Anxiety Attacks vs Panic Attacks: What’s the Difference?

As a therapist at Madison Square Psychotherapy, I often hear stories from clients about times when they’re just sitting at their desks or driving when their heart starts to pound, and their palms get sweaty. Their chests get tight, and things start to feel a bit fuzzy. Sometimes this reaction seems to come out of nowhere. 

This is a scary experience for many people, especially when they don’t know what it is or what caused it. And what we often discover in therapy is that these reactions are anxiety or panic. 

While most people use the terms “anxiety attack” and “panic attack” to describe the same experiences, they don’t represent the same thing. In this article, I’ll help you understand the panic attack vs. anxiety attack distinction and the patterns beneath them so you feel less controlled by fear.

What’s an Anxiety Attack?

An anxiety attack is not a clinical diagnosis but usually refers to anxiety that comes up around anticipation or specific stressors. The symptoms might feel like an attack because they’re intense or difficult to manage. For example, you might have an “anxiety attack” while you’re waiting to perform in front of a crowd or while waiting for medical test results. But instead of it coming on suddenly, anxiety symptoms usually build gradually as you sit and think about a situation.

Common anxiety symptoms usually include:

• Persistent worry or racing thoughts

• Restlessness or feeling on edge

• Muscle tension

• Irritability

• Difficulty concentrating

• Nausea or stomach discomfort

• A faster heartbeat

• Trouble sleeping

• Feeling overwhelmed or unable to cope

Anxiety is one of the most common mental health conditions in the U.S., with studies showing that more than one in six adults have an anxiety disorder. The symptoms can range from uncomfortable to severe and impact people differently.

What’s a Panic Attack?

When considering the panic attack vs. anxiety attack distinction, it may be helpful to know that panic attacks typically refer to intense or overwhelming fear that comes on suddenly. A panic attack can happen as a response to a feared situation, but it can also seem to come out of nowhere. Unlike anxiety, panic attacks often reach their highest intensity very quickly, which is why people sometimes think they’re having a heart attack or other medical emergency.

Common panic attack symptoms may include:

• A racing or pounding heart

• Chest pain or tightness

• Shortness of breath or a choking sensation

• Sweating, trembling, or shaking

• Dizziness or lightheadedness

• Chills or hot flashes

• Numbness or tingling

• Nausea

• Feeling detached from yourself or your surroundings

• Fear of losing control

• Fear of dying

While a panic attack can happen to anyone, not everyone who gets them has panic disorder. A diagnosis of panic disorder involves multiple, unexpected panic attacks along with concerns about having another attack or changing behaviors to prevent one. Panic attacks happen to around 9.5% of adults, and panic disorder occurs in around 3% of adults.

Panic Attack vs Anxiety Attack: What’s the Main Difference?

The difference between anxiety attack vs. panic attack starts to become clearer when we think about how the symptoms began, what triggered them, and how quickly and intensely they came on. The following sections outline the difference between anxiety attack and panic attack:

When It Starts (Onset)

Anxiety usually builds more slowly, and you might start to notice physical sensations such as your muscles tensing and your heart rate increasing. Or maybe your hands start to shake, you have a harder time concentrating, and you start to sweat.

A panic attack tends to start quickly and abruptly, so you may not even have time to notice the symptoms before they happen. Your nervous system activates so fast that you might go from being relatively calm to terrified in moments. 

The Cause (Trigger)

We usually experience anxiety around stressful situations or around those we think of as “threatening.” But it’s usually a circumstance we can identify, like an upcoming appointment or a fear of public speaking. 

On the flip side, panic attacks can happen suddenly and intensely. We may know the trigger, like a fear of flying, but panic attacks can also occur without an obvious cause. There’s usually a trigger, but we might just not be aware of what it is.

The Level of Distress (Intensity)

We can experience many levels of anxiety, from mild worry with a little bit of a higher heart rate to severe distress where we can barely focus. But panic attacks are almost always intense fear, distress, or a feeling of immediate danger. 

How Long Symptoms Last (Duration)

How long symptoms last can usually tell you whether it’s a panic attack vs. an anxiety attack. Anxiety is usually longer, lasting for hours, days, or even weeks because it’s tied to a specific concern or situation. In contrast, most panic attacks are short and quick, lasting less than an hour. Though they’re often short, they can be intensely scary, making them feel like they last longer.

How to Tell if It’s an Anxiety Attack or Panic Attack

There are some questions you can ask yourself if you’re trying to figure out whether you’re experiencing an anxiety attack or a panic attack. For instance, when you feel ready, ask yourself: 

• Did the discomfort happen suddenly or gradually?

• Was there something I was worried about before it happened?

• How quickly did it take for the symptoms to become overwhelming?

• Did I fear an immediate catastrophe, death, or loss of control?

• Did the episode peak and then ease fairly quickly, or did the distress last for a while?

These questions can help you determine whether it’s panic attacks vs. anxiety attacks that you’re experiencing because they can help you describe what happened, what caused it, and how intense it felt. 

What to Do During an Anxiety or Panic Attack

When your nervous system is on high alert, trying to force yourself to calm down usually just creates more pressure rather than reduces anxiety. Anxiety or panic attack treatment usually starts with focusing on helping your body feel safer. To do that, try to:

• Slowly lengthen your exhale through your mouth without forcing a deep breath

• Press your feet into the floor and notice the support beneath you

• Look around the room and name a few things you can see, hear, and feel

• Unclench your jaw and lower your shoulders

• When possible, move to a quieter environment

You can even try to remind yourself, This sucks, but it’ll pass. Remember that not every strategy works for everyone, nor will they work every time. Practicing them regularly, especially during times of lower anxiety, can make them more easily accessible during moments of intense anxiety or panic. 

Move Beyond the Fear With Madison Square Psychotherapy

Anxiety and panic symptoms aren’t weaknesses. Instead, they reflect a nervous system trying to protect you, even when the alarm response might be overactive. 

At Madison Square Psychotherapy, our therapists can help you understand what’s underneath the anxiety or panic. Panic or anxiety treatment with us is a personalized approach that might draw from cognitive behavioral therapy, psychodynamic therapy, exposure-based approaches, mindfulness practices, and trauma-informed care. 

Book a consult with myself or one of our therapists to begin panic or anxiety treatment in New York City. If you’re not sure of the best fit, we’ll thoughtfully match you with a therapist who matches your needs. Together, we can explore what’s contributing to your distress, build more effective ways to respond, and help you feel less controlled by fear.

FAQs About Panic Attacks vs. Anxiety Attacks

We know that it can still be difficult to understand the anxiety attack vs. panic attack symptoms. Many of the symptoms overlap, leaving you with concerns about what you just experienced, so we’ve addressed some of the questions we often hear about panic attacks vs. anxiety attacks.

Final thoughts

Whether you’re experiencing anxiety attacks, panic attacks, or something in between, professional help is something to consider. Whether virtually across New York or New Jersey or in person near Nomad section of Manhattan, I’d be honored to be a part of your journey towards finding relief. Our office is conveniently located blocks from Madison Square Park and close to the Empire State Building, making it easy to get the care you deserve. If you want to learn more what therapy can look like, about how I work, or just have questions about logistics, reach out to book a free consult call.

Written by: Georgia Kulok, LMSW

Clinically Reviewed by: Kristin Anderson, LCSW