Guide to When Anxiety Attacks Its A Panic Attack
Know about panic attack and anxiety. What are the differences, signs, triggers, how to handle, crisis management and long-term strategies to manage and more.
Written by Dr. Rohinipriyanka Pondugula
Reviewed by Dr. Vasanthasree Nair MBBS
Last updated on 7th Oct, 2025
Introduction
That sudden, overwhelming wave of fear, your heart pounds, you can't catch your breath, and the world feels like it's closing in. Is it a severe anxiety attack, or are you experiencing a full-blown panic attack? While the terms are often used interchangeably, understanding the distinction is crucial for effective management and peace of mind. This intense experience can be terrifying, leaving you feeling out of control and searching for answers. This guide will demystify these episodes, breaking down the key differences in symptoms, triggers, and duration between general anxiety and a clinical panic attack. By the end, you'll be equipped not only to identify what you're experiencing but also with practical strategies to navigate both situations, helping you move from fear to understanding. Let's unravel the mystery behind these overwhelming moments.
The Fundamental Difference: Anxiety vs. Panic
While both anxiety and panic are rooted in fear and share physical symptoms, their core nature is different. Think of anxiety as a high baseline of worry related to a potential stressor, while a panic attack is an intense, acute spike of terror that often feels like it comes out of nowhere.
Consult a Top General Practitioner for Personalised Advice
What is an Anxiety Attack?
The term "anxiety attack" isn't a formal clinical diagnosis but is widely used to describe an intense episode of worry and physical arousal in response to a perceived threat. It's typically linked to a specific stressor like financial troubles, work deadlines, or relationship conflict. The symptoms build gradually, mirroring the building pressure of the stressor itself. You might feel progressively more tense, irritable, and on edge for hours or even days before it peaks into what feels like an "attack." This makes the experience distressing but often predictable in its connection to life's challenges.
What is a Panic Attack?
A panic attack, on the other hand, is a recognised psychological event characterised by a sudden, overwhelming surge of intense fear and discomfort that peaks within minutes. The most defining feature of a panic attack is its lack of an obvious trigger. It can strike while you're relaxing, watching TV, or even waking you from sleep (nocturnal panic attack). This "out-of-the-blue" quality is what makes it so frightening and can lead to a fear of having another attack, creating a cycle of anxiety about anxiety itself.
Key Differentiator: The Element of Surprise
The simplest way to distinguish them is by asking: "Was there a clear cause?" If the episode was a direct and
proportional response to a stressful situation, it was likely a severe anxiety attack. If it hits you like a lightning bolt on a
clear day, with no apparent reason, you're probably dealing with a panic attack. This distinction is vital for seeking the
correct treatment for panic attacks, as recurrent, unexpected panic attacks are a hallmark of Panic Disorder.
Symptom Showdown: Comparing How They Feel
Both conditions activate the body's sympathetic nervous system, the "fight-or-flight" response, leading to significant
physical overlap. However, the intensity and combination of symptoms can provide clues.
Common Symptoms of High Anxiety
Anxiety attacks often manifest as a combination of psychological and physical symptoms that persist over time.
Common signs include:
- Restlessness, feeling "keyed up" or on edge.
- Excessive worry that is difficult to control.
- Muscle tension, especially in the neck and shoulders.
- Irritability and difficulty concentrating.
- Sleep disturbances (trouble falling or staying asleep).
- Fatigue and feeling easily drained.
- The physical symptoms, like a racing heart or shortness of breath, are present but are generally less intense and
overwhelming than in a panic attack.
Hallmark Symptoms of a Panic Attack
A panic attack is defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as an abrupt surge of
intense fear that peaks within minutes and includes at least four of the following physical symptoms of a panic attack:
- Palpitations, pounding heart, or accelerated heart rate.
- Sweating.
- Trembling or shaking.
- Sensations of shortness of breath or smothering.
- Feelings of choking.
- Chest pain or discomfort.
- Nausea or abdominal distress.
- Dizziness, unsteadiness, lightheadedness, or faintness.
- Chills or heat sensations.
- Numbness or tingling sensations (paresthesia).
