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I'm wondering if someone can help me understand what the differences between a panic attack and an anxiety attack are.

Daniel E.
My understanding is that the term "anxiety attack" usually describes something less severe than a "panic attack." Both have physical symptoms of the fight-or-flight response, but the term "panic attack" would seem more likely to include more severe symptoms like hyperventilation, fainting, etc.

David Baxter PhD

Late Founder
Anxiety attack isn't a precise term, really... it generally refers to any bout of increased anxiety with varied or diffuse symptoms:

Definitions of anxiety attack on the Web:

an episode of extremely uncomfortable anxiety. Severe forms of anxiety attacks are usually called panic attacks.

a sudden acute episode of intense anxiety and feelings of panic
The term panic attack is somewhat more precisely defined, and usually includes a constellation of physical symptoms:

Definitions of panic attack on the Web:

is an intense and sudden feeling of fear and anxiety. It is associated with many physical symptoms such as rapid heart beat, trembling, rapid shallow breathing, pins and needles in the arms and feeling faint. Many people who have a panic attack fear that they will collapse or die. These attacks are not harmful and usually go away within 20-30 minutes.

A sudden episode consisting of terrifying bodily symptoms such as labored breathing, choking, dizziness, tingling in the hands and feet, sweating, trembling, heart palpitations, and chest pain. Panic attacks occur in a number of mental disorders and are common in phobias, panic disorder, and post-traumatic stress disorder (PTSD).

an episode of panic that resembles an extreme form of anxiety attack and may sometimes result in temporary paralysis or fainting. People often describe a panic attack as, "a frantic feeling that I am about to die." Sensations of horror or terror can be extremely acute during a panic attack, to the degree that a person may fear going insane as a result. In panic disorder, such attacks typically last about half an hour; however, in extreme cases attacks may last several hours or even several days (Status Panicus).

A period of sudden, intense apprehension, fearfulness or terror often associated with impending doom and accompanied by physiological symptoms, such as shortness of breath, palpitations, pounding heart or chest discomfort.

A panic attack is a period of intense fear or discomfort, typically with an abrupt onset and usually lasting no more than 30 minutes. Symptoms include trembling, shortness of breath and sensations of choking or smothering. The disorder is strikingly different from other types of anxiety in that panic attacks are very sudden, appear to be unprovoked, and are often disabling.
Panic attack - Wikipedia

Daniel E.
From Dorlands Medical Dictionary:

panic attack, [DSM-IV] an episode of acute intense anxiety, with symptoms such as racing or pounding heart, sweating, trembling, chest pains, nausea, dizziness, faintness, chills or hot flashes, and feelings of choking or smothering. It is the essential feature of panic disorder (q.v.) but may also occur in agoraphobia and other anxiety disorders, as well as in other psychiatric disorders such as schizophrenic disorders or mood disorders. Called also anxiety attack.

When you look up "anxiety attack" in The American Heritage Dictionary or in Dorlands Medical Dictionary, you get something like "see panic attack." So "anxiety attack" is not given much definition in dictionaries.
Thanks for your responses.

I remember having my first panic attack when I was about 9 or 10 years old but no one knew that's what it was. In fact, I didn't understand that I was having panic attacks until fairly recently.

From the time of my first panic attack until my younger sister died (when I was 23) the panic attacks were few and far between. However, since her death, they've increased and become different. They are preceded by an obvious (well, obvious to me) trigger and are always accompanied by hyperventilation. And during the last panic attack I experienced temporary paralysis. This scared the crap out of me. I guess it was because there was not enough blood or oxygen getting to my muscles? I was hyperventilating and I first noticed it in my hands, then arms, then face. I couldn't talk or breath.

Anyway, I wondered if I had made a transition from anxiety attack to panic attack or something, but according to the definitions, it just sounds like I'm experiencing some different symptoms related to the panic/anxiety attack??


Hi Healthbound,

Something I've noticed is that the descriptions of panic attacks don't seem to capture anything of the feeling of an anxiety/panic attacks.

I know that there are palpitations, dry mouth, all that stuff. But it is the FEAR that does for me. In a panic attack I wouldn't even know if I had palpitations or a dry mouth - I'm way past that - I'm not even in my body at all.

Let's put this into perspective with other experiences I have had. Being beaten up in the street by some thugs, fear factor - 3/10, having teeth out 3/10, having a colonoscopy for suspected cancer 5/10. Panic attack - 10/10+++

For me, panic attacks are the absolute pits, they are qualitatively different from anything else I have known, except for the hangover of generalised anxiety which can carry on for months after an attack.

But, saying all that, I do survive this stuff and will continue to do so. It is the fact of survival, and continuing to live my life, which is a matter of honour with me.

Cheers, Philos

David Baxter PhD

Late Founder
Healthbound, it sounds to me like the intensity of the panic attacks has increased recently, with some additional symptoms. Are you being treated for this currently?

You're correct, Philos. A panic attack is accompanied by a feeling of fear or dread or apprehension, as if something terrible is about to happen, and it can indeed by very intense.
Philos -
Thanks for writing a bit about your experiences. I laughed to myself when I read about your fear factor ratings - because it's so true...nothing compares anxiety.

