Are Anxiety Attack And Panic Attack The Same?
You may have heard the term anxiety attack used freely when someone is talking about an attack that’s associated with the difficulty in catching the breath, rapid heartbeat and feeling faint.
In fact according to the "Diagnostic and Statistical Manual of Mental Disorders” [i] , which is what doctors use to diagnose mental health illness, anxiety attacks are not even listed.
Although anxiety attacks may seem on paper to be like panic attacks, they are slightly different and this article we’ll identify the similarities and differences for each one. In order to be accurate, this article has taken clinical guidance from the "Diagnostic and Statistical Manual of Mental Disorders” manual.
The Difference Between Anxiety And Panic Attacks And Where They Overlap
On the outside it can seem that anxiety and panic can mean the same thing. However they do have different features. Here is a diagram to help illustrate the differences.
As you can see anxiety symptoms include insomnia, achy muscles, obsessive thinking, high levels of fear. Panic attacks symptoms are chest pains, which make you think you’re going to die, difficulty in breathing and disassociating from what’s going on around you.
Where are the symptoms overlap is in shortness of breath and increased heart rate. The medical term for shortness of breath is 'hyperventilation'.
What Is Hyperventilation?
Hyperventilation feels as if you haven’t got enough oxygen in your body.
However, hyperventilation actually creates too much oxygen in the body and not enough carbon dioxide. This stops the body from retaining the required amount of carbon dioxide needed to use the available oxygen you’ve got.
It feels like you haven’t got enough air when in fact you’ve got too much. Here is an article about hyperventilation and the role it plays in anxiety: Click Here
You may not even noticed that you’re shallow breathing. Research has shown that shallow breathing can take place for up to an hour before a panic attack without the sufferer even being aware of it. This shallow breathing incites increased heart rate, which can make you feel spaced out or dizzy.
High levels of anxiety lead to shortness of breath and increased heart rate which can develop into a panic attack. This is when you feel chest pain, you disassociate from what’s going on around you, have shortness of breath and might think you’re going to die.
Anyone can experience anxiety and panic attacks indeed many people experience them once or twice in their life. In one sense they are a protective auto response hard wired into us to help protect us from danger.
However it’s the frequency of panic attacks and levels of anxiety, which take this from a protective resource into a mental health disorder. When either occurs frequently there is cause for concern.
Specific Differences Between Anxiety And Panic Attacks
Professionals use the term anxiety to describe a set of features which are core to several disorders. These are all placed under the headings of various disorders:
Trauma and/or stress related
Some of the most common disorders under these headings include:
Post-traumatic stress disorder
Generalised anxiety disorder
Separation anxiety disorder
Social anxiety disorder
It could be said that’s the best way to describe the specific differences between anxiety and panic is that anxiety is longer term where panic is much shorter. When I spoke to professionals about this subject, I wasn’t entirely convinced that they were crystal clear about the difference and this was the most straightforward answer I got.
Specifically, anxiety is related to excessive worry and intensifies over a longer period of time. Medics tell me that what they mostly deal with is an excessive worry about a perceived danger that is not real.
One doctor told me of patients who believed they were going to die from the world imploding. According to this doctor, these were the hardest people to help because is the fear is real to them is but the ‘danger’ is a fantasy.
If the anxiety of the danger builds up, cortisol levels increase. When you add in low carbon dioxide levels, these two scenarios can make the sufferer feel overwhelmed.
Other symptoms may include:
Aches and pains
Inability to concentrate
Unable to catch the breath
Feeling of being on high alert
Even though some of these symptoms are the same as those of a panic attack, they are less intense but may be very long lasting and persistently hanging around for weeks, months or even years.
Panic attacks, on the other hand, often arise out of the blue and last up to an hour. In that hour the symptoms peak for 10 minutes then subside.
Sometimes panic attacks can last a lot longer especially when the peak comes several times in one day. The after effects will leave leave within 24 hours.
Panic attacks are intense, sudden and accompanied by a feeling of terror, overwhelming fear, apprehension, or trepidation. Symptoms of panic attacks are so extreme that they often take out the day. They are usually unexpected feel like they’ve come out of the blue.
However, they’ve been building up and we didn’t realise it. It’s the suddenness and for ‘no apparent reason’ that can make them so frightening.
Of course, the signs were there but we don’t recognise them. One study[ii] has found that shallow breathing isn’t just a symptom of a panic attack; it can actually bring an attack on. This study says that shallow breathing can happen up to an hour before the anxiety attack even starts.
Many people who suffer from panic attacks don’t even realise they are shallow breathing until they are so far in they feel as if they’ve lost control. Then it seems as if the panic attack came out of nowhere when they’d been shallow breathing for up to an hour.
Are Anxiety Attack And Panic Attack The Same? Not exactly But They Have Overlapping Symptoms
The "Diagnostic and Statistical Manual of Mental Disorders” [iii] manual, states that the definition of a panic attack is if someone experiences four or more of these symptoms:
Accelerated heart rate
Sensations of shortness of breath, difficulty breathing
Feeling of choking
Chest pain or chest discomfort
Abdominal distress including Nausea
Feeling dizzy, unsteady, lightheaded, or faint
Feelings of unreality i.e. disassociation or being detached from oneself i.e. depersonalization
Fear of losing control or going crazy
Fear of dying
Tingling sensations or Numbness
Feeling chilly or experiencing hot flashes
These symptoms include some anxiety symptoms but they become more pronounced during a panic attack.
How Are Anxiety Attack And Panic Attack Different? One Drives The Other!
Anxiety comes first and, if unchecked, leads into a panic attack. The symptoms can seem very similar and there is an overlap, as demonstrated by the diagram.
The key to stopping panic attacks is to first look at the anxiety.
Why Do We Suffer With Such Persistent Anxiety? What’s The Source? What Can We Do To Heal It?
All good questions and there’s lots of treatment for anxiety. Therapy, group counselling and self-help techniques all work well. Here’s a link to my article on how to help yourself through anxiety: Click Here
You may find that one thing that offers you instant relief.
One last word
None of us were born with anxiety. It’s not a biological problem. Something’s happened to us to make us feel anxious. It’s not our fault. We didn’t ask to be anxious and we wouldn’t wish it on anyone else.
*** Please remember I am not a doctor. This is my opinion only and should never replace medical advice*****
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[i] American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (Fifth edition). Washington, D.C.: American Psychiatric Association; 2013.
[iii] American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (Fifth edition). Washington, D.C.: American Psychiatric Association; 2013.