Panic attack vs anxiety attack: what is the difference?

Having a panic attack right now? Go to our guide on how to stop a panic attack.

Panic attack vs anxiety attack: the short answer

Where official references do use “anxiety attack”, they use it in two ways. The APA Dictionary of Psychology’s whole entry for it reads “see panic attack”^[2], and MedlinePlus, from the US National Library of Medicine, lists “anxiety attacks” as another name for panic attacks^[3]. In everyday speech, people often mean something else. An NHS talking therapies service explains that when someone says they have had an anxiety attack, “they are often describing a period of very intense anxiety”. It adds: “Usually, there is some kind of build-up behind it”^[4].

So when you say you had an anxiety attack, you may mean a panic attack, or a wave of anxiety that grew over time. The same service is clear that “anxiety attack” is not a formal diagnosis. “That does not mean the experience is any less real or important.”^[4]

Difference between anxiety and panic attacks at a glance

This table is a guide, not a way to diagnose yourself.

Based on DSM-5 (as summarised in a clinical guideline), ICD-11, the APA Dictionary of Psychology, MedlinePlus, the NHS, NIMH, the American Psychiatric Association and NICE^{[1][5][2][3][4][6][7][8][9][10][11][12][13][14]}.

What is a panic attack?

Under DSM-5, as summarised in a clinical guideline, a panic attack peaks within minutes and includes at least four of 13 symptoms^[1]. The WHO describes “discrete episodes of intense fear or apprehension characterized by the rapid and concurrent onset of several characteristic symptoms”^[5]. The APA Dictionary adds that this happens “in the absence of actual danger”^[15]. The symptoms are^[1]:

• a pounding or racing heart
• sweating, trembling or shaking
• feeling short of breath, smothered or choked
• chest pain or discomfort
• nausea or stomach discomfort
• feeling dizzy, unsteady, light-headed or faint
• chills or feeling hot
• numbness or tingling
• feeling unreal, or detached from yourself
• fear of losing control, “going crazy” or dying

You may read that a panic attack peaks within 10 minutes. That was the old rule. DSM-5 removed the “10-minute” window and now just says “within minutes”^[1]. The NHS says most panic attacks last between 5 and 20 minutes, and some have been reported to last up to an hour^[6].

Panic attacks are common. In surveys across many countries, 13.2% of adults had had at least one in their lifetime, about 1 in 8. Only 12.8% of those people met the criteria for panic disorder^[16]. For what a panic attack feels like and what to do during one, see how to stop a panic attack.

What is an anxiety attack?

“Anxiety attack” is not a diagnosis, and the WHO’s ICD-11 does not use the term^[5]. When people use it, they usually mean one of two things:

• A panic attack. The APA Dictionary and MedlinePlus treat the two as the same thing^[2][3].
• A build-up of intense anxiety. This is the everyday meaning. One NHS talking therapies service says anxiety often builds gradually, and it “may increase over hours, days or even weeks, especially during times of ongoing stress”^[4]. That is one service’s description, not a clinical rule.

The WHO’s manual draws a similar line between panic and generalised anxiety. Panic disorder involves “recurrent, unexpected, self-limited episodes of intense fear or anxiety”. Generalised anxiety is “a more persistent and less circumscribed chronic feeling of apprehensiveness, usually associated with worry about a variety of different everyday life events”^[5]. In plain terms, panic comes in sharp episodes. Ongoing anxiety is more of a steady background.

How long does an anxiety attack last?

There is no official answer, because “anxiety attack” is not defined. If you mean a panic attack, usually 5 to 20 minutes^[6]. If you mean anxiety building up, it has no set length. Stress usually “goes away once the situation is resolved”, while anxiety can involve “a persistent feeling of apprehension or dread that doesn’t go away”^[12].

What does an anxiety attack feel like?

When anxiety builds, NHS Every Mind Matters lists signs such as^[9]:

• feeling tired, restless or irritable
• feeling shaky or trembly, dizzy or sweating more
• being unable to concentrate or make decisions
• trouble sleeping
• a faster or irregular heartbeat, or shortness of breath

Put that list next to the panic attack symptoms above. A racing heart, sweating, trembling, dizziness and breathlessness appear in both. The WHO’s description of generalised anxiety even includes heart palpitations, sweating, trembling and nausea^[5]. So your body cannot tell you the label.

What tends to differ is intensity and timing. In a panic attack, “several of these symptoms occur in combination”^[8], suddenly, often with a fear of dying, losing control or going mad^[5]. Ongoing anxiety is more often worry, tension and feeling on edge, spread out over time^[5][10].