Dr Baxter -
Thank you for your concern. I went on medical leave from work about 8 months ago and was diagnosed with complex ptsd and major depression. My brain wasn't working the way it used to - I couldn't absorb new information and my memory, concentration and decision making skills were almost non existent. Also, on weekends, I was sleeping more than 15 hours per night. I lost interest in everything (even my son) and had made a decision to permanently disengage with life by ending mine.

Being suicidal confused me greatly. I had felt this way once before immediately after my younger sister died. She had taken her life and I found it extremely traumatizing as she called me right before she did it - I arrived at her apartment only minutes after she leapt from her balcony. There were already many issues that I had worked hard to overcome at the time of her death and the mere fact that she had been witness to most of them made me feel validated. With her gone, I only thought about being with her and ridding myself of the horrible feelings I was feeling. I was eventually hospitalized and then participated in an intensive cognitive and behavioral program made of group as well as individual therapy. It was during my time there that I learned to drastically alter my thoughts and actions - and therefore my feelings. I was no longer suicidal and was functioning as a healthy person. Perhaps better than ever. That was from 1993 - 1995.

My depression etc. followed an obvious traumatic event. However, when I began feeling similarly more than a decade later about 2 ½ years ago, I was very confused and kept it to myself until I had truly felt that there was no other option other than death. A large part of my confusion was due to the fact that my sister's death had such an impact on me and I wondered how I could even entertain the thought (never mind the decision) of doing the same thing knowing the affect it could have on my son.

At that point, I began one on one therapy with a local organization and saw a psychiatrist. I have been seeing a therapist there for about 10 months and just finished a 12 week group on emotions. I am not doing cognitive or behavior psychotherapy this time as the organization practices psychodynamic psychotherapy. I've found this kind of therapy to be quite different than cbt and is very challenging most of the time. During many of my sessions - especially in the beginning - I felt like I was having flashbacks or was getting re-traumatized until I got half way through the 12 week group where I learned some techniques to bring me back to reality. The tools I learned helped me feel more in control of what was happening and most importantly have helped me connect to myself, to my son and to life. I also now realize that just because I have intense feelings doesn't mean I'm going to completely lose touch with reality (after my parents split up when I was about 11 years old, my mom experienced periods of psychosis) or will kill myself.

My time with the group was a significant as I am finally feeling like I'm finally coming out of my depression. When I started it, I could barely sit through the group without having visible panic. I had become very "high-strung" and full of anxiety. Since the group has ended, I've decided to take a short break from my therapist.

But, for some reason, my panic attacks are getting significantly worse. And even with all the work I've done, I genuinely feel very out of control when I experience them. I've identified a few very key triggers, but I find that I am also triggered unexpectedly sometimes too.


SO - to answer your question:
I am currently taking a break, but yes, I am being treated however I haven't specifically focused on panic. The triggers that are inducing the recent panic attacks seem to be related to the way my boyfriend expresses his anger (except for one panic attack during a group session on boundaries). We live in different provinces, so we only see each other about once a month so the opportunity to be triggered is somewhat lessened.

I think I might also be having minor anxiety attacks sometimes when there appears to be no trigger. All of the sudden I will become hyper-aware of all the noises around me and can seemingly hear everyone and everything all at once. The noises are extremely loud in my head and feel very intrusive and I feel like I can't make it stop. At those times, I feel like I might go crazy or have a psychotic episode or something (although I've never had a psychotic episode before and am 34 years old). This is different from the panic attacks where I hyperventilate and cannot stop. When those happen, I know I'm panicking and feeling extreme sadness in addition to intense fear. It is scary, but it's more a feeling of shock and isolation mixed with intense fear and again, I just want the activities around me to stop.

If you've made it this far, I appreciate your taking the time to read my mini-novel! I'm sure you read a millions stories like mine. I had no intention of typing on like this, but now that I have I feel a sense of relief :)

Feedback welcome.

David Baxter PhD

Late Founder
One of my clients experiences anxiety/panic/OCD symptoms that are similar to yours, including the heightened awareness of and hypersensitivity to sensory stimul -- sounds, touch, visual mostly. I view it as indicative of an increased general anxiety level which periodically spirals into a full-blown panic attack.

I realize that you have been through a great deal, both in your life and in your recent therapy -- and there's nothing wrong with taking a brief respite from all of that. But it seems clear what your next step must be.

Good luck, healthbound. There is a lot of strength and determination evident in your posts, even if it doesn't feel that way to you on a day to day basis.
Dr Baxter -

Thanks for you reply. Yes, it seems my next step would be to get my butt back into therapy, but beyond that, I still feel confused about what my focuses there should be. Because there is so much in my past that would logically explain much of my panic, depression, ptsd etc. I seem to "get stuck" focusing on my traumas. I wonder if it might be a good idea to focus on my present situations for a while instead? This way, I would perhaps be putting some of my disturbed thoughts, memories and feelings from my past to rest by experiencing my strength/control with situations in the present.

All of the most disturbing traumas were things that were very scary and completely beyond my control. However, if I can demonstrate to myself that I DO have control over my feelings/experiences in the present, maybe I can let go of some of my feelings and memories from the past - then the triggers might not have such a major impact??

David Baxter PhD

Late Founder
That's what I'm, suggesting: Focus on managing the anxiety and panic symptoms for a while. Once they are under better control, then you can worry about the origins.
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