When Anxiety Attacks

Written by: Marie Chesaniuk, PhD

What is the difference between and anxiety attack and a panic attack?

As far as the general public is concerned, there might be a difference and there might not be a difference. ‘Anxiety attack’ is a non-clinical term used by the general public to refer to a moment of peak anxiety, characterized by a mixture of cognitive (racing thoughts, imagining worst case scenarios) and physiological (muscle tension, rapid heart rate) symptoms of anxiety. In general conversation, most people don’t draw a strong distinction between panic attacks and anxiety attacks and sometimes people use them interchangeably. However, the DSM does not use these terms interchangeably.

As far as the DSM-5-TR (the latest iteration of the psychiatric diagnostic manual used in the US) is concerned, there is no such thing as an anxiety attack. The term is not included in the DSM. In the DSM, there are panic attacks and a number of anxiety disorders, suggesting that, as far as the DSM is concerned, an ‘anxiety attack’ is a moment of heightened anxiety that is subsumed by the larger anxiety disorder, adjustment disorder with anxiety, or just part of a normal reaction to a highly stressful situation and not part of an anxiety disorder at all, meaning anyone can have one even if they don’t have a diagnosis. Similarly, anyone can have a panic attack. 

The Cleveland Clinic reports that up to 11% of Americans experience a panic attack each year. However only 2-3% of Americans have panic disorder. A panic attack is characterized by severe physical anxiety symptoms, such as chest pain, increased heart rate, difficulty breathing, dizziness or faintness, shaking, and chills or hot flashes. Many people believe they are having heart attacks and go to emergency rooms during a panic attack. 

There are some notable differences between panic attacks and anxiety attacks (when not using the term as a catch all for severe anxiety episodes.) Duration, severity, and context help separate the two. Regarding duration, panic attacks usually peak within minutes whereas anxiety attacks go on much longer. Duration is related to severity. 

The more intense and severe an episode is, the more physiological and emotional resources are required to support it, and thus the faster that supply runs out. So, in general, the more severe and intense an episode is, the shorter it lasts because the mind and body run out of resources faster due to increased demand. The less severe, the longer the episode can keep running since there is a lower demand on resources. As such, a panic attack tends to burn out resources faster at a higher intensity whereas an anxiety attack typically lasts longer (sometimes even days!) because it uses fewer resources at one time and is therefore considered less severe, though no less painful and valid than a panic attack. 

Finally, the context in which each type of attack occurs is different. Panic attacks are notable for lacking context. While they may occur in relation to triggers of a larger phobia (especially needle phobias), in panic disorder, panic attacks often occur ‘out of the blue’ or with no warning or discernable cause. The uncertainty of when a panic attack will strike is definitive of panic disorder and sometimes agoraphobia. As such, panic attacks are often out of step with one’s daily life and are particularly disruptive and difficult to anticipate. Anxiety attacks, on the other hand, are much more embedded in one’s daily life. While still disruptive in that they can impinge on functioning, they tend to happen more in line with what is going on in someone’s life and have specific and more predictable triggers that are part of someone’s day to day life (e.g., an upcoming presentation at work or school, waiting for important medical test results.) Anxiety attacks are more related to the context of someone’s everyday life than are panic attacks.

What can I do about panic attacks and anxiety attacks?

Depending on the causes of someone’s panic attacks and/or anxiety attacks, there are a number of treatments and coping skills available. We get in depth on how panic disorder is treated here, but in a nutshell, a combination of Cognitive Behavioral Therapy (CBT) and exposure therapy is a proven treatment. For anxiety attacks, Cognitive Behavioral Therapy (CBT), exposure therapy, and other emotion regulation skills such as those taught in Dialectical Behavior Therapy (DBT), mindfulness, and Acceptance and Commitment Therapy (ACT) may all be options for alleviating these episodes.

The important takeaway here is that no matter how you describe your anxiety episodes, there is a way to treat them and get back to living your life.

Anxiety Attack Panic Attack Venn Diagram

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Sources
Cleveland Clinic. Panic attacks & panic disorder. My.ClevelandClinic.org. (2025, September 17). https://my.clevelandclinic.org/health/diseases/4451-panic-attack-panic-disorder