Mental health is increasingly being discussed by diverse groups of people around the world. We now understand that being depressed and having anxiety attacks or panic attacks are not a result of being weak. Rather, they are signs of attempting to cope with uncomfortable or unwanted situations.
Most of the time, the terms panic attack and anxiety attack are used interchangeably without understanding the underlying causes, symptoms and treatment options for each. This article will explore what is a panic attack vs. anxiety attack and how to identify and treat them.
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Understanding Panic Attacks and Anxiety Attacks
The Diagnostic and Statistical Manual of Mental Disorders (5th edition), commonly known as DSM-5, helps mental health practitioners understand the differences between a panic attack vs. anxiety attack.
Though there is no such ailment as an "anxiety attack", anxiety disorders are what DSM-5 describes in detail.
An anxiety disorder is a group of mental health illnesses that includes several phobias such as agoraphobia (fear of crowded places), claustrophobia (fear of confined places), acrophobia (fear of heights) and disorders like separation anxiety disorder, panic disorder, generalised anxiety disorder (GAD), obsessive-compulsive disorder (OCD) and others.
An anxiety attack is a colloquial term used to describe extended periods of anxiety that disrupt a person’s day-to-day activities and affect functionality, causing prolonged periods of distress.
On the other hand, a panic attack is clinically defined by DSM-5 as a sudden episode of intense fear triggering severe physical reactions in the absence of danger or another obvious cause. Though a panic attack can be triggered by factors similar to anxiety such as phobias, stress, social disorders, or driving, they tend to be more sudden and intense.
If someone experiences panic attacks frequently over time, they may have a panic disorder and need to consult a therapist. A panic disorder is often also the result of post-traumatic stress, having experienced a traumatic event such as a sudden death.
Causes of Panic Attack vs. Anxiety Attack
An anxiety attack is usually a response to a perceived threat, an anxiety disorder such as OCD, GAD, social phobias, or other phobias.
Anxiety attacks may also occur as a response to specific stressful situations when anxiety increases beyond normal levels. Such conditions include a job change, relationships, stress related to finances, speaking in front of others (stage fright), a medical diagnosis and more.
Another significant risk factor that leads to anxiety attacks is genetics. People in the same family might suffer from anxiety attacks due to shared genes.
The common causes of a panic attack include traumatic events that may lead to panic disorders, stressful life situations, certain chronic health conditions, suffering from a mental health condition such as depression, genetics, overuse of stimulants such as caffeine and smoking or substance abuse.
Symptoms of Panic Attack vs. Anxiety Attack
When someone suffers from an anxiety disorder, the common mental symptoms include excessive irritability, worry, fear, distress, a sense of uneasiness, restlessness, or difficulty concentrating on a task.
An average level of anxiety is common, and even encouraged, to ensure the fight or flight response when faced with a stressful situation or a threat. However, when the anxiety level rises too high, it disrupts daily life and affects productivity and efficiency, becoming a cause for concern.
The common physical symptoms associated with an anxiety attack are sleep disruption, fatigue, elevated heart rate and heart palpitations, pain in the chest, dryness in the mouth, tightness in the throat, sweating, dizziness, numbness or tingling, and shaking, among others.
While the physical symptoms faced while experiencing a panic attack are similar to that of an anxiety attack, the mental symptoms include excessive fear, a sense of detachment, fear of losing control, among others.
Common Differences Between Panic Attacks and Anxiety Attacks
Since most of the triggering factors and symptoms are more or less common between the two, certain key differences can be used to identify anxiety attacks vs panic attacks.
Even though the triggering factors may be similar between panic attacks and anxiety attacks, what differs is the appearance of the attack. This means that an anxiety attack is never sudden. You may start to feel anxious because of your phobias or the stressful situations you find yourself in.
An anxiety attack occurs after your anxiety builds up for a significant amount of time and rises to a level where you start feeling overwhelmed.
On the other hand, a panic attack will oftentimes be sudden and before you realise what triggered it, you may already be feeling the symptoms like shortness of breath or heart palpitations.
An anxiety attack is slow and usually accompanied by multiple symptoms before an attack. It is also caused by a specific factor or an underlying cause perceived as stressful or threatening.
A panic attack is sudden and without a specific cause. However, there may be certain precursors which may help in identifying the onset, such as increased heart rate or palpitations.
Although the physical symptoms are largely similar in the two cases, the key difference lies in the level of intensity. Panic attacks are usually more severe than anxiety attacks.
Chronic anxiety attacks last longer, while panic attacks start and end quickly. The average time a panic attack lasts varies between 5-20 minutes. However, a person experiencing several panic attacks in a row may experience them for longer.
Triggers for an anxiety attack are most often situational, depending on what factors cause a person’s anxiety. On the other hand, it is difficult to pinpoint the underlying cause or trigger for a panic attack since it is extremely sudden.
While it is difficult to diagnose an anxiety attack, doctors can identify the symptoms of anxiety disorders and panic attacks.
A mental health practitioner usually conducts a thorough physical exam to rule out any underlying medical conditions, such as heart disease or thyroid problems, with similar symptoms. This is done by running blood tests and performing an EKG or ECG for a heart test. A proper medical history of the patient is also mapped out.
After properly understanding the symptoms based on their intensity, duration and impact on the patient’s life and conducting a complete psychological evaluation, the mental health practitioner may come up with a diagnosis based on the DSM-5 criteria.
Treatment of Panic Attacks and Anxiety Attacks
Cognitive Behavioural Therapy: A counsellor helps in developing strategies that may aid the patient in identifying and managing anxiety triggers when they arise.
Cognitive Therapy: This helps the patient identify, overcome or manage the worries that usually underlie an anxiety disorder.
Exposure Therapy: This involves facing your fear before it builds up to become a trigger.
Relaxation: Certain breathing exercises, meditation strategies and guided imagery may help overcome the triggering thoughts.
In severe cases, a doctor may prescribe certain anti-depressants or anti-anxiety medicines, such as benzodiazepines, to suppress the symptoms. In cases of extreme physical symptoms, prescribing beta-blockers may also be necessary to counter the effects of rapid heart rate and related symptoms.
It is important to note that most of these drugs are habit-forming and should only be used following a doctor’s prescription.
When faced with an attack, certain common steps can help calm one’s anxiety. The first step is acknowledging that you are having an attack and that it will pass soon. Taking deep breaths also helps. Relaxation techniques such as aromatherapy are also known to provide a calming effect.
Making certain changes in lifestyle may go a long way in preventing anxiety and panic attacks and reducing their severity.
Lowering stress to controllable levels is crucial. One should also try to identify and avoid negative thoughts, such as "what if" scenarios that usually cause anxiety.
A proper diet and nutrition intake, combined with regular exercise, is a foolproof method to lower stress and help combat anxiety. It is also important to reduce the intake of coffee and alcohol.
In some instances, joining support groups and exchanging experiences and learnings with others facing anxiety and panic disorders is equally helpful.
With there are commonalities between anxiety attacks and panic attacks in terms of their physical symptoms and triggering factors, it is also important to identify their key differences to be well-equipped to understand whether one is suffering from a panic attack or an anxiety attack.
Most importantly, one should know when to reach out for help through support groups or a therapist/doctor to help deal with the attacks. Suffering from a panic attack or an anxiety attack is more common than people think and it is recommended to step forward to get help. Avoiding addressing the issue and not opting for the proper treatment may have serious consequences.