Anxiety Attack vs Panic Attack: What’s the Difference?
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What is the difference between an anxiety attack and a panic attack? From the outside, they may seem extremely similar. However, there are significant differences in how they are experienced.
Their differences primarily lie in their duration and severity. And while treatment of each has common factors, anxiety and panic attacks require somewhat different approaches.
What is an Anxiety Attack?
When a person has an anxiety attack, they experience anxious feelings and thoughts building up until the anxiety becomes severe. It commonly occurs in the leadup to an event which triggers the start of the attack.
That being said, anxiety attacks do not occur in a vacuum. While it may be the prospect of a specific event that triggers the attack, it generally comes in the context of a period of prolonged stress.
How Long Does an Anxiety Attack Last?
Anxiety attacks can last over an extended period of time. There are two phases: the buildup and the intense attack.
In the buildup phase, the anxiety remains present but feels manageable. Anxious thoughts become gradually more intense and the body experiences physical symptoms such as nausea. This phase can last from minutes to hours or even days.
Eventually, the anxiety attack hits its highest intensity. The reaction in both the body and the mind is severe. This lasts from a few minutes to half an hour. However, residual anxiety may still be felt once the mind and body begin to calm down.
Physical Symptoms
People often associate anxiety with thoughts but it is felt deeply in the body. Everyone occasionally notices physical feelings, such as queasiness, when experiencing anxiety. Physical symptoms are significantly more severe during an anxiety attack. They include:
Shortness of breath
Muscle tension
Increased heart rate
Sweating
Dizziness
Stomach upset
Emotional Symptoms
The emotional symptoms also become severe, as the anxiety in the buildup of the attack begins to feel overwhelming. Emotional symptoms include:
Racing thoughts
Difficulty focusing
Persistent worry
A feeling of dread
Fixating on worst-case scenarios
What Does an Anxiety Attack Look Like?
If you have never had an anxiety attack, or are unsure whether you have had one, an example might help you better understand it.
Imagine a big exam is approaching and getting good results feels critical. An anxiety attack might start with negative thoughts about one’s capabilities and the potential consequences of not meeting one’s expectations. It becomes difficult for the person to maintain focus and study. Racing thoughts can make it hard to sleep.
Eventually, the person's anxiety peaks, potentially on the day of the exam. They start having trouble breathing and sweat heavily, as it feels like everything that could go wrong will go wrong. This lasts a few minutes, during which you experience severe distress.
How Do You Treat an Anxiety Attack?
Anxiety attacks can be very distressing. The good news is that treatment can help prepare in advance, ensuring that the person can regulate the attack or prevent it from building up in the first place.
Talk Therapy
Finding the right therapist is the first step towards treating anxiety attacks. Psychotherapy helps the person speak through the anxious thoughts and explore the source of them. This often involves delving into one’s childhood to understand the internalized beliefs that impact the anxiety.
Through talk therapy, it becomes easier to challenge the anxious thoughts. But treatment goes beyond speech.
Octave has therapists who are experts at treating anxiety.
Relaxation Skills
When people think about anxiety, they tend to focus on the thoughts. Anxiety is, however, a very physical experience as well. This is why some of the most effective skills for managing an anxiety attack are physical.
In individual therapy or in a group setting, a person who suffers from anxiety attacks may learn a number of techniques to ground and relax their body. These include breathing techniques, during which the person focuses on – and alters – their breathing.
Medication
Various medications are available for treating anxiety.
Many anxiety medications are in the benzodiazepine class. These help to calm the person’s thoughts and can be very useful prior to or in the midst of an anxiety attack. However, they are not usually prescribed as a treatment in isolation as their effects are temporary.
Antidepressants help many individuals by lowering their base level of anxiety. Their effects are more consistent, but should be accompanied by therapy in order to address the source of the person’s struggles.
Any medication for anxiety should only be prescribed by a licensed psychiatrist. It is crucial that they take into account all factors, as when used recklessly, some medications can lead to addiction, overdose, and other dangerous scenarios.
What is a Panic Attack?
Panic attacks are also intense episodes, during which the person experiences physical and emotional symptoms. However, unlike anxiety attacks, panic attacks do not have an extended buildup. They can also seem to come out of nowhere, often with no recognizable trigger.
During a panic attack, the person experiences intense anxiety or fear that something catastrophic is happening or will happen, such as a heart attack or death. Both the physical and emotional symptoms are severe.
How Long Does a Panic Attack Last?
Panic attacks usually last for between five to twenty minutes. Although the relief is significant after the peak of the attack, residual feelings may take longer to disappear. The severity of the attack can leave the person feeling physically exhausted or shaken for hours afterwards.
Physical Symptoms
During a panic attack, the person may experience the following physical symptoms, some of which are similar to, yet more severe than, those of an anxiety attack.
