As a psychiatrist, one of the most common questions I hear from patients is, “How do I know if what I’m experiencing is anxiety or a panic attack?” The terms are often used interchangeably in conversation, but they refer to very different experiences. Understanding the distinction can help people seek the right kind of support and feel more in control when symptoms arise.
Let’s explore the difference between general anxiety and panic attacks—what they feel like, how they manifest, and how each can be managed.
Anxiety: A Slow Burn
Anxiety is best understood as a chronic state of worry, nervousness, or unease. It tends to build gradually and is often tied to a specific situation, stressor, or concern—like work deadlines, finances, or health. In fact, a certain level of anxiety is a normal part of life and can even be helpful. It motivates us to prepare for a big presentation, study for an exam, or plan ahead.
However, when anxiety becomes excessive, persistent, or difficult to manage, it may indicate an anxiety disorder. Common symptoms include:
- Restlessness or feeling “on edge”
- Trouble concentrating
- Fatigue
- Muscle tension
- Irritability
- Sleep disturbances (difficulty falling or staying asleep)
This type of anxiety is often described as generalized anxiety. You may feel like something bad might happen, but you don’t know exactly what or when. The discomfort builds slowly and can persist for days, weeks, or longer.
Panic Attacks: Sudden and Intense
In contrast, a panic attack is a sudden surge of intense fear or discomfort that reaches a peak within minutes. It can happen unexpectedly, even during periods of rest or relaxation, and often feels like it comes “out of the blue.”
During a panic attack, people may experience:
- A racing or pounding heart
- Shortness of breath or hyperventilation
- Chest pain or discomfort
- Sweating
- Trembling or shaking
- Nausea or abdominal distress
- Feeling dizzy, lightheaded, or faint
- A sense of unreality (derealization) or detachment from oneself (depersonalization)
- Numbness or tingling sensations
- Fear of “going crazy,” losing control, or dying
These episodes are brief but intense, typically lasting 5 to 30 minutes and fully resolved in 1 hour, though they can feel much longer in the moment. People often describe them as terrifying and may even seek emergency care, fearing they’re having a heart attack.
Key Differences
The major differences lie in intensity, duration, and onset:
| Feature | Anxiety | Panic Attack |
|---|---|---|
| Onset | Gradual | Sudden and abrupt |
| Duration | Prolonged (days to months) | Brief (minutes to an hour) |
| Intensity | Mild to moderate | Intense, overwhelming |
| Trigger | Often known or chronic stress | Can be situational or out of the blue |
| Physical symptoms | Mild physical symptoms | Dramatic physical symptoms |
| Fear component | Worry about future | Fear of imminent catastrophe |
It’s also worth noting that while panic attacks can be a feature of panic disorder, they can also occur in other anxiety disorders, depression, PTSD, or even without a psychiatric diagnosis.
What Can You Do?
If you’re struggling with anxiety or panic attacks, know that you’re not alone—and help is available.
For generalized anxiety, tools like cognitive behavioral therapy (CBT), mindfulness, lifestyle changes (like sleep, exercise, and limiting caffeine), and sometimes medication can be very effective.
For panic attacks, a combination of psychoeducation (understanding what’s happening in your body), breathing techniques, and exposure therapy to help you regain control. If panic attacks are frequent and impairing, medications like SSRIs or benzodiazepines may be considered as part of a comprehensive plan.
It’s important to consult a mental health professional who can accurately assess your symptoms and guide you toward the right treatment. Whether you’re navigating persistent anxiety, acute panic episodes, or both, support is available—and relief is possible.
Final Thoughts
Both generalized anxiety and panic attacks are real, treatable conditions—not signs of weakness or personal failure. If you’re feeling overwhelmed, talking to a psychiatrist or therapist can be the first step toward healing. With the right support, you can better understand what your mind and body are telling you—and begin to feel like yourself again.
