Anxiety or a panic attack: What’s the difference?

Persistent anxiety and sudden panic attacks can share symptoms, but understanding their differences can help you recognize when to seek support.

Feeling anxious is a normal part of life. You may worry about work, relationships, your health or even overthinking a text message you just sent. In many cases, anxiety is temporary and connected to a specific concern.

An anxiety disorder is different. It involves fear or worry that is persistent, difficult to control and disruptive to daily life. Symptoms may occur in many situations, continue when there is no immediate threat and become more intense over time.

Anxiety disorders are common, can affect people of all ages and are treatable. Depending on the severity of your symptoms, support may include therapy, healthy lifestyle changes, medication or a combination of approaches recommended by a mental health professional.

There are several types of anxiety disorders, including generalized anxiety disorder and panic disorder. Although these conditions may share similar symptoms, they are not the same. It is also important to distinguish between a panic attack — an intense episode that can occur with several conditions — and panic disorder, which involves recurring panic attacks and ongoing concern about having another one.

Understanding the differences among anxiety, panic attacks and panic disorder can help you describe what you are experiencing and recognize when it may be time to seek support.

What is generalized anxiety disorder?

Occasional worry is not the same as generalized anxiety disorder (GAD). People with GAD experience excessive anxiety or worry about several areas of life. The worry can be difficult to control, continue for months or longer and interfere with work, school, relationships or everyday responsibilities.

According to the National Institute of Mental Health, GAD often develops gradually and may begin at any age, although it frequently starts during early adulthood. Women are diagnosed with GAD more often than men, and anxiety symptoms may begin or intensify during pregnancy or the postpartum period.

Anxiety is related to fear, but the two are not identical. Fear is generally a response to an immediate threat. Anxiety is often focused on something that might happen in the future.

Common symptoms of GAD

People with GAD may:

• Worry excessively about everyday situations
• Have trouble controlling their worry
• Feel restless, irritable or on edge
• Have difficulty concentrating
• Become tired easily
• Have trouble sleeping
• Experience headaches, stomachaches or muscle tension
• Tremble, sweat or feel lightheaded
• Feel short of breath

Adults with GAD may worry intensely about work, finances, health, family responsibilities, being late or completing everyday tasks.

Children and teenagers may worry about school, friendships, activities, the future, making mistakes or disappointing others. Some may strive for perfection as a way to manage their fears.

Symptoms may become more noticeable during stressful periods, such as a family conflict, illness, job change or financial difficulty.

How is a panic attack different from anxiety?

Anxiety is often ongoing and may vary in intensity. A panic attack is a sudden episode of intense fear or discomfort that usually reaches its peak within minutes.

Panic attacks often include strong physical symptoms, such as chest pain, shortness of breath, dizziness, shaking or a pounding heartbeat. Because these symptoms can be so intense, some people believe they are having a heart attack.

A panic attack may be triggered by a feared object or situation, but it can also occur unexpectedly. Panic attacks may happen alongside other mental health conditions, including depression, obsessive-compulsive disorder, bipolar disorder and post-traumatic stress disorder.

Other symptoms may include:

• A sense of impending doom
• A racing or pounding heart
• Numbness or tingling
• Sweating
• Chills or hot flashes
• Nausea
• A choking or smothering sensation
• Feeling detached from yourself or your surroundings
• Fear of losing control of dying

A panic attack can happen at any time, including during sleep. Some people experience several attacks within a short period, while others have them only occasionally.

After having a panic attack, a person may become preoccupied with the possibility of another one. They may also avoid places, activities or situations associated with a previous attack. Over time, this fear and avoidance can contribute to ongoing anxiety.

Although panic attacks can feel frightening, the symptoms usually subside. However, symptoms such as chest pain, trouble breathing, fainting or an irregular heartbeat can also be signs of a medical emergency. Seek immediate medical care when symptoms are new, severe or different from anything you have experienced before.

Having an occasional panic attack does not necessarily mean you have panic disorder. Panic disorder may be diagnosed when a person has recurring, unexpected panic attacks followed by persistent worry about future attacks or significant changes in behavior, such as avoiding activities or places. These symptoms must also interfere with daily life.

Why do anxiety disorders and panic attacks happen?

There is no single known cause of anxiety disorders or panic disorder. Genetics, brain biology, life experiences and environmental stress may all play a role.

Certain medical conditions, medications and substances can also cause symptoms that resemble anxiety or panic, including:

• Thyroid disorders
• Heart rhythm problems
• Asthma and other breathing conditions
• Low blood sugar
• Anemia
• Hormonal changes
• Medication side effects
• Excessive caffeine use
• Alcohol or drug use
• Withdrawal from certain substances or medications

A healthcare professional can review your symptoms, medications, substance use and medical history and determine whether an examination or testing is appropriate.

What should I do if I experience anxiety or panic attacks?

Start by talking with a primary care provider or qualified mental health professional. They can assess your symptoms, consider possible medical causes and help you find an appropriate treatment plan.

Consider seeking help when anxiety or panic:

• Happens repeatedly
• Is becoming more severe
• Interferes with sleep, school, work or relationships
• Causes you to avoid places or activities
• Leads you to use alcohol or other substances to cope
• Makes it difficult to complete everyday responsibilities

How are anxiety and panic disorders treated?

Treatment may include therapy, medication, stress-management strategies or a combination of approaches. Finding the most effective treatment may take time, so continue communicating with your care team about your symptoms, progress and any side effects.

Therapy

Common approaches include:

Cognitive behavioral therapy: Helps people identify unhelpful thought and behavior patterns and develop healthier responses.

Exposure-based therapy: Gradually helps people face feared sensations or situations in a safe, structured way.

Acceptance and commitment therapy: Helps people respond differently to difficult thoughts and feelings while taking action based on their values.

Medication

Certain antidepressants, including selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors, may be prescribed for anxiety disorders.

Other medications may be used in specific situations. Some fast-acting anti-anxiety medications can cause sedation, tolerance or dependence and are generally prescribed selectively.

Do not start, stop or change a medication without talking with the prescribing physician.

Healthy habits can support treatment

Healthy routines can't always prevent anxiety or panic attacks, but they can support overall mental and physical well-being. Helpful habits may include:

• Getting regular physical activity
• Following a consistent sleep routine
• Eating regular, balanced meals
• Limiting caffeine and alcohol
• Avoiding nicotine and recreational drugs
• Practicing mindfulness, relaxation or gentle breathing techniques
• Spending time with supportive people
• Follow your treatment plan

When to get immediate help

If you or someone you know is experiencing emotional distress or having thoughts of suicide, call or text the 988 Suicide & Crisis Lifeline at 988 or use its online chat service. In a life-threatening emergency, call 911.