The difference between panic attacks and anxiety attacks

Emily Shiffer
Photo credit: Science Photo Library - Getty Images

From Cosmopolitan

It happened as I was walking home from class during my second year of college.

Seemingly out of nowhere, my heart started racing, I felt like I couldn't breathe, and I began sweating, even though it wasn't even hot outside. Terrified of what was happening in my body, I ran home - I legitimately thought I was going to die.

I had recently started seeing a therapist for depression and anxiety, so I called her as soon as I made it to my room. She knew exactly what was happening: I was having a panic attack.

Over the years, I learned I wasn't alone - though some people referred to these episodes of extreme fear as 'anxiety attacks', while others called them 'panic attacks'.

But are the two terms really interchangeable - or do they mean two different things, entirely?

Is there a difference between panic attacks and anxiety attacks?

Let's clear something up from the get-go: Panic attacks are a documented mental illness, part of a panic disorder, according to the NHS. They are also listed as such in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) by the American Psychiatric Association (APA).

Anxiety attacks, however, aren't officially listed in the DSM-5. "An anxiety attack is a more colloquial term," says C. Vaile Wright, Ph.D., licensed psychologist and director of research and special projects at the American Psychological Association.

So, if you're feeling something you might describe as an anxiety attack, you're likely actually experiencing a panic attack.

So what exactly is a panic attack, then?

"A panic attack is a very sudden episode of intense fear that can come unexpectedly, and usually peaks within 10 minutes," says Wright.

These extreme episodes occur when the body's flight-or-flight response kicks in. "But when fight or flight kicks in when you're not in any actual danger, like it does during a panic attack, it...can be very debilitating," says Wright.

According to the Anxiety UK, typical symptoms of a panic attack include:

  • Racing heartbeat
  • Shortness of breath
  • Chest tightness
  • Dry mouth
  • Butterflies in stomach
  • Nausea
  • Urge to pass urine/empty bowels
  • Tremor
  • Sweating
  • Pins and needles

What causes panic attacks?

Honestly, panic attacks can be caused by a specific trigger (like a feared object or situation), or nothing at all, per the National Institute of Mental Health.

But if you develop recurrent and unexpected panic attacks, the fear of impending or frequent panic attacks, or start avoiding situations that may cause a panic attack, you may be experiencing panic disorder.

"For example, people with panic disorder may notice a symptom that is pretty benign, like increased heart rate. They interpret it as being negative, which makes them even more anxious. And from there it becomes a panic attack," says Wright.

Can certain things make you more susceptible to panic attacks?

Panic attacks can happen to anyone, but there are a few factors that might put you especially at risk.

1. Gender

Women are twice as likely as men to experience anxiety, according to a 2016 study published in the journal Brain and Behaviour. That's because of differences in brain chemistry and hormones, as well as the way women handle stress compared to men, according to study authors.

In women, for example, the fight-or-flight response is activated more quickly than men, and stays activated longer thanks to the hormones oestrogen and progesterone. The neurotransmitter serotonin (which plays a role in stress and anxiety) also isn't processed as quickly in women as men.

2. Genetics

Genetics may play a big role in getting diagnosed with panic disorder. A 2013 study published in the Journal of Neuroscience found that people with panic disorder have a gene called NTRK3 that exaggerates fear and the response to that fear.

3. Other mental health disorders

If you struggle with other mental disorders, including depression, you also may be more susceptible to panic attacks, according to the ADAA. Other anxiety disorders like social phobias or obsessive-compulsive disorder have also been shown to make you more susceptible to panic attacks.

4. Environmental factors

"If you grew up with a parent or family member with an anxiety disorder, you are also more likely to have one," says Wright. Besides the genetic factor, "this can also influence your temperament and basic learned behaviours."

Other particularly stressful environmental factors, like losing a job or having a death in your family, can also make you more susceptible to panic attacks, per the APA.

How can you treat panic attacks?

An important reminder: You don't have to live with these panic attacks. "I think because panic attacks can be so frightening, people can be discouraged, but there are a lot of things people can do to help manage panic attacks," says Wright.

First, if you're seriously concerned about any of the symptoms you may experience during a panic attack (like heart issues), get checked out by a doctor, says Wright. After you've been deemed healthy, your doctor will most likely suggest one cognitive behavioural therapy and/or anti-anxiety medication.

Cognitive behavioural therapy (CBT) is a a talking therapy that can help you manage your problems by changing the way you think and behave, according to the NHS.

"The goal is...to recognise symptoms, what they are and what they mean, and demystify them so if a panic attack does happen, they are not losing control or going crazy or think it will kill them," says Wright.

Medications can also be prescribed - usually in addition to CBT. According to the ADAA, antidepressants that work as long-acting anxiety suppressants can be effective.

Fast-acting anti-anxiety medications may also be prescribed to relieve acute symptoms of anxiety like quickened heart rate or sweating.

The bottom line: "Panic attack" is actually the correct term for an episode of sudden, intense fear-"anxiety attack" is a misnomer.

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