What’s the Difference Between an Anxiety Attack and a Panic Attack?

Panic Attack

It’s very common—and normal—to get a case of the jitters before taking a test, giving a presentation, or going on a first date with someone. In most cases, your brain will calm down once you get distracted by the task at hand.

Unfortunately for some people, it is very difficult to settle their minds. They can get keyed up for hours or even days in advance, with mounting tension that eventually starts to feel overwhelming. They may describe their experience as having an anxiety attack or a panic attack—terms that are often used interchangeably. However, in a clinical sense, these two types of “attacks” differ in numerous ways.

What Happens in an Anxiety Attack?

Anxiety is one of the most common mental health conditions. According to the National Institute of Mental Health, approximately 31% of adults in the U.S. will have an anxiety disorder at some point in their life. To some degree, anxiety is a normal response to a threat—whether real or imagined—and is part of our human condition. However, people who have persistent anxiety go beyond the norm. They tend to be chronic worriers, and consequently carry bigger burdens of stress.

Unfortunately, there are times when that stress and worry can lead to what feels like an “attack” because of symptoms like these:

  • Increased heart rate and muscle tension
  • Hypervigilance, such as being easily startled or feeling jumpy
  • Restlessness and problems sleeping
  • Fatigue and/or dizziness
  • Difficulty concentrating
  • Irritability

These symptoms of anxiety can build up slowly and be temporary in response to a certain situation, or they can last for days—even months. Without coping strategies to get the worries and fears under control, these symptoms can interfere with normal and healthy functioning.

The symptoms of anxiety can build up slowly and be temporary in response to a certain situation, or they can last for days—even months—and can interfere with normal and healthy functioning. Click To Tweet

Panic attacks are also disruptive to daily functioning, but because they are less predictable and the symptoms are more intense, they can cause significant amounts of distress for those who suffer from them.

How Panic Attacks Differ from Anxiety Attacks

Aside from being more acute, a panic attack is different from an anxiety attack in a few ways. Whereas anxiety symptoms gradually build up, panic attacks can come on suddenly. They may seem to come out of the blue, or the onset of one may be in response to a known trigger, such as:

  • Having a phobia, like to snakes, and seeing one nearby in the grass
  • Fear of traveling through tunnels or over long bridges
  • Getting into an airplane or an elevator

Whether they are expected or not, the symptoms can come on rapidly and with an intensity that can be momentarily impairing. These include:

  • Chest pain and a pounding or racing heart, causing someone to think they are having a heart attack
  • Hyperventilation and shortness of breath can lead to feeling lightheaded and dizzy
  • Shaking, sweating, hot flashes, or chills
  • Nausea or stomach pain
  • A sense of being choked or smothered
  • Feeling detached from their body or surroundings

Because these symptoms often strike unexpectedly, a person suffering through them may feel like they’re losing control, going crazy, or even that they’re about to die.

Fortunately, panic attacks usually only last about 10 minutes, although it is possible for a person to have multiple ones in a row making symptoms endure for longer. Nonetheless, because of the distress they cause, a person who has had one or multiple panic attacks in public may begin to feel unsafe leaving their home for fear of having another and subsequently feeling embarrassed or helpless if it happens.

5 Steps to Break a Panic Attack

One of the challenges with a panic attack is that because people tend to have shallow breathing, the brain can sense of decrease in oxygen making the out-of-control symptoms even worse. However, the good news is that there are things you can do to help offset them.

Dr. Daniel Amen, neuropsychiatrist and founder of Amen Clinics, teaches his patients these 5 steps to break a panic attack:

1. Stop and take 3 slow, deep breaths.

When you breathe quickly from your upper chest it triggers an adrenaline response which makes you feel more panicked. Instead, use your diaphragm/belly to inhale for a count of 3, hold 2 seconds, and exhale to the count of 3, and repeat this pattern a few times.

2. Do not leave the area unless you are in real danger.

To break your panic attack, you should stay and overcome your initial adrenaline reaction, showing yourself there is no reason to “fight or flight.”

3. Break your tunnel vision.

When your fear sets in, you will quickly have tunnel vision, and this will cause you to feel trapped. By looking slowly from side to side, you become aware of your surroundings and can begin reasoning that there is no danger.

4. Focus on something outside of yourself or warm your hands.

Once your brain knows you’re safe, it’s helpful to focus on any object in front of you, noticing its color, texture, and size. This can distract you from your symptoms and help you feel calmer. Also, running your hands under warm water offers an immediate relaxation response.

