Panic Attack vs Anxiety Attack: How to Tell the Difference

Dr. JeanAnne Johnson, PsyD, PhD, APRN-BC, FNP, PMHNP, PMHS

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Dr. JeanAnne Johnson is a Psychiatric/Mental Health Nurse Practitioner with over 30 years of medical experience. She holds advanced degrees from Georgetown University and Rush University, along with multiple certifications in psychiatric care, addiction treatment, and pediatric mental health. She is currently pursuing a fellowship in Precision Psychiatry and Functional Medicine.

JeanAnne provides psychiatric services across 14 clinics, specializing in mental illnesses, substance use disorders, and criminogenic programs. A national speaker and author of I Can Do Hard Things: Tools to Manage Anxiety When Medication Isn’t Enough (2019), she is passionate about holistic mental health care. Her approach addresses the root causes of mental illness through nutrition, lifestyle changes, and functional medicine.

Outside of work, JeanAnne enjoys outdoor activities with her two children, is a cancer survivor, and loves animals.

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“I’m having a panic attack.” or “I’m having an anxiety attack”, are often said interchangeably when someone is suffering from symptoms of anxiety. Panic attacks have a clinically recognized criteria in the DSM-5, whereas anxiety attacks are often a broader term that can encompass a range of anxiety symptoms. 

What is a Panic Attack?

A panic attack is a sudden episode of intense fear or discomfort that often peaks within minutes. They can occur unexpectedly or in response to a trigger, and their criteria are classified in the DSM-5. 

For a diagnosis of panic disorder, panic attacks must be recurring, and followed by at least one month of anxiety about having future attacks. Some people with panic attacks may struggle with substance use disorders, particularly alcohol and benzodiazepines.    

Symptoms of a Panic Attack 

According to the DSM-5, the diagnostic criteria for panic attacks include [1]: 

  • Sudden, often short episodes of intense fear 
  • At least four physical or psychological symptoms
    • Chest tightness, increased heart rate, shortness of breath
    • Sweating, trembling, dizziness
    • Fear of losing control, dying, or going crazy 
  • They may be expected (triggered by a known fear) or unexpected (unknown trigger)

Causes of a Panic Attack 

Panic attacks do not always have a distinct cause. If they occur unexpectedly, it could be due to unknown internal cues (e.g., physical sensations, a slight increase in heart rate). Some people are genetically more prone to suffering from panic attacks, especially if they have chemical imbalances in the brain, like GABA or serotonin. A family history of panic disorder can also increase the risk of vulnerability [2]. 

Other causes or triggers that can increase the risk of panic attacks include:

  • External phobias (spiders, snakes, heights) 
  • Caffeine 
  • Drug or alcohol withdrawal 
  • Medication or supplements 
  • Work stress 
  • Medical conditions such as thyroid or hormone problems 

What is An Anxiety Attack? 

An anxiety attack does not have a set of specific criteria and is not a stand-alone diagnosis. “Anxiety attacks” is a more casual term to refer to someone who is experiencing symptoms of anxiety. 

For some, an anxiety attack overlaps with symptoms of a panic attack and includes physical symptoms. For others, it can refer to a buildup of stress, tension, nervousness, worry, and emotional distress. 

Anxiety attacks” or symptoms of anxiety typically build up over periods of time and develop more slowly, and can persist for longer periods of time. They are often linked to specific triggers or fears [3]. 

Symptoms of an Anxiety Attack 

Anxiety attacks don’t have a formal criteria as they are linked to multiple anxiety disorders, including generalized anxiety, social anxiety, phobia disorder, and trauma-related anxiety or PTSD

It’s not always a sudden, onset “attack” but rather an ongoing presentation of symptoms. Typical symptoms of anxiety could include:

  • Muscle tension, especially in the neck and shoulders 
  • Worry, fear, apprehension
  • Headaches, migraine, dizziness
  • Nausea, indigestion, dry heaving, vomiting 
  • Panic attacks 

Risk Factors for Anxiety and Panic Attacks

There are several factors that can increase the risk of experiencing anxiety or panic attacks. These include [4]: 

  • Being diagnosed with an anxiety disorder, such as panic disorder, generalized anxiety, or social anxiety.  
  • Experiencing trauma or witnessing trauma, either as a child or adult (e.g., natural disaster, school shooting, combat, working in emergency services). 
  • Dealing with a major transitional life event, such as the death of a parent or divorce.
  • Living under financial stress, such as with overdue bills or credit card debt.
  • Being a parent or caregiver, especially to a child or adult who is physically or mentally ill.
  • Living with a chronic illness or life-threatening illness.
  • Having a naturally anxious personality or the presence of another mental health condition.
  • Having close family members who also suffer from panic attacks or anxiety.
  • Using illegal drugs and alcohol.
  • Being bullied, discriminated against, or continuously mistreated.

How to Know If You’re Having a Panic Attack 

Onset: Panic attacks often arrive out of nowhere and aren’t always triggered by something. Especially if you’ve had them in the past, this can cause built-up anxiety to trigger one in the future. Practicing healthy stress management is essential for prevention. 

Distress Level: During a panic attack, your fight or flight response kicks in, and physical symptoms such as dizziness, chest tightness, and shortness of breath are more common.

Long-Term Effect: Panic attacks may trigger intense fears about future episodes of having another attack. Some people may avoid places or situations they believe they are at risk of having a panic attack.   

Grounding Yourself During A Panic Attack 

Panic attacks are scary, distressing, and can come out of nowhere. If you’ve had one before, you may worry about future episodes. Learning coping skills to self-soothe can help reduce anxiety about future attacks. A few tips include: 

  • Take slow, deep breaths, focusing your attention on each inhale and exhale. Count down from 10 as you breathe out and repeat this process until you feel your breathing slow. 
  • Recognize you’re having a panic attack and accept what you are feeling. Remind yourself that the symptoms will pass. 
  • Practice mindfulness to bring yourself back to the present. Observe your thoughts without judgment, and feel where sensations arise in your body during moments of panic or stress. 
  • Self-soothe your nervous system with a hot bath, a splash of cold water on the face, aromatherapy such as lavender, or a weighted blanket. 

End The Cycle of Suffering and Heal from Trauma at Maple Mountain 

At Maple Mountain Mental Health and Wellness, we are committed to following the principles of trauma-informed care to address the physical, mental, and spiritual needs of our clients. 

Our PTSD and complex trauma inpatient treatment combines evidence-based therapies, including EMDR, Accelerated Resolution Therapy, and Somatic Experience, with integrated wellness activities such as ceramics, painting, dance, and trauma-informed yoga. 

We work with you to address the individual and collective impacts of trauma to achieve lasting emotional growth and well-being. Contact our admissions team today to regain control and begin your healing journey. 

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Sources 

[1] SAMHSA. Impact of the DSM-IV to DSM-5 Changes on the National Survey on Drug Use and Health.[2] National Institute of Health. Panic Disorder: What You Need to Know
[3] Washington, N. 2025. What’s the Difference Between a Panic Attack and an Anxiety Attack? Healthline. 
[4] Kendler, S. et al. (2014). Risk factors for anxiety disorders: common and specific effects in a national sample. Depression and anxiety, 31(9), 756–764.

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