Anxiety Attack vs. Panic Attack: The Truth, the Symptoms, and How to Regain Control

Anxiety Attack vs. Panic Attack: The Truth, the Symptoms, and How to Regain Control

Are You Having a Heart Attack, or Is It Panic?

Your heart hammers against your ribs, a drumbeat so loud you’re sure everyone can hear it. The room begins to feel distant, unreal, as if you’re watching yourself from outside your own body. You can’t catch your breath. A chilling thought grips you: “Am I having a heart attack? Am I dying? Am I losing my mind?”

Moments later, the wave recedes, leaving you exhausted, shaky, and terrified.

If this experience sounds familiar, you are not alone. As a clinical psychologist, this is one of the most common and frightening experiences my clients describe. And it almost always comes with a question: “Was that an anxiety attack or a panic attack?”

You’ve likely seen these terms used interchangeably on social media, often with conflicting definitions. This confusion can make an already scary experience feel even more isolating.

So, let’s clear this up with clinical-grade clarity. Understanding what is really happening in your body and brain is the first, most powerful step toward reclaiming your calm.

The “Anxiety Attack”: Why Your Therapist Might Not Use That Term

First, let’s address the term everyone uses: “anxiety attack.”

In our digital world, “anxiety attack” has become a popular catch-all phrase. People often use it to describe a general, intense buildup of anxiety, perhaps in the lead-up to an exam, a social event, or a difficult conversation.

Here is the crucial takeaway: “Anxiety attack” is not a formal clinical diagnosis.

You won’t find it defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the guidebook mental health professionals use. Because it lacks a set definition, it can mean different things to different people. This is why you might see self-proclaimed “criteria” for it online, but these are not clinically recognized.

The Harmful Myth of the Trigger

One of the most persistent myths I see online is that an “anxiety attack” is caused by a specific stressor, while a “panic attack” comes out of the blue.

Let’s be very clear: This is false, and it’s a harmful piece of misinformation.

The truth is, high-level anxiety can often feel free-floating, with no identifiable cause. Conversely, panic attacks can be highly predictable, happening in the same specific situation (like a crowded supermarket or before public speaking) every single time.

Using a “trigger” as the defining factor is unreliable and inaccurate. The real distinction lies in the nature of the episode itself.

So, What Is a Panic Attack? (The Clinical View)

A panic attack, unlike an “anxiety attack,” is a very specific, clinically defined event.

The key feature is an abrupt surge of intense fear or discomfort that reaches a peak within minutes. This isn’t a slow burn; it’s a sudden, overwhelming spike.

To be classified as a panic attack, the episode includes at least four of the following physical and cognitive symptoms:

• Palpitations, a pounding heart, or an accelerated heart rate
• Sweating
• Trembling or shaking
• Sensations of shortness of breath or smothering
• Feelings of choking
• Chest pain or discomfort (This is what so often sends people to the ER)
• Nausea or abdominal distress
• Feeling dizzy, unsteady, light-headed, or faint
• Chills or heat sensations (hot flushes)
• Numbness or tingling sensations (paresthesias)
• Derealization (feelings of unreality) or depersonalization (being detached from oneself)
• Fear of losing control or “going crazy”

• Fear of dying

While high anxiety is deeply unpleasant, a panic attack is a different level of intensity. It’s when the symptoms become so severe that you genuinely believe you are in immediate, mortal danger or losing your grip on reality.

It’s also vital to know that having a panic attack doesn’t necessarily mean you have “panic disorder.” Panic attacks can occur in the context of many other conditions, including trauma (PTSD), social anxiety, specific phobias, or OCD.

The Panic Spiral: Why Your Brain Shouts “Danger!”

To stop a panic attack, you first have to understand why it happens. It’s not a sign of weakness; it’s a sign that your body’s built-in alarm system has become too effective.

Think of it as a hypersensitive smoke detector. It’s designed to protect you, but it’s going off when you just burned the toast.

Most panic attacks follow a predictable, vicious cycle. It looks like this:

Step 1: The Spark (A Trigger)

The trigger can be external (like walking into a crowded, ‘unsafe’ place) or, more often, internal. An internal trigger is simply a physical sensation. Maybe your heart is pounding because you had too much coffee, you’re breathing shallowly because you’re stressed, or you’re dizzy because you stood up too fast.

