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Panic Attack vs Anxiety Attack

November 6, 2018

 

 

Is it a “Panic Attack” or an “Anxiety Attack?” Basically these 2 labels mean the same thing. A panic attack is a severe form of anxiety, so one could say it's an anxiety attack. However the correct clinical term used to describe the symptoms is Panic Attack. 

 

Panic Attack

 

A Panic Attack is a sudden and uncontrollable feeling of fear and anxiety.

 

The Diagnostic and Statistical Manual of Mental Disorders (DSM 5, APA 2003) defines a Panic Attack as an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes and during which time four (or more) emotional and physical symptoms are experienced.

 

Note that the abrupt surge can occur from a calm state or an anxious state.

 

Panic attacks can happen during specific feared situations and they can happen randomly during periods of non-threatening, normal activities such as sitting and watching TV.

 

Panic attacks are the body’s evolutionary response to a perceived external threat. The fight, flight, or freeze response is helpful if we encounter a wild animal poised to eat us. The adrenaline that begins flowing through our bodies aids in our escape and survival. When the external threat is defeated or evaded, the symptoms disappear. 

 

For most people today, however, there is no wild animal. It’s a false alarm that signals an internal threat or danger. It’s a misperception of danger.

 

After experiencing a first panic attack, the fear becomes about experiencing another one. 

 

Fear of experiencing a panic attack may actually bring on a panic attack and accelerate the symptoms of one already in progress, also known as, Fear of Fear.

 

Symptoms of a Panic Attack:

 

  • Palpitations, pounding heart, or accelerated heart rate.

  • Sweating.

  • Trembling or shaking.

  • Sensations of shortness of breath or smothering.

  • Feelings of choking.

  • Chest pain or discomfort.

  • Nausea or abdominal distress.

  • Feeling dizzy, unsteady, light-headed, or faint.

  • Chills or heat sensations.

  • Numbness or tingling sensations.

  • Derealization (feelings of unreality) or depersonalization (being detached from oneself).

  • Fear of losing control or “going crazy.”

  • Fear of dying.

 

 

Anxiety

 

Anxiety is the physiological feelings of tension, nervousness, racing heart, sweating, and feelings of dread that can be triggered by worried thoughts and/or fear. 

 

Anxiety can be a feeling of apprehension about something in the future and anxiety can be experienced in the moment during stressful events.

 

All anxiety related disorders fall under the umbrellas of Anxiety Disorders, Panic Disorder, Obsessive-Compulsive Disorders, and Trauma Related Disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM 5, APA 2003). In the United States mental health professionals use the DSM as a universal authority for psychiatric diagnoses.

 

The DSM does not contain the term “Anxiety Attack.” It’s just referred to as “Anxiety”, and it is not the same as a Panic Attack.

 

Symptoms of Anxiety:

 

  • Having difficulty controlling worry

  • Sense of impending danger or doom

  • Restlessness or feeling on edge

  • Trembling, twitching

  • Fatigue

  • Difficulty concentrating or mind going blank

  • Breathing rapidly (hyperventilation)

  • Increased heart rate

  • Muscle tension or muscle soreness

  • Poor sleep

  • Frequent urination and/or diarrhea

  • Sweating

  • Nausea

 

 

Causes of Panic Attacks

Stress and Anxiety

Chronic stress adds up overtime. If you don’t find a way to cope with the stress, your body will respond with anxiety. This leaves you vulnerable to panic attacks.

 

A buildup of stress from life events such as losing a job, death of a loved one, or divorce may cause symptoms of anxiety that could lead to a panic attack. Our bodies experience a physiological response to these stresses that could lead to symptoms of a panic attack.

 

Thinking

Catastrophic thoughts turn on the body's fight or flight stress response that could lead to panic attacks.

 

Misinterpretation of bodily sensations is another common trigger for a panic attack. Two minutes after running up a flight of stairs, a pounding heart and shortness of breath is misinterpreted as an internal threat such as a heart attack or other cardiac event.

 

This misinterpretation causes fear of survival which turns on the flight or freeze response. This increases the heart rate and physical discomfort further and confirms the person’s misinterpretation of physical danger.

 

Avoidance

Behaviorally avoiding situations that are associated with panic attacks only temporarily relieves anxiety. Avoidance actually strengthens anxiety and panic.

 

When having a panic attack you most likely have been running away from the situation, avoiding situations you associate with panic attacks, or becoming over-controlled when feeling anxious.