The "Impending Doom" Feeling: A Panic Attack Signature
A symptom that strongly points toward a panic attack is derealization (feelings of unreality) or depersonalization
(feeling detached from oneself). But the most terrifying for many is the overwhelming sense of impending doom or fear
of losing control—a conviction that you are about to die, have a heart attack, or go crazy. This feeling is so intense and
visceral that it often leads people to seek emergency medical care, convinced they are having a cardiac event.
Triggers and Timelines: Why and When They Happen
Understanding the "why" and "when" can further help you identify what you're experiencing.
The Build-Up of Anxiety
Anxiety is typically tied to the anticipation of a future threat. The trigger is identifiable, such as:
- Work-related stress or an upcoming presentation.
- Conflict in personal relationships.
- Health concerns (yours or a loved one's).
- Financial instability.
- The timeline is gradual. The worry builds, and the anxiety attack represents the peak of this sustained period of stress. It
may last for a more extended period, from minutes to hours, and the intensity can wax and wane with your thoughts
about the stressor.
The Sudden Onset of Panic
A key characteristic of a panic attack is its rapid and often unexpected onset. While they can sometimes be cued by a
feared object or situation (like a phobia), unexpected panic attacks occur without an obvious trigger. They come on
"like a wave," reaching peak intensity within 5-10 minutes. Because of the extreme physiological arousal, they are
usually short-lived, subsiding within 20-30 minutes, though the after-effects of exhaustion and worry can last much
longer. The unpredictability is a core part of what makes them so debilitating.
What to Do in the Moment: Crisis Management Techniques
When you're in the midst of an episode, knowing a few grounding techniques for panic attacks can be a lifeline.
Grounding Techniques for a Panic Attack
It includes:
- Grounding techniques help anchor you in the present reality when you feel detached or overwhelmed.
- The 5-4-3-2-1 Method: Identify and name silently to yourself: 5 things you can see, 4 things you can feel, 3 things you
can hear, 2 things you can smell, and 1 thing you can taste. - Temperature Change: Splash cold water on your face, hold an ice cube, or grab a cold drink. The shock of cold can
disrupt the panic cycle. - Focus on an Object: Pick a nearby object and describe it in exhaustive detail its color, texture, shape, weight, and
purpose.
Breathing Exercises to Regain Control
During a panic attack, breathing becomes rapid and shallow (hyperventilation), which worsens symptoms like dizziness
and chest tightness. Slowing your breath is critical.
- Diaphragmatic Breathing: Place one hand on your chest and the other on your belly. Breathe in slowly through your
nose for 4 seconds, feeling your belly rise. Hold for 2 seconds. Exhale slowly through your mouth for 6 seconds, feeling
your belly fall. This stimulates the parasympathetic nervous system, promoting calm. - Box Breathing: Inhale for 4 seconds, hold your breath, exhale, and hold the exhale for 4 seconds. Repeat.
Long-Term Strategies: Managing Anxiety to Prevent Panic
While immediate techniques are vital, long-term management focuses on reducing your overall anxiety levels, which
can prevent panic attacks from occurring.
Lifestyle Changes for Anxiety Reduction
Consistent self-care builds resilience against stress.
- Regular Exercise: Aerobic exercise is a powerful anxiety reliever. It burns off stress hormones and releases endorphins.
- Prioritise Sleep: Sleep deprivation significantly lowers your threshold for anxiety. Aim for 7-9 hours of quality sleep per
night. - Limit Stimulants: Caffeine, nicotine, and other stimulants can trigger or mimic anxiety and panic attack symptoms.
- Mindfulness and Meditation: Regular practice helps you observe anxious thoughts without being controlled by them,
reducing their power over time.
The Role of Therapy and Professional Help
If your anxiety is interfering with your daily life or you experience recurrent panic attacks, professional help is essential.
- Cognitive Behavioural Therapy (CBT): This is the gold-standard treatment for panic attacks and anxiety disorders. CBT
helps you identify and challenge the distorted thought patterns that fuel your anxiety and teaches you behavioural skills
to manage symptoms. - Medication: In some cases, doctors may prescribe antidepressants (SSRIs/SNRIs) or anti-anxiety medications to help
manage the chemical imbalances that contribute to these conditions.
If your symptoms persist beyond two weeks and significantly impact your work, relationships, or well-being, consult a
doctor online with Apollo24|7 for further evaluation. They can help rule out other medical conditions and guide you
toward the most effective treatment path.
