Similar but not the same: Here’s the difference between anxiety and panic attacks

Anxiety and panic disorders might have similar symptoms, but knowing the difference between the two can help you get the right treatment.
anxiety and panic attacks
Knowing the difference between anxiety and panic attacks can make all the difference. Image courtesy: Shutterstock
Dr Rajesh Parikh Updated: 30 Oct 2023, 16:16 pm IST
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Anxiety and panic have a lot in common and hence are often mistaken for each other. However they are very different in their causes, symptoms. and management. And if they go untreated or inappropriately managed, they can result in much physical and mental distress.

This makes it important for us to understand the difference between anxiety and panic attack.

Yes, there really is a difference between anxiety and panic attacks

Both have excessive worry, apprehension, nervousness, fear, difficulties in breathing, sweating, palpitations and tremulousness at their core.

However, anxiety is usually related to the anticipation of a stressful situation, experience, or event. It comes gradually and is generally not very specific. In fact, it is often described as ‘free floating’. It can be mild, moderate or severe. 

Panic, on the other hand, is almost always severe, sudden and involves intense, overwhelming fear with more severe physical symptoms.

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The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) recognizes panic attacks as a distinct mental disorder, classifying them as unexpected or expected. Unexpected panic attacks occur without an obvious cause, whereas expected panic attacks are triggered by external stressors. 

Panic attacks can occur if you’re very anxious

A panic attack can be superimposed on an anxiety episode. Let’s say you are anxious about an upcoming exam. During the exam, your anxiety may progress to a panic attack. Sometimes a panic attack may result in anticipatory anxiety of another episode of a panic attack.

Panic attacks and anxiety can be caused by a genetic predisposition, childhood experiences, and external stressors such as occupational pressures, social situations and specific phobias.

Hormonal irregularities especially in the thyroid and reproductive hormones and insulin can also cause anxiety and panic attacks. Drugs such as cocaine and marijuana as well as stimulants such as caffeine can induce anxiety and panic.

Here’s how panic attacks and anxiety episodes are treated

In order to treat anxiety and/or panic disorders, doctors need a history on the onset, duration, and progress of the symptoms along with a family history of medical and psychiatric disorders.

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They might need to conduct a physical examination with laboratory tests and investigations such as an ECG and sometimes an echocardiogram. They often need psychometric evaluation which consists of psychological paper and pencil tests.

The usual measures to manage anxiety and panic include:
  • Slow and deep breathing to reduce immediate physical distress
  • Yoga and meditation to relieve psychological distress
  • Relaxation exercises to build resilience
  • Mindfulness to improve the quality of life
  • Counselling and psychotherapy to bring about long term changes.
  • Treatment of underlying medical conditions such as hyperthyroidism and menopause.
  • Medications such as antianxiety and antidepressant drugs to deal with underlying biochemical causes.
  • Lifestyle changes to minimize recurrences and have long lasting solutions

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Usually an individually-tailored approach that has a combination of treatments is recommended. In today’s age, both anxiety and panic, although different in their causes and manifestations are common and eminently treatable. Most patients improve considerably within a few weeks. However, some may require long term treatment and very rarely hospitalization.

It is important to recognize the symptoms of anxiety and panic and not to hesitate to seek help from one’s family, friends, counsellors and psychiatrists. Untreated, these disorders can contribute to personal and occupational problems and sometimes can result in  physical and mental disorders. Treated appropriately, individuals should lead meaningful and joyful lives while attaining their true potentials.

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About the Author

Dr Rajesh Parikh is the director of the Department of Psychiatry and Research at Jaslok Hospital and Research Centre, Mumbai. ...Read More

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