It has always interested me how different sources seem to have conflicting opinions on anxiety attacks and panic attacks. Some medical and psychological publications and sources treat them as synonyms, meaning the same thing and only being a matter of preferred name. Other sources that are legitimate treat them as separate experiences, with panic attacks being a more severe but also unique type of experience versus the more mild anxiety attacks. Even the very popular website WebMD (often the source of many jokes about googling symptoms and finding out you have some rare incurable disease) describes panic and anxiety attacks in a way that makes them seem like the same thing, but also indicates that they may be different. In my practice as a counselor, I have found it both more useful and more in line with people’s personal experiences to differentiate the two.

The differentiating is helpful for two primary reasons. First, it can be used to separate the severity of both experiences, with panic attacks typically being the “worse” of the two. Being able to get perspective on the intensity of stress reactions by dividing anxiety and panic attacks helps myself and clients measure progress or decline in their mental well-being. The second reason is the most important in my view. Treating them as two different experiences is helpful and necessary, because they often impact people in very different ways. Clients will talk about panic attacks, and a certain set of common symptoms are described. Anxiety attacks are talked about in a totally different tone and with different symptoms. The difference in experiences leads to treating them differently in therapy. We will look at the typical presentation of each of these uncomfortable mental states first, then discuss a few ways to deal with each.

Panic Attacks Symptoms vs Anxiety Attack Symptoms

Remember, this is a grey area in terms of officially diagnosing these conditions. There doesn’t seem to be a true consensus on whether a panic attack and anxiety attack are different. But, my experience and the experience of many others has shown that they do present as two different things. Panic attack symptoms are very well documented. People experiencing a panic attack can expect symptoms like:

• Rapid heartbeat
• Quick, shallow breathing
• Feeling that you may die or go crazy
• Nausea/vomiting
• Racing thoughts

Panic attacks are very frightening, and people often describe them as the most intensely uncomfortable experiences in their lives. Many people end up visiting the Emergency Room due to panic attacks, particularly when they are new to a person. The first time someone experiences a panic attack, they may believe they are having a stroke or heart attack. While panic attacks are extremely frightening, they are not dangerous and are not linked to any serious complications or damage to internal organs. Your heart may feel like it is being taxed to the max, but it is more like doing an intense exercise which your heart can handle for the short duration of panic attacks. Dizziness can also be a symptom, but as long as we take care not to put ourselves in dangerous situations there are no lasting physical repercussions of panic attacks. Panic attacks are usually short duration and very intense, which is why many people find them to be the more severe than anxiety attacks. But what is an anxiety attack like?

Anxiety attacks biggest differentiating factor from panic attacks is often duration. Anxiety attacks can last hours, even a day and seem to go on unendingly. Anxiety attack symptoms typically show up as:

• Muscular tension
• Headaches
• Nausea
• General feeling of uneasiness
• Trouble focusing

These symptoms can be a bit similar to panic attacks, but they are usually less intense but last longer. A person having an anxiety attack may be struggling to accomplish their daily tasks, but unlike a panic attack they may still be functional. Anxiety attacks are also subtle at times. Some people notice chronic tension headaches and changes in digestion but may not even notice anxious thoughts. Anxiety attacks are not dangerous but chronic stress is linked to many health issues over long periods of time. Most people will not feel the need to visit an emergency room or fear they are going to die or go crazy during an anxiety attack. Because of the ability to function somewhat and the lack of intense urgency to seek help during an anxiety attack, they are often seen as the less severe of the two conditions.

Managing Panic and Anxiety Attacks

There are some ways to manage panic and anxiety attacks that don’t require treating them separately. Anxiety management in skills will often show results for both panic and anxiety attacks. Things like meditation, exercise, yoga, proper sleep, reducing caffeine and sugar intake, and expressing our emotions instead of holding them in, are all ways to reduce general anxiety. Lower levels of general anxiety will typically lead to less panic attacks and anxiety attacks. It is important to note that none of these things are as simple as they sound. Regularly practicing things like meditation or yoga or becoming more open with our emotions sound like things you can do in 1 day, but it takes weeks or even longer for these habits to truly show their benefits. It takes patience and consistency to reduce general anxiety. There is also the option for medications like SSRIs (antidepressants) that are effective in treating chronic anxiety and reducing the occurrence of anxiety and panic attacks.

There are different ways to treat panic and anxiety attacks from one another, mostly focused on the differences in duration and intensity. Starting with panic attacks, they are short duration, so a person usually wants to find ways to reduce their panic symptoms immediately. On the medical side, this is where benzodiazepines like Xanax or Klonopin are typically used. These medications are fast acting and powerful. Many people find within minutes of taking a Xanax their panic is gone. However, these medications can be addictive and may mask one’s source of anxiety making it harder to process. From a mental health viewpoint, panic attacks best respond to breathing regulation. The rapid and shallow breathing is both a symptom of panic attacks as well as a cause. When we rapidly breath and don’t fill our lungs, our body activates feelings of anxiety and panic. Taking deeper breaths with the aid of a phone app or learning breath counting strategies has a strong panic reduction effect. Without going too deep into the physical science, deep breaths that expand our stomach and slow exhales activate the parts of our nervous system that calm us down. We can also use grounding techniques, like grabbing onto something cold, or physical contact with someone we trust, or even interacting with nature, to calm down a panic attack.

Anxiety attacks, since they are longer lasting and less intense, may motivate people less to seek relief. Still, it is important to address them. Anxiety attacks respond to breathing techniques as well. Taking deeper breaths to fill our belly area will lessen anxiety attack symptoms. Anxiety attacks also respond well to distraction. This is not to say to avoid what is making you anxious, but if your anxiety is taking on a mind of its own and have no clear trigger, focusing on enjoyable tasks tend to lessen their impact. Anxiety attacks are also responsive to talking through one’s feelings in a way that panic attacks may not be. The intensity of panic attacks makes it very difficult to talk out the issue, particularly at the peak. Anxiety attacks do not cause that loss of ability to think clear enough to sit down and have a full conversation on what may be bothering you. Sometimes, people find that just expressing their feelings of being anxious to another person who validates their feelings can reduce the anxious symptoms.

Both conditions, anxiety and panic attacks, respond to talk therapy significantly. Some people use medication and therapy together for even greater results. If you struggle with anxiety or panic attacks please contact Life Enhancement Counseling Services today at 407-443-8862 to schedule an appointment with one of our experienced mental health counselors.