Conclusion
Understanding the difference between an anxiety attack and a panic attack is the first step toward reclaiming a sense of control. While both are deeply challenging, recognising the patterns—the gradual build-up of anxiety versus the sudden storm of panic—empowers you to respond effectively. Remember, the terrifying physical sensations of a panic attack, while real and alarming, are not dangerous. They are your body's emergency system misfiring. By arming yourself with immediate coping tools and committing to long-term strategies that lower your overall anxiety, you can break the cycle of fear. This journey is about management, not magic cures. Be patient with yourself, celebrate small victories, and know that with the right support and knowledge, you can navigate these experiences and live a full, vibrant life. If your condition does not improve after trying these methods, book a physical visit to a doctor with Apollo24|7 to create a personalized treatment plan.
Consult a Top General Practitioner for Personalised Advice
Consult a Top General Practitioner for Personalised Advice
Dr. Anand Ravi
General Physician
2 Years • MBBS
Bengaluru
PRESTIGE SHANTHINIKETAN - SOCIETY CLINIC, Bengaluru
Dr Syed Mateen Pasha
General Physician
2 Years • MBBS
Bengaluru
PRESTIGE SHANTHINIKETAN - SOCIETY CLINIC, Bengaluru
Dr. Avinash Pasuparthy
General Practitioner
5 Years • MBBS
Visakhapatnam
Apollo Clinic Vizag, Visakhapatnam
Dr. Pankaj Tripathi
General Practitioner
20 Years • MBBS, MD Pathology
Lucknow
Best Diabetologist Clinic, Lucknow
Dr Bhargav Vuppumalla
General Physician/ Internal Medicine Specialist
5 Years • MBBS MD GENERAL MEDICINE
Bengaluru
Apollo Medical Center, Marathahalli, Bengaluru
Consult a Top General Practitioner for Personalised Advice
Dr. Anand Ravi
General Physician
2 Years • MBBS
Bengaluru
PRESTIGE SHANTHINIKETAN - SOCIETY CLINIC, Bengaluru
Dr Syed Mateen Pasha
General Physician
2 Years • MBBS
Bengaluru
PRESTIGE SHANTHINIKETAN - SOCIETY CLINIC, Bengaluru
Dr. Avinash Pasuparthy
General Practitioner
5 Years • MBBS
Visakhapatnam
Apollo Clinic Vizag, Visakhapatnam
Dr. Pankaj Tripathi
General Practitioner
20 Years • MBBS, MD Pathology
Lucknow
Best Diabetologist Clinic, Lucknow
Dr Bhargav Vuppumalla
General Physician/ Internal Medicine Specialist
5 Years • MBBS MD GENERAL MEDICINE
Bengaluru
Apollo Medical Center, Marathahalli, Bengaluru
More articles from Anxiety disorders
Frequently Asked Questions
1. Can you die from a panic attack?
No, you cannot die directly from a panic attack. While the symptoms—like chest pain and a racing heart—can feel like a heart attack, they are a result of the fight-or-flight response and are not medically harmful. However, because the symptoms can be similar, it's crucial to seek medical attention if you're unsure, especially if it's your first episode.
2. How long does a panic attack usually last?
Most panic attacks peak within 5-10 minutes and subside within 20-30 minutes. It is very rare for a full-blown attack to last for hours, though you may feel exhausted and on edge for a considerable time afterwards.
3. What is the best way to help someone having a panic attack?
Stay calm and present. Speak to them in a reassuring, low voice. Don’t dismiss their fear by saying 'calm down.' Instead, validate their experience with phrases like, 'I see you're feeling scared, but you're safe. This will pass.' Guide them through slow breathing exercises and stay with them until the symptoms subside.
4. Can anxiety cause chest pain that feels real?
Yes, absolutely. Anxiety and panic can cause very real chest pain, often described as a sharp, stabbing sensation or a dull ache. This is typically due to muscle tension or hyperventilation. However, any new or unexplained chest pain should be evaluated by a doctor to rule out cardiac causes.
5. Are panic attacks a sign of a more serious mental illness?
A single panic attack does not mean you have a mental illness. However, recurrent, unexpected panic attacks are the primary symptom of Panic Disorder. Panic attacks can also occur in the context of other anxiety disorders, such as Social Anxiety Disorder or PTSD.