Step 2: The Scan (Hypervigilance)

You notice this sensation. And because you’ve felt anxious before, you become apprehensive. You start to scan your body for other “symptoms”. “Uh oh… my heart is beating fast. Am I getting anxious?”

Step 3: The ‘Fatal’ Flaw (Catastrophic Misinterpretation)

This is the single most important step in the spiral. This is where anxiety tips over into panic.

You misinterpret the normal (or anxiety-related) physical sensation as something catastrophic.

• Your thought isn’t: “My heart is pounding. That’s anxiety.”
• Your thought is: “My heart is pounding. I’m having a heart attack.”
• Your thought isn’t: “My throat feels tight. I’m stressed.”
• Your thought is: “My throat is closing. I’m going to suffocate.”

Step 4: The Surge (The Panic Attack)

The second your brain truly believes it is about to die or suffocate, it does exactly what it’s supposed to do: it hits the big red panic button.

It floods your body with adrenaline to “save you” from the perceived threat. This adrenaline rush causes the very symptoms on the checklist: the racing heart, the sweating, the shaking, the shortness of breath.

You are now in a full-blown panic attack, all because your brain misinterpreted a harmless signal.

How to Stop the Panic Spiral: 3 Evidence-Based Tools

So, how do you get out of this loop? If the “fatal flaw” is misinterpreting the signal, the solution is to correct the interpretation.

Here are three of the most effective tools from therapy.

Tool 1: Re-Label and Reframe (Break the Cycle)

Since the spiral is caused by a catastrophic thought, the fastest solution is a cognitive one. You must break the cycle of misinterpretation.

As you feel the symptoms rise, re-label them.

• Instead of “I’m dying,” say to yourself: “This is a panic attack. It is not dangerous. It is my body’s alarm system. I am safe.”

• Instead of “I can’t breathe,” say: “This is a normal symptom of adrenaline. It feels like I can’t breathe, but I am breathing. This will pass.”

By recognizing the symptoms as anxiety, you strip them of their catastrophic power. You’re telling your brain, “Stand down. It’s just burnt toast.”

Tool 2: Control Your Breath, Calm Your Brain

The quickest way to calm your mind is through your body. When you panic, you hyperventilate (breathe too fast and shallowly). This throws off your oxygen/CO2 balance and creates symptoms like dizziness and tingling.

You can manually reverse this by controlling your breath. The goal is simple: make your out-breath longer than your in-breath. This activates your parasympathetic nervous system, your body’s natural “brake.”

• Try 7-11 Breathing: Breathe in slowly for a count of 7. Breathe out slowly for a count of 11.
• The numbers don’t matter as much as the ratio. Just breathe out for longer than you breathe in.
• Crucial tip: This won’t work in one breath. You must do it for a few minutes to give your brain time to send the “slow down” signal to your heart. Be patient with it.

Tool 3: The ‘Brave’ Choice: Do Not Avoid

This is the most important tool for long-term recovery.

If you had a panic attack in the supermarket, your brain’s first instinct is to tell you, “The supermarket is dangerous. Never go back”.

It might feel like a good decision, but avoidance is the fuel that feeds anxiety.

Every time you avoid a place, a person, or a situation because of panic, you are teaching your brain that the “danger” was real. This makes your anxiety grow, and your world shrink.

The brave choice is to not avoid. This doesn’t mean you have to run back into the supermarket five minutes later. But it does mean you must, with support if needed, gradually and safely return to that situation. By going to the supermarket and not having a panic attack (or by having one and surviving it), you provide your brain with new, “safe” evidence. You are re-training your alarm system.

Your Path Forward

Understanding the difference between the vague concept of an “anxiety attack” and the clinical reality of a “panic attack” is more than just semantics. It’s about diagnosis, clarity, and empowerment.

Panic attacks are terrifying, but they are not dangerous, and they are highly treatable. They are not a sign that you are “crazy” or weak; they are a sign that your body’s protection system is in overdrive.

You are not broken. You are just trying too hard to stay safe.

If these experiences are interfering with your life, please reach out to a doctor or a qualified mental health professional. You do not have to live in fear of the next attack. With the right tools and understanding—learning to re-label your symptoms, control your breathing, and face your fears—you can and you will regain control.

Author Bio: Written by Aamir Ranjha, a clinical psychologist specializing in anxiety, trauma, and evidence-based mental health care.

Reflection Question

Which of the three tools (Re-label, Breathe, Don’t Avoid) do you find most challenging, and what’s one small step you could take to practice it this week?