Mind and body

Panic vs. Anxiety: How to Tell the Difference

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A panic attack is a sudden surge of intense fear and physical symptoms that usually passes within minutes. Anxiety, in the clinical sense, is worry and tension that persist, often most of the time and for months. The two can occur together, and both are treatable, but knowing which one you are dealing with changes what you ask for.

What does a panic attack feel like?

Sudden and physical. The NHS guidance on panic disorder describes a rush of intense mental and physical symptoms that can come on very quickly and for no apparent reason. Symptoms it lists include:

  • a racing heartbeat, chest pain or shortness of breath;
  • sweating, trembling, hot flushes or chills;
  • feeling faint, dizzy or nauseous;
  • numbness, pins and needles or tingling in the fingers;
  • a choking sensation or dry mouth;
  • a feeling of dread or a fear of dying, or feeling disconnected from your body.

Most panic attacks last between 5 and 20 minutes, according to the NHS, though some have been reported to last up to an hour. Although they are frightening, the NHS says they are not dangerous and will not cause physical harm.

What does ongoing anxiety feel like?

Persistent rather than sudden. The NHS guidance on generalized anxiety disorder describes the main symptom as feelings of stress or worry that affect daily life and are difficult to control. Other symptoms can include difficulty sleeping, restlessness or irritability, trouble concentrating, tiredness, tension, stomach problems, palpitations, light-headedness and low mood.

The NHS adds that most people feel anxious sometimes and that this does not always mean a disorder. Generalized anxiety disorder is more likely if you feel anxious most of the time and it affects everyday life; a GP may diagnose it when the anxiety has been present a lot of the time for at least six months.

How are they diagnosed differently?

By pattern, not by a single episode:

  • Panic disorder may be diagnosed when you have regular, unexpected panic attacks followed by at least a month of continuous worry about having more.
  • Generalized anxiety disorder may be diagnosed when you often worry about a wide range of things, find the worry hard to control and have felt anxious much of the time for at least six months.

A single panic attack is not panic disorder, and a stressful month is not an anxiety disorder.

Can you have both?

Yes. The NHS notes that it is common to have more than one anxiety disorder at the same time, and lists sudden attacks of panic among the other forms anxiety can take. Panic can also feed itself: the NHS describes how fear of another attack can lead people to avoid situations, creating a cycle of living “in fear of fear” that can bring on more attacks.

Why does the distinction matter?

Because the first step differs. Panic symptoms overlap with physical problems; the NHS warns that most panic symptoms can also be symptoms of other conditions, and a GP may examine you to rule those out. As a general safety rule, chest pain, breathlessness or fainting that you have not had checked before needs medical assessment, not self-diagnosis.

For both conditions, the NHS lists talking therapies, usually cognitive behavioral therapy (CBT), and medicines as the main treatments. Hypnotherapy is used for anxiety as well, and a 2024 review in Frontiers in Psychology reports that it works better when combined with established psychological treatment such as CBT.

A rule for telling them apart

Ask two questions. Did it come on suddenly, last minutes rather than days and bring strong physical symptoms? That points to panic. Is it a background of worry that has been with you most days for weeks or months? That points to ongoing anxiety. If the answer to either is yes and it is affecting your life, see a GP or licensed mental health professional, and if physical symptoms are new to you, get them checked first.

This article is general information, not medical or psychological advice; talk with a licensed clinician about your own situation.

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