Panic Attack vs. Anxiety: How to Tell the Difference

Not all anxiety is the same. This checklist can help you determine what’s happening, before you talk to your doctor.

Everyone gets anxious from time to time, like before a big job interview, finding out test results or buying a new house.

“Feeling anxious or worried is a part of everyday life,” says Jonathan S. Wong, PsyD, a clinical psychologist at Keck Medicine of USC and clinical assistant professor of psychiatry and the behavioral sciences at the Keck School of Medicine of USC. “It’s a normal human reaction to care about something important to us.”

But for about 6 million Americans who have panic disorder or nearly 7 million who have generalized anxiety disorder (GAD), these feelings turn into extreme worry or fear — even when there’s no real cause for concern. Here’s how to tell the difference between the two.

1. Always worrying versus sudden fear

One key difference between GAD and panic disorder is the speed at which things develop and the pattern of behaviors that follows, Dr. Wong explains.

“GAD is about anticipating something bad happening in the future,” he says. “Things may be going okay right now, but you believe this won’t last, which puts you in a constant state of feeling tense and on edge, both psychologically and physically.”

This constant worry then results in behaviors that are meant to prevent a future threat from happening. For example, you may plan excessively, worry about unknown details or constantly check to see whether the feared situation has begun to occur.

On the other hand, having a sudden surge of fear, anxiety or worries about being safe — or even dying — is typical for panic disorder.

“If you have panic disorder, you attempt to change or escape the immediate situation, when you feel a surge of fear, and you have a persistent worry that future panic attacks can happen at any moment,” he adds.

2. Ongoing versus acute physical symptoms

With GAD, you may have trouble concentrating, feel restless, twitch or tremble, find it hard to swallow, tire easily and sweat or feel light-headed on an ongoing basis. You may have headaches, muscle aches or stomachaches. And you may even realize that you worry far more than you should.

Although some symptoms of the two conditions are similar, those of panic disorder come on suddenly and intensely, and for no apparent reason. Your heart might pound so hard you could think you’re having a heart attack, and you might sweat profusely and feel as though you’re unable to breathe. Stomach or chest pain, chills and dizziness can also begin without warning. But, after a few minutes of these severe symptoms, they’ll subside.

3. Prolonged unease versus distress over when the next attack will strike

Both GAD and panic disorder may cause you to avoid situations and places where you’ve had these bad feelings. With GAD, you might not take advantage of job opportunities, trips or social events that you think will be too difficult for you. Even everyday situations, such as chores or appointments, can seem daunting. In this way, GAD negatively affects your quality of life.

But, with panic disorder, the uncertainty of not knowing when the next attack will happen can be debilitating. This dread can lead to the development of further anxiety disorders, such as agoraphobia, or fear of leaving the house.

What to do if you think you have GAD or panic disorder

Luckily, anxiety disorders, like GAD and panic disorder, are very treatable.

“The majority of people who experience these disorders are able to reduce or eliminate symptoms after several months of psychotherapy, or even after just a few sessions,” Dr. Wong says. “Scientific research supports a combination of psychotherapy and medication, or psychotherapy alone, as ways to treat GAD and panic disorder.”

“If you think you may have an anxiety disorder, speaking to a doctor or mental health professional is key and a great first step toward getting help,” Dr. Wong adds.

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