5. Speak out loud in complete sentences.

This will prevent you from hyperventilating, and initially, you will speak with short, blunt words, but as you gain control, you will also be able to express your emotions accurately.

Manage your Anxious Thoughts with This Easy Technique

If you struggle with anxiety or a panic disorder, it’s easy to get caught up in fearful and stressful thoughts that can trigger you. Dr. Amen knows this is a pervasive problem for many people. He refers to these automatic negative thoughts as ANTs and he teaches his patients how to recognize and challenge them, so their thoughts can become more realistic.

Using a technique borrowed from Byron Katie, when you recognize a negative and anxiety-provoking thought running through your mind, ask yourself these 4 questions:

  1. Is this thought true?
  2. Do I absolutely (100%) know it’s true?
  3. How would I feel if I didn’t have this thought?
  4. Who would I be without the thought?

Then turn your original thought around to its opposite and see if that is actually truer. Chances are, it is. By practicing this regularly, you’ll begin to have more accurate thinking, rather than believing the thoughts that make you feel anxious.

By incorporating these simple strategies when panic or anxiety starts to set in, you can help to minimize the distress caused by the symptoms and develop a greater sense of control over what can otherwise feel very overwhelming.

Anxiety disorders, panic disorders, and other mental health problems can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, remote clinical evaluations, and video therapy for adults, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.


  1. Thank you for your informative information. I would like to give my experience regarding the above. I am 60 years old, and have been in an abusive marriage for 40 years, and am still trapped, and trying desperately to get free. During the last 3 to 4 years, I observed symptoms of anxiety in my body, which I have managed to dissipate with various techniques. By now the covert psychological abuse is extreme, and when in proximity of his presence I can feel the anxiety take hold, which I manage well. BUT at least four times now over two years, after an interaction with him, I wake up at 2am, extremely nauseous, painful, burning chest, chills, tingling hands and feet and severe ongoing vomiting, By 6 – 8am my children take me to the emergency rooms, where I receive a drip, stay there for a few hours or overnight before I am discharged. Please give me your professional opinion on what is happening to me. I am normally a well-balanced, calm, responsible person who is a third-year psychology student. My husband denies any psychological/emotional abuse and threatens me with purgery should I go ahead with a protection order. – I am going ahead anyway!

    Comment by Catherine Louise Jonker — September 1, 2021 @ 3:21 AM

  2. I love this! It really helps. I combine it with scriptural promises to help find the opposite of ANT thoughts.
    Sharing with a group today.
    Thank you!

    Comment by Jeff — September 1, 2021 @ 3:49 AM

  3. These are all great suggestions and I have tried them but they don’t always work for me because my anxiety is noticeable and when someone comments on what they notice, which is I usually turn all red and blotchy, it just makes it worse. How do you control that?

    Comment by JoAnn LaMothe — September 1, 2021 @ 5:33 AM

  4. Dear Dr. Amen,
    Very good reading material. It really fits me. I would like to avail if there is an online consultation? I am suffering from panic attacks for 11 years already every time I perform in public, churches, or in front of many people. I am a musician so I can’t avoid musical performance but in the past years I always find a way to reject or deny any invitation to perform but if I perform in small churches I do not experience panic attacks. I know with God’s mighty power I can be totally healed of my abnormal stage fright, performance anxiety, or panic attacks during a performance. It is my prayer that you can help me and reach out to me. I really need your help because I want to use my musical talents and full potentials for God’s Glory and Honor!

    Sincerely Yours,
    Jhonna Toledo

    Comment by Jhonna Toledo — September 1, 2021 @ 5:56 AM

  5. Thank you I suffer from both. Anxiety being the current. Also diagnosed with PTSD due to several fires in my building followed by random alarm going off. I find my mind thinking its going to happen again at random times especially at night.

    Comment by Patricia Feuerstein — September 1, 2021 @ 6:59 AM

  6. How to deal with these anxiety attacks I have issues like increased heart rate and left side headaches and muscle tension

    Comment by Vijaya Suresh — September 1, 2021 @ 8:41 AM

  7. Thank you for the brake down in steps to cope with anxiety and/or panic. I am using this to help some of the older kids I am working with. One girl is learning how to drive. She is over coming her fears. Thank You.

