, but you are more likely to run into problems with habituation (i.e. getting used to the benzodiazepine) when you have anxiety attacks because those tend to be more frequent. When it comes to Cognitive Behavioral Therapy, the most effective technique by far for panic attacks will be the interoceptive (body) exposures; whereas, for anxiety attacks, the most effective techniques will usually be relaxation training and thought restructuring. In addition, when you are using cognitive behavioral therapy, you are far more likely to need to do agoraphobia exposures if you have panic attacks because they can so easily trigger agoraphobia (i.e. the avoidance of certain situation and activities).

One final note: Whether you are having anxiety attacks or panic attacks, or both, treatment is very likely to be effective! I hope that you find this information useful. Good luck!