 

Avoiding confirms and maintains the belief that the situation and/or the symptoms are dangerous. You might not have a panic attack by avoiding a particular place but you have also reinforced that whatever you just avoided is dangerous.

 

 

Treatment For Panic Attacks

If you believe you could have Panic Disorder it will be helpful and important to seek consultation with a mental health professional to first verify the diagnosis and then receive appropriate treatment.

 

Treatment often consists of a combination of medication and psychotherapy. Medication helps take the edge off the physical symptoms of anxiety and psychotherapy helps to challenge irrational thinking and beliefs that lead to the panic attacks.

 

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) is a well-researched and highly effective form of talk therapy that focuses on learning more helpful ways of thinking and behaving.

 

You learn different ways of responding to the symptoms of a panic attack.

 

Exposure Therapy

Also known as prolonged exposure, exposure therapy is a form of CBT.

 

As with most anxiety disorders, in order to learn how to overcome the symptoms of panic disorder, you need to have the experience of successfully managing the symptoms.

 

This often means exposing yourself to the thoughts, images, and the public places that trigger the panic attacks, and then applying the coping strategies until the thoughts, images, and public places no longer produce the same level of fear.

 

Medication

Please consult with your primary care physician or a psychiatrist regarding the use of any medication.

 

Medication can help reduce the symptoms of anxiety that occur in public situations that you have been avoiding such as school, work, and any other necessary public location.

 

Commonly prescribed medications include benzodiazepines, anti-depressants, and beta blockers.

 

Benzodiazepines are quick acting sedatives that are generally safe and effective for short term use.

 

Anti-depressant medications are also effective at reducing symptoms of anxiety on a daily basis. This helps dampen the physical and emotional effects of anxiety and increases a person’s capacity to cope with stressful situations.

 

Beta Blockers are used to treat high blood pressure, heart arrhythmias, and migraines. They are also prescribed for off-label use by physicians to help reduce the physical symptoms of anxiety.

 

Beta blockers have the ability to control rapid heartbeat, shaking, trembling, and blushing in response to a panic attack. Beta blockers do not interfere with cognitive performance and are by far my favorite for removing the jitters before a speech.

 

 

What's the Difference between a panic attack and anxiety?

 

The symptoms are so similar that it can be difficult to tell the difference between a panic attack and anxiety.

 

Here are some descriptions that can help:

  • Panic attacks can occur without a trigger

  • Anxiety is a response to a perceived stressor or threat

  • Symptoms of a panic attack are intense and cause avoidance

  • Panic attack symptoms involve a sense of things feeling unreal or detached from one's body

  • Anxiety symptoms can go from mild to severe

  • Panic attacks appear suddenly, while anxiety is more gradual

  • Panic attacks usually subside after a few minutes, while anxiety symptoms can last for longer periods of time

 

Summary

 

"Panic Attack" and "Anxiety Attack" are often used interchangeably and refer to the same set of symptoms. However the correct clinical term is Panic Attack.

 

Anxiety can progress to panic attacks. We can become anxious about feeling anxious, and then have fear of feeling fearful.

 

If a person experiences repeated panic attacks beyond one month and are not due to some kind of phobia, then they can be diagnosed with Panic Disorder.

 

Check out this article on Health.com for more information on "How to Tell the Difference Between a Panic Attack and an Anxiety Attack."

 

For more information:

 

Please purchase my book “Attacking Panic:  The Power to Be Calm” for more in depth information on how to stop panic attacks quickly and how to treat the root cause (Amygdala/Sympathetic Nervous System). 

 

 

The book shows you how to go beyond just giving up control and allowing yourself to experience a panic attack.  

 

The book has more powerful strategies that will short-circuit your fight or flight system, stop a panic attack very quickly, and even prevent a panic attack from occurring. 

 

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Russell Hunter, Psy.D.
Licensed Clinical Psychologist

I want to help you. Please feel free to contact me confidentially by email below with any questions or if you need some advice about the content posted on The Fear Blog.

Attacking Panic: The Power To Be Calm. Copyright © 2017 Russell A. Hunter, Psy.D. All rights reserved. Attacking Panic is available in paperback and Kindle edition at Amazon and in paperback at Barnes & Noble and other online retailers.

How to Stop A Panic Attack Quickly.

Russell A. Hunter, Psy.D. Psychology Today Profile

National Register of Health Service Psychologists

8644 Sudley Road, Suite 315 Manassas VA 20110

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