Because panic disorder is a form of anxiety, the terms “panic attack” and “anxiety attack” are often interchangeable. Adding to the confusion, anxiety and panic can share some physical symptoms; like accelerated heart rate, chest pain, and shortness of breath. At their core, though, anxiety and panic differ in emotional states — They have different triggers and different expressions.

“In my experience, a patient will say, ‘I had an anxiety attack,’ but what they mean is that they had a panic attack,” Neda Gould, Ph.D., a clinical psychologist and associate director of the Johns Hopkins Bayview Anxiety Disorders Clinic, told SELF. “‘Anxiety attack’ is more of a layperson’s term.”

So could what you refer to as a panic attack really be anxiety? Or could your anxiety attack really be a panic attack? Read on to find out.

What is a Panic Attack?

A panic attack is a feature of panic disorder. During a panic attack, a person may experience an elevated heart rate, trouble breathing, sweating, nausea, dizziness, trembling, numbness or tingling, chills or hot flashes, and/or chest pain. In fact, panic attacks are often mistaken as heart attacks, causing many people to visit the emergency room only to be diagnosed as NCCP (non-cardiac chest pain). These physical symptoms are accompanied by a detached feeling — called de-realization — or a fear of dying.  

The symptoms come on suddenly, either in response to a known trigger or out of nowhere, and their intensity peaks within ten minutes or less. Panic attacks are associated with the autonomic nervous system and the amygdala — places in the brain designed to detect threat and danger.

Descriptions of panic attacks are visceral and vivid. “The physical symptoms are unlike anything else I’ve felt,” one sufferer wrote. “A tightness in my chest so pronounced it actually feels like choking, dizziness like I’ve been hanging upside down for hours, tingling legs and numb hands. The exhaustion the next day is also uncanny. Your brain really makes your body pay for it.”

“I feel like I can’t breathe,” another described, “almost as if I’m being held underwater with no way of coming up for air. Afterwards, it’s like my body is in shock. I can’t stop shaking and feel so exhausted — like all the life has been sucked out of my body.”

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What is an Anxiety Attack?

“Attack” implies something swift, but anxiety symptoms don’t tend to come on quickly —  nor do they pass quickly, either. Unlike panic, anxiety builds gradually. Anxiety is associated with the prefrontal cortex, which has to do with planning and anticipating. It tends to be excessive and persistent worry tied to everyday concerns, such as work, finances, or health problems. If the intensity of anxiety from work or a health issue reaches a fever pitch, it could feel like an “attack.” You may experience a racing heart, muscle tension, have difficulty sleeping, be unable to concentrate, or feel dizzy. You may even scare more easily.

The “attack” may last as long as you’re dealing with the stressor. “When the stressor goes away,” Cathy Frank, M.D., Director, Outpatient Behavioral Health Services, Henry Ford Hospital told ABC News, “so does the anxiety attack.”

What’s the Difference?

Triggered by different parts of the brain, “panic attack” and “anxiety attacks,” are fundamentally different.

  • Panic attacks are intense, disruptive, and sudden. Anxiety symptoms vary in intensity from mild to severe, and develop in intensity over minutes, hours, or days.
  • Panic attacks tend to peak and subside within ten minutes. Anxiety symptoms can last for long periods of time.

Surprisingly, only one of them is officially recognized by mental health professionals. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is used by mental health professionals to recognize and diagnose patients. The DSM-5 only recognizes panic attacks, and categorizes them as unexpected or expected. It does not recognize “anxiety attacks.”

“An anxiety attack is a more colloquial term,” C. Vaile Wright, Ph.D., a licensed psychologist and director of research and special projects at the American Psychological Association, told Women’s Health.

That doesn’t mean that extreme or severe anxiety is not “as bad” as an official panic attack. If anxiety is affecting your quality of life, it’s important to seek help and treatment — and even more helpful to use language doctors who will understand and recognize your symptoms.