Anxiety Attack vs. Panic Attack: How to Calm Both

Two everyday names for intense moments

People say "anxiety attack" and "panic attack" for moments when fear or worry takes over. The NHS and Cleveland Clinic, two of the sources behind this page, describe panic attacks in detail, and the National Institute of Mental Health (NIMH) in the United States gives the U.S. crisis numbers. Cleveland Clinic also sets them beside what it calls anxiety attacks, so it helps to know how the two are described.

Whichever name you use, what you are feeling is real, and you do not need to settle the label before you start looking after yourself.

The key differences

According to Cleveland Clinic, the main difference is that certain stressors often trigger anxiety attacks, and they may build up gradually. Panic attacks, in contrast, typically happen unexpectedly and suddenly.

Cleveland Clinic adds that anxiety often causes physical symptoms such as a racing heart or knots in your stomach, but these symptoms are generally less intense and last longer than a panic attack, which has very intense but brief symptoms.

• Onset: a panic attack happens suddenly. The NHS says it can come on very quickly and for no apparent reason. Anxiety attacks may build up gradually.
• Trigger: certain stressors often trigger an anxiety attack, while a panic attack typically comes unexpectedly. Cleveland Clinic notes there is often no specific trigger for a panic attack.
• Length: Cleveland Clinic says panic attack symptoms usually peak within 10 minutes and then disappear soon after. The NHS says most panic attacks last between 5 and 20 minutes, and some have been reported to last up to an hour.
• Body in a panic attack: the NHS lists a racing heartbeat, feeling faint, sweating, nausea, chest pain, shortness of breath, trembling, dizziness, numbness or pins and needles, and a feeling of dread or a fear of dying.
• Body with ongoing anxiety: for generalised anxiety disorder, the NHS lists difficulty sleeping, feeling restless, irritable or finding it difficult to concentrate, getting tired easily, feeling tense, stomach problems and a more noticeable or unusual heartbeat.

What you can try in the moment

The NHS suggests the following steps when you feel a panic attack coming on. Cleveland Clinic lists similar ones for managing the symptoms until an attack resolves.

• Stay where you are, if possible.
• Breathe slowly and deeply. Cleveland Clinic suggests breathing in as slowly, deeply and gently as you can through your nose and out slowly through your mouth, with your eyes closed and your focus on your breathing.
• Remind yourself that the attack will pass, and remember that it is not life threatening.
• Focus on positive, peaceful and relaxing images.
• Relax your muscles. Cleveland Clinic suggests focusing on one muscle group at a time to reduce tension and stay present.
• Stay with the present. Cleveland Clinic suggests mindfulness, focusing on the present to centre your thoughts and ground yourself.

Calming ongoing anxiety over the day

For generalised anxiety disorder (GAD), the NHS lists things you can try yourself. They are everyday steps, not instant fixes.

• Talk about your feelings to a friend, family member, health professional or counsellor. The NHS also gives Samaritans on 116 123 (UK) if you need someone to talk to.
• Learn to relax with calming breathing exercises, or try activities such as yoga or pilates.
• Try to get enough sleep. The NHS says this can help you have the energy you need to cope with difficult feelings and experiences.
• Exercise regularly. The NHS says activities such as running, walking, swimming and yoga can reduce anxiety and stress and help you sleep better.
• Eat a healthy diet with regular meals to keep your energy levels stable.
• Do not focus on the things you cannot change. Put your time and energy into helping yourself feel better.
• Do not drink lots of coffee, tea, cola or energy drinks. The NHS says the caffeine in them can disrupt your sleep and make it harder to control your anxiety.
• Do not use alcohol, cigarettes, gambling or drugs to relieve anxiety, because the NHS says these can all contribute to poor mental health.

When the two are mixed together

The NHS says it is common to have more than one type of anxiety disorder at the same time, for example generalised anxiety disorder and panic disorder. It also says you may start to avoid certain situations because you fear they will trigger another attack, which can create a cycle of living "in fear of fear" that adds to your sense of panic.

Cleveland Clinic says that for some people the fear of having a panic attack is often enough to trigger one. It also says that knowing you are having a panic attack, and not a dangerous health episode, can help manage the fear, so the reminder that it will pass is worth repeating to yourself.

After the episode: settle the rest of the day

Whichever kind of episode it was, the hours afterwards are a good time to be gentle with yourself. Cleveland Clinic notes that panic attacks can be extremely uncomfortable and can take a toll on your mental health.

Drink some water and eat something simple if you are hungry. Put off hard conversations and big decisions until you feel more settled.

• Keep the next hour light, and choose one small task you can finish.
• Plan something calming for the evening, such as a walk, a shower or music.
• If it helps, tell someone you trust how the episode went.
• If it keeps happening, make a note of when it happened and what helped, so you can describe it to a doctor.

Getting help for anxiety or panic

This page is self-help for the moment. It cannot tell you whether you have a condition, and it does not replace a doctor. If anxiety or panic keeps coming back or gets in the way of your life, talk to a GP or your own doctor about what would suit you. Cleveland Clinic says to call a healthcare provider if you have panic attacks and also have long-lasting anxiety that interferes with daily life, sleep problems, extreme irritability or a fear of leaving your home, or if panic attack symptoms last longer than 15 minutes.

Some panic attacks have signs that can resemble a physical problem, like a heart attack. Cleveland Clinic says that if you have chest pain, trouble breathing or lose consciousness, seek emergency medical care. If you ever have thoughts of harming yourself, contact emergency services or a crisis line straight away. In the U.S., call or text 988, and in a life-threatening situation call 911 (NIMH). In the UK, the NHS lists where to get urgent help for mental health.