Heart palpitations
Shortness of breath
Chest pain
Dizziness or lightheadedness
Sweating and shaking
Nausea and upset stomach
Tingling or numbness
Hot or cold flashes
Emotional Symptoms
Whereas the emotional symptoms of an anxiety attack are often related to a specific trigger, during a panic attack they include:
Fear of dying
A feeling of having no control
Detachment or derealization (the sense that nothing is real)
What Does a Panic Attack Look Like?
In contrast to an anxiety attack, a panic attack has no buildup and can seem to come out of nowhere. The person may be in a calm environment, when all of a sudden they feel a pain in their chest. Their heart starts racing and they hyperventilate. They start to feel dizzy and disoriented, as well as nauseous.
The person also feels a flood of fear, while feeling like they have no control to do anything about it. They feel physically and emotionally overwhelmed until the panic begins to subside.
How Do You Treat a Panic Attack?
Like anxiety attacks, panic attacks can be treated with a combination of medication, therapy, and relaxation skills. However, there are differences in how these treatments are applied.
Talk Therapy
Panic attacks seem to come out of nowhere but they actually occur in response to a trigger. Part of the process of psychotherapy is therefore identifying the triggers that lead to panic attacks, then exploring why they do so.
The therapist may use various techniques to address the underlying causes of the panic attacks, including challenging negative thoughts and exposure therapy. Exposure therapy refers to helping the person gradually face the trigger from a position of safety.
Medication
Medication should not be the sole method of treatment for panic attacks, but it can help lower their severity. As with anxiety attacks, benzodiazepines can provide relief in the moment and antidepressants can lower the anxiety the person might experience as a baseline.
Distress Tolerance Skills
It is possible to lessen the severity of a panic attack as it is happening by using distress tolerance skills. These include breathing techniques, as well as other methods of self-soothing.
Skills for Treating Anxiety and Panic Attacks
While an anxiety or panic attack is occurring, there is no foolproof method of alleviating it entirely. However, certain skills can provide significant relief and return a sense of control to the person.
These skills are sometimes referred to as distress tolerance. The goal is not to immediately solve the underlying problem but rather to lessen the distress and make it easier to ride out the storm.
Distress Tolerance Techniques
Breathing
Focusing on the breath has proven an effective mindfulness method for thousands of years. In its simplest form, it involves observing as you breathe in and out, without changing anything.
During an anxiety attack or a panic attack, additional breathing techniques can help to counter shortness of breath, calming the nervous system and providing a greater sense of control. Try one or more of the following:
Diaphragmatic (belly) breathing: Sit comfortably or lie on your back. Turn your attention to your breath. You will find that you are controlling your breathing from your nose and chest. Take the next breath by expanding your stomach, then exhale by compressing it again. This leads to long, deep breaths.
Square Breathing: Sit comfortably or lie on your back. Turn your attention to your breath. Inhale for a count of four seconds, hold in the breath for four seconds, exhale for four seconds, and then pause for four seconds. Continue to do this for a number of breaths, until the panic or anxiety has lessened in intensity.
Progressive Muscle Relaxation
Another technique is to alleviate the symptoms by relaxing your body one part at a time.
Lying down, focus on your feet. Tense your feet as strongly as possible. Then release. Move your attention upwards and go through this process with each muscle group, helping your body find relaxation.
Grounding Yourself
Grounding yourself in your body is an effective way to regain a sense of safety and control. To do so, bring your attention to the physical world:
Focus your attention on what your eyes can see. Try to notice colors, shadows, and movement.
Move your attention to what you can hear. Listen for the closest sounds, then expand your attention to hear sounds coming from further away.
Move your attention to what you can smell. Notice how certain scents have remained beneath your attention until now.
Bring your focus to what your body is feeling. Is it cool or warm? Do you feel the air touching it? Notice pain points as well as where your body is feeling pleasure.
Another grounding technique is known as the 3-3-3 method. Identify 3 objects, followed by 3 sounds. Then move 3 parts of your body. Repeat the process to ground yourself further.
Distraction
The most effective method of getting through an anxiety or panic attack is often by using distractions. Listen to music or play a game. Speaking to someone if they are available can also be helpful.
Practice When Anxiety is Low
The above skills can be extremely useful. However, if you try them for the first time in the midst of an anxiety or panic attack, you will find them very difficult. The key is to practice these techniques when you are not experiencing a panic attack or when your anxiety is relatively low.
The more natural the techniques become, the more likely they are to help during an attack, as you find them at hand rather than out of reach. Over time, these techniques can help prevent anxiety or panic attacks, especially when used in combination with other kinds of treatment.
It is also useful to list the types of distractions that are most likely to help during an attack. Through preparation, you can develop your own toolbox of skills that will help you through these difficult episodes.
Anxiety and panic attacks share many similarities but they have key differences and require specific treatment. With therapy, as well as medication and relaxation techniques, you can find relief for these distressing attacks.