Last reviewed:
Mar 30th 2023
M.A., LPCC
Anxiety is a common feeling for many people and may be mild, moderate, or severe, with a severe and prolonged period of anxiety often being referred to as an anxiety attack. Panic is an extreme form of anxiety and can cause very intense and distressing symptoms. A period of extreme panic is called a panic attack.
A panic attack is the sudden onset of extreme physiological symptoms and a feeling of extreme fear. Panic attacks can be very intense and distressing, particularly if they occur unexpectedly [1].
People who regularly experience unexpected panic attacks may be diagnosed with panic disorder, which is one of several anxiety disorders listed in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), although panic attacks may also occur in the context of other anxiety disorders and mental health conditions [2][3].
Panic attacks can occur suddenly and unexpectedly, for seemingly no clear reason, or may occur due to a trigger, fear, or phobia. For example, someone with agoraphobia may experience a panic attack upon leaving their house [4].
People with panic disorder or who regularly experience panic attacks may live in fear of a panic attack occurring, due to the distress that the symptoms can cause [1].
Anxiety disorders typically cause ongoing and persistent symptoms, occasionally with periods of more severe or troubling symptoms, which many refer to as an anxiety attack. However, this is not a diagnosable condition or official term in the DSM-5 [3], so, anxiety attacks may differ from person to person, depending on how they define their own symptoms of anxiety.
Often, people experience an anxiety attack in the context of an anxiety disorder, due to the anticipation of a feared situation. For example, someone with social anxiety disorder may experience an anxiety attack in the days leading up to a big presentation at work. A presentation at work would be an event in which a socially anxious person expects to experience the fear of being judged or making a mistake [5].
Anxiety attacks can cause an avoidance of the anticipated fear. Avoidance can reduce the symptoms of anxiety if the situation is no longer going to occur, but this is likely to then reinforce the avoidant behaviors and fear associated with the situation [3][5].
The onset of symptoms of a panic attack often occurs very quickly, within a matter of minutes, and are very extreme. A panic attack may last a short time, between a few minutes and up to an hour, before subsiding [2].
The symptoms of a panic attack are often so distressing that people sometimes feel that they are experiencing a heart attack. People experiencing panic attacks might be afraid that they may die or be in serious danger, especially if they have not had prior experience of panic attacks. Because of this fear, people sometimes attend the emergency room or call 911 during a panic attack, which may even exacerbate their symptoms [4].
Common symptoms of a panic attack include [2][3]:
In comparison, symptoms of an anxiety attack tend to start more gradually and increase over time. Typically, the physical symptoms are not as severe as those of a panic attack, although they may include similar sensations that are mild or moderate in comparison [4][5].
However, symptoms of an anxiety attack can last much longer and are usually brought on by a trigger, so potentially can last for days prior to an upcoming situation that evokes fear [3].
Symptoms of an anxiety attack can include [3][5]:
The cause of panic attacks and anxiety attacks is not clear and may differ from person to person, although there are several potential factors that can increase the risk of their occurrence.
Panic attacks can occur unexpectedly, with no clear cause, while anxiety attacks are typically related to a trigger. Panic attacks can even occur during sleep, causing the individual to wake suddenly with the onset of a panic attack. These are known as nocturnal panic attacks [6].
In other cases, a panic attack may occur due to a trigger, as might an anxiety attack. However, a panic attack will usually occur in a triggering situation, such as being faced with a fear or phobia, while an anxiety attack tends to be triggered by the anticipation of a fear or situation that causes anxiety, with prolonged symptoms prior to the actual situation [3][4].
There are many risk factors that can contribute to the occurrence of panic attacks and anxiety attacks.
These risk factors may include [1][4][5][7]:
Panic attacks and anxiety attacks are typically treated with the same medications and therapies, although this may vary slightly depending on the condition in which the attack occurs.
Medications used in the treatment of panic attacks and anxiety disorders can include [1][2][5][8]:
Various types of therapy can be useful in managing anxiety and panic attacks, including [1][4][8]:
Symptoms of anxiety and panic attacks can potentially be reduced or managed by [1][2][7][9]:
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