“Anxiety attack” isn’t a formal medical term. Some people may use it to refer to an emotional and physical response to certain stressors. Panic attacks are episodes of intense anxiety that lead to severe cognitive, emotional, and physical symptoms.

Panic attacks are common in people with panic disorder, but anyone may experience one during their lifetime.

The Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR) doesn’t include anxiety attacks as a stand-alone diagnosis. Instead, the reference manual lists anxiety disorders.

This includes the following conditions:

Anxiety is an experience usually related to the anticipation or handling of a stressful situation, experience, or event. It may come on gradually or suddenly.

Symptoms of anxiety include:

  • worry
  • distress
  • fear

When these symptoms come on suddenly and intensely, a person may refer to them as an anxiety attack, when they may be describing a panic attack instead or an episode of severe anxiety.

Panic attacks come on suddenly and involve intense and often overwhelming fear. They’re accompanied by very challenging physical symptoms like a racing heartbeat, shortness of breath, or nausea.

The DSM-5-TR recognizes panic attacks and categorizes them as unexpected or expected.

Unexpected panic attacks can occur without an obvious cause. Expected panic attacks are cued by external stressors, such as phobias.

Panic attacks can happen to anyone, but having more than one may be a sign of panic disorder, a mental health condition characterized by sudden and repeated panic attacks.

Because anxiety attacks aren’t a formal condition or experience, there are no specific diagnostic criteria or symptoms for it.

A panic attack can cause physical and emotional symptoms, including:

  • apprehension and worry
  • intense distress
  • fear of dying or losing control
  • a sense of detachment from the world (derealization) or oneself (depersonalization)
  • heart palpitations or an accelerated heart rate
  • chest pain
  • shortness of breath
  • tightness in the throat or feeling like you’re choking
  • dry mouth
  • sweating
  • chills or hot flashes
  • trembling or shaking
  • numbness or tingling (paresthesia)
  • nausea, abdominal pain, or upset stomach
  • headache
  • feeling faint or dizzy

It may be difficult to know when you’re having a panic attack. Keep in mind the following:

  • The cause: Anxiety is typically related to something that’s perceived as stressful or threatening. Panic attacks aren’t always cued by stressors. They most often occur out of the blue.
  • The level of distress: While anxiety can be mild, moderate, or severe, panic attacks are intense experiences. For example, you may be unable to move or react when having a panic attack.
  • Fight-or-flight response: During a panic attack, the body’s autonomous fight-or-flight response takes over. Physical symptoms are often more intense than when you’re feeling anxious in general.
  • Speed of onset: Panic attacks usually occur abruptly and may last a few minutes or hours.
  • Effect: Panic attacks may trigger intense worries or fears related to having another attack. This may have an effect on your behavior, leading you to avoid places or situations where you think you might be at risk of a panic attack.

Everyone’s different and may feel anxious about a variety of situations. You may feel anxious about a first date, job interview, or coming up with solutions to an unexpected personal problem. This anxiety may be mild to severe, depending on your emotional resources and support.

Panic attacks may occur for expected or unexpected reasons.

Unexpected panic attacks have no clear external triggers. For example, you may be taking a nap and wake up with a panic attack.

Expected panic attacks happen when you face a known trigger. For example, if you’re afraid of flying, you could have a panic attack before boarding your flight.

Other sources and causes of mild to severe anxiety, including panic attacks, may include:

Anxiety, in general, may be more likely when you have a few risk factors, including:

  • experiencing trauma or witnessing traumatic events, either as a child or as an adult
  • experiencing a stressful life event, such as the death of a loved one or a divorce
  • experiencing ongoing stress and worries, such as work responsibilities, conflict in your family, or financial woes
  • living with a chronic health condition or life threatening illness
  • having an anxious personality
  • having another mental health condition like depression
  • having close family members who also have anxiety or panic disorders
  • using illegal drugs or consuming alcohol

People who live with an anxiety disorder are at an increased risk of experiencing panic attacks. However, having anxiety does not mean you will experience a panic attack.

Because it’s not a formal condition, healthcare professionals will not diagnose anxiety attacks. Instead, if you have persistent anxiety or panic attacks, they may diagnose an anxiety disorder.

A doctor will ask you about your symptoms and conduct tests to rule out other health conditions with similar symptoms, such as heart disease or thyroid problems.

To get a diagnosis, a doctor may:

  • conduct a physical exam
  • order blood tests
  • order a heart test, like an electrocardiogram (ECG or EKG)
  • recommend a psychological evaluation or questionnaire

Learn more about how to tell the difference between a heart attack and a panic attack.

Mental health professionals may prescribe different strategies, including psychotherapy, lifestyle adjustments, and medications, to manage anxiety disorders.

Counseling and psychotherapy

Talking therapies for anxiety and panic attacks can involve the following, often in combination:

  • Cognitive behavioral therapy (CBT): This type of therapy can help you see things that worry you in a new way. A counselor can help you develop strategies for managing triggers when they arise.
  • Cognitive therapy: This can help you pinpoint, reframe, and neutralize the underlying unhelpful thoughts that tend to accompany anxiety disorder.
  • Exposure therapy: This form of therapy involves controlled exposure to situations that trigger fear and anxiety, which can help you learn to confront those fears in a new way.
  • Relaxation techniques: These include breathing exercises, guided imagery, progressive relaxation, biofeedback, and autogenic training. A doctor can explain these techniques.

A doctor may also suggest attending individual sessions, group sessions, or a combination of the two.

Medication

Examples of medications a doctor may prescribe for anxiety symptoms are:

All these drugs can have side effects. SSRIs and SNRIs are typically prescribed for long-term use, and it can usually take time to feel the effects of these drugs. Benzodiazepines are typically prescribed for short-term use only, as there is a high risk of dependence.

Often, a doctor recommends a combination of treatments. They may also need to alter your treatment plan over time.

If you have anxiety or anticipate a panic attack, consider the following:

  • Take slow deep breaths: When you feel your breath quickening, focus your attention on each inhale and exhale. Feel your stomach fill with air as you inhale. Count down from four as you exhale. Repeat until your breathing slows.
  • Recognize and accept what you’re experiencing: If you’ve already experienced an anxiety or panic attack, you know that it can be incredibly challenging. Remind yourself that the symptoms will pass.
  • Practice mindfulness: Mindfulness-based interventions are increasingly used to treat anxiety and panic disorders. Mindfulness is a technique that can help you ground your thoughts in the present. You can practice mindfulness by actively observing thoughts and sensations without reacting to them.
  • Use relaxation techniques: Relaxation techniques include guided imagery, aromatherapy, and muscle relaxation. If you’re experiencing symptoms of anxiety or a panic attack, try doing things that you find relaxing. Close your eyes, take a bath, or use lavender, which has relaxing effects.

Lifestyle changes

The following lifestyle changes can help you prevent anxiety and panic attacks, as well as reduce the severity of symptoms when an attack occurs:

The term “anxiety attacks” may be used to refer to episodes of heightened anxiety, but it does not correspond to a formal mental health symptom or condition.

Panic attacks are recognized episodes of intense anxiety with severe physical and mental symptoms. They are temporary and may come suddenly with or without a clear trigger.

If you have panic attacks or intense anxiety that doesn’t go away after a few days, consider reaching out to a healthcare professional.

Read this article in Spanish.