Which one did I have? Questions to ask yourself

Professionals will usually want to understand the pattern: “how quickly it came on, how long it lasted, whether there was a trigger”^[4]. You can ask yourself the same things:

1. How fast did it come on? An abrupt surge points towards panic. A build-up over hours or days points towards anxiety^[1][4].
2. Did it peak and then pass? A panic attack peaks within minutes, and most are over within 5 to 20 minutes. Anxiety tends to hang around without a sharp peak^[1][6][5].
3. Was there a trigger, or did it come out of the blue? “Out of the blue” points towards panic. But panic attacks can also be “expected, such as a response to a feared object”^[8]. For example, someone with social anxiety may have one just thinking about an upcoming presentation^[20].
4. Are you now worried about having another one, or avoiding places because of it? That is worth talking to a professional about^[7].

This is not a diagnosis. The answers can point you one way or the other, but the symptoms overlap, and only a professional can assess what is going on. As the NHS service puts it, “The label matters less than understanding what you are going through”^[4]. Our anxiety self-test can show whether to talk to someone, but it cannot diagnose you either.

When it may be panic disorder or GAD

One panic attack vs panic disorder

“An isolated panic attack is not a mental disorder”, says NIMH^[7], and most people who have one never develop panic disorder^[16]. Panic disorder means recurrent, unexpected panic attacks, with at least one followed by a month or more of worry about further attacks or what they mean, or of changing your behaviour to avoid them^[1][7]. Avoiding things because of the attacks can create a cycle the NHS calls living “in fear of fear”^[6]. Over time, it is common for people with panic disorder to develop some symptoms of agoraphobia^[5].

Panic attacks inside other conditions

Panic attacks are not only part of panic disorder. They can happen with other conditions, such as social anxiety, phobias, PTSD or depression, and with some medical conditions^[5][1][15]. If the attacks only happen in those situations, such as in social settings for someone with social anxiety, a separate diagnosis of panic disorder is not needed^[5].

Generalised anxiety disorder (GAD)

GAD “is not the same as occasionally worrying about things or experiencing anxiety due to stressful life events”^[10]. In the UK, a GP may consider it if you have felt anxious a lot of the time for at least 6 months^[11]. NIMH describes difficulty controlling worry “on most days for at least 6 months”^[10]. People with GAD “may experience panic attacks that are triggered by specific worries”^[5], so you can have both. For more, see high-functioning anxiety and stress vs anxiety.

What helps with each

During a panic attack, the NHS advice is to stay where you are if possible, breathe slowly and deeply, and remind yourself that the attack will pass^[6]. The full steps are in our guide on how to stop a panic attack.

For anxiety that builds, NHS self-help suggests a daily “worry time”, bringing your attention back to the present moment, and facing fears gradually rather than avoiding them^[9]. Our guide on how to stop overthinking has more.

For longer-term help, CBT is the best-studied talking therapy. NIMH calls it the “gold standard” for panic disorder. It often includes interoceptive exposure: gently facing the body sensations linked to panic^[7]. In a Cochrane review, CBT was often better than other therapies for panic, but by a small margin, and the evidence was of low quality^[21]. For GAD, UK guidance recommends CBT or applied relaxation^[14]. Medication is another option, to discuss with a doctor^[7][10].

Getting help on Bliss Therapy

Telling a panic attack from a build-up of anxiety depends on describing what happened: how fast it came on, how long it lasted, and what set it off^[4]. That can be easier in your own language. The WHO notes that “the symptom presentation of panic attacks may vary across cultures”^[5], and UK guidance recommends offering anxiety treatment “in the preferred language of the person with GAD if possible”^[14]. NIMH says therapy “can be effective when delivered in person or virtually via telehealth”^[7]. On Bliss Therapy you choose a therapist who speaks your language, by video, with no waitlist. 52 psychologists and counsellors list anxiety and stress, with sessions from €30 (about £25); 42 of them list CBT.

Our therapists are based outside the UK and the US, so they are unlikely to be on UK registers or covered by US health insurance. Ask any therapist about their training and their registration in the country where they practise.

When to get help

See a doctor after a first panic attack, or if your symptoms are new, severe, unusual for you or different from before, so physical causes can be checked^[4][8]. Panic disorder is treatable, “so it’s best to get medical help as soon as you can”^[6]. Talk to a doctor or therapist if attacks keep happening, you are struggling to cope, what you are trying yourself is not helping, or anxiety gets in the way of your everyday life or makes you avoid things^[7][13][12]. In the UK, start with your GP. In the US, start with your doctor or primary care provider.