Anxiety Attacks vs Panic Attacks: Spot the Difference

Tightness in the chest, a constant state of worry, heavy breathing, and trembling hands and legs.

Have you ever experienced symptoms like these? I have. College was a period of both the best and most challenging times of my life. While "challenging" might sound too harsh, it was an uncomfortable phase that shaped who I am today. One significant experience occurred during my first year.

Imagine this: one of your classes gets relocated at the last minute, and you have to rush from one building to another to avoid missing it and losing your attendance. Like anyone else in that situation, I hurried to grab a seat and catch up with the class. However, things didn’t go as planned. Arriving late not only meant losing a seat but also becoming the "center of attention" for the entire class. That’s exactly what happened to me as I walked into a room filled with 60 to 70 students, all staring at me at once. It was at that moment that I experienced what I can only describe as an "uncomfortable feeling attack."

A few years later, I found myself still reflecting on that day’s incident. Even as a psychology major, I struggled to identify what had gone wrong. Was it a “panic attack” or an “anxiety attack”? To gain a better understanding, I decided to consult the DSM-5, the definitive guide in the field of psychology. Here’s what I discovered, and I thought it would be good to share it with you as well!

Anxiety and panic are often thought to be synonymous in the English language, but the DSM-5, which is commonly used for educational purposes, draws a distinction between the two. According to the DSM-5, Generalized Anxiety Disorder (GAD) is characterized by "excessive fear and the presence of excessive anxiety and worry about a variety of topics, events, or activities. Worry occurs more often than not for at least six months and is considered excessive."

Generalized Anxiety Disorder

Imagine waking up in the morning with a list of tasks planned for the day. A person diagnosed with GAD, or someone who has yet to be diagnosed, will likely experience feelings such as irritability, and restlessness throughout the day. These feelings persist for at least six months. During this period, it is common for these individuals to experience anxiety, as well as episodes known as "anxiety attacks."

So how do we know that you are having an anxiety attack and not a chest pain. Some of the common symptoms/features of an “anxiety attack” are: 

• Anxiety attacks do not have a specified trigger point (i.e. no particular cause). There could be n-number of causes for getting an anxiety attack. 

• The feelings of “nervousness”  “irritability”, “rapid breathing”, “sweating” develop in a gradual state (i.e. developing slowly). 

• These uncomfortable feelings will mostly prevail for a longer period of time. Without any definite time limits. 

If we take the instance of getting up in the morning and having a list of things planned. Your day would look like this- 

• Excessive worry even from the night before.

• Anticipation of whether all of the chores would go well or not. 

• Restless and active pacing. 

Panic Disorder

What exactly is a "panic disorder"? This is likely a question on many of your minds. I agree that the symptoms of panic disorder and generalized anxiety disorder can be quite similar, but upon closer examination, they do have distinct differences. Panic attacks typically occur suddenly. For example, imagine you are planning a party or an event, and at the last minute, something goes wrong. This triggers a common feeling of panic or fear. However, it’s important to note that not every instance of panic leads to a full-blown panic attack. So, what does it feel like to have or be diagnosed with a panic disorder? 

Let’s take a look at what the DSM (Diagnostic and Statistical Manual of Mental Disorders) has to say about it. “Panic disorder” can be termed when there is a sudden/abrupt intense fear/discomfort that reaches to a peak within minutes. Some of the most common features/characteristics of a panic disorder/attack differentiate it from an anxiety attack in a subtle manner.

• Persistent concern or worry about additional panic attacks or their consequences (e.g., losing control, having a heart attack, “going crazy”).

• Symptoms such as intense fear, chest palpitations, shortness of breath, feelings of choking, fear of losing control of oneself amongst others can continue for a duration of 30 mins. 

• A significant maladaptive change in behavior related to the attacks (e.g., behaviors designed to avoid having panic attacks, such as avoidance of exercise or unfamiliar situations).

• These attacks are usually unexpected. This is one major difference between anxiety and panic attacks. Because as mentioned before, “anxiety attacks" have a particular “cause”, and “panic attacks” are “more sudden”. 

In the end, I suppose I never found out whether I experienced an anxiety attack or a panic attack. I’m confident it was neither, as I don’t meet the criteria for either condition. However, I empathize with you, even if you found this post overwhelming or educational. I hope this gives everyone something to think about. Until the next blog, sayonara! And please remember, do not self-diagnose!