    Comment by Carol Cordes — September 1, 2021 @ 8:54 AM

  8. Have had anxiety all my life, turned to major panic in 1991. Started benzos then per doctor. In 2020 I discovered how bad benzos ate for brain so I stopped abruptly (told my doc, no help offered). Withdrawal was hell- now @13 months later still having heart pounding/hyperventilation/terror on waking and throughout day. Extreme night clenching/jaw pain with crowns on every molar and several cracked crowns replaced even with religious night guard use. Doctor suggested masseter muscle Botox injections (am now 67). Very poor sleep, almost housebound. Please help.

    Comment by Elaine — September 1, 2021 @ 9:52 AM

  9. interesting post!

    Comment by Doug — September 1, 2021 @ 10:01 AM

  10. Oh, Wow! My anxiety increased and nearly caused a panic attack as I mentally replayed a previous panic attack event while reading this blog entry. Breathe slowly while looking side to side is a fantastic yet simple technique! Thank you!

    Comment by Doug — September 1, 2021 @ 10:32 AM

  11. Hello Jhonna, thank you for reaching out. We are offering Telehealth and Video Therapy options. For more information about Telehealth: https://amenclinics.com/services/telehealth-and-video-therapy/

    Comment by Amen Clinics — September 1, 2021 @ 11:16 AM

  12. I am here because I suffer Panic and Anxiety attacks. I cannot hold down a job because of this. I can’t get help because I have no insurance, was turned down from disability, what can I do, I want to be healthy and work.

    Comment by Barbara — September 1, 2021 @ 12:31 PM

  13. When I have been in the absolute height of a panic attack, I first acknowledge to myself, “this is just a panic attack, you have been hyperventilating and the excess oxygen is causing these symptoms.” Then I breathe into a paper bag slowly, followed by the cyclical breathing technique described in this article. The paper bag trick works almost instantly.

    Comment by ANGELA F LOPEZ — September 1, 2021 @ 1:04 PM

  14. Excellent and practical recommendations I believe this is an approach that is simple and easy to use regardless of age, and experience or challenges that you are facing in life.

    Comment by Kathy Guajardo — September 1, 2021 @ 5:17 PM

  15. I have had anxiety attacks for years related to childhood abuse. This article has helped me a lot. Deep breaths and looking around calm me down quickly. Thank you for this information.

    Comment by Juanita Shanks — September 2, 2021 @ 8:42 AM

  16. I try to live my life being very positive in my life. So when I start thinking negatively. I auto pilot to hurry and find a positive in it. Because I couldn’t live in that frame of mind.

    Comment by Kimberly Williams — September 2, 2021 @ 2:53 PM

  17. Hello Barbara, thank you for reaching out. We’d be happy to contact you directly with information regarding insurance, reimbursement, financing options, and other information on our services.

    Comment by Amen Clinics — September 4, 2021 @ 7:32 PM

  18. Hello Elaine, thank you for reaching out. We’d be happy to contact you directly with more information about SPECT scans and our services. We look forward to speaking with you.

    Comment by Amen Clinics — September 4, 2021 @ 7:37 PM

  19. Dr Amen, you should also discuss the deadly physical side effects of panic/chronic anxiety: stroke and cardiac problems. I’d also be interested in your thoughts on when panic warrants disability and why it’s so hard to be awarded this help even though we’ve paid into the system for years. Because of a chronic illness (not recognized as a disability) I began to have problems with my job (unsupportive of work from home which is ironic now) and after a year turned into sheer panic when I sat at my desk. Forcing myself to stay there until it resolved was not possible. It got to the point that even seeing the exit for the city my job was in caused panic. Benzos only made me groggy and unable to drive to and from work. I began to think certain individuals were following me home or around town. This was in 2018. I still get triggered when I hear the names of certain individuals I worked with. Sometimes I worry that the our society has created an unsustainable work/life balance situation that is only going to create more and more chronic anxiety. At what point do we acknowledge we have a looming health and economic crisis?

    Comment by Kristy — September 8, 2021 @ 11:05 AM

  20. For once someone gave us some useful information without having us listen to a long boring video that tells us nothing. In the end, we find they are only trying to sell a book or a bottle of pills made from some jungle plants that we have never heard of. The instructions on the pill bottles are in such small writing they don’t intend for anyone to read it. Thank you for this information that we can clearly understand.

    Comment by Alma L Burney — September 15, 2021 @ 5:27 AM

  21. I was wondering if you can text me the name of the of the acedic acid that has no garlic or onions it that I heard about one of the podcasts that I
    Listen to before. It was a month before?

    Comment by Joanie Scharf — November 7, 2021 @ 7:20 AM

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