One of these two terms has a precise clinical definition and the other has none. Panic attack is defined in DSM-5 as an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes, during which at least four of thirteen listed symptoms occur. [apa-2013-dsm5] Anxiety attack appears nowhere in the manual.
That asymmetry is the whole answer, and it is more useful than the tidy comparison table this question usually gets. People are not describing two different diagnoses. They are describing one defined event and one everyday phrase that different people use for different things.
What counts as a panic attack
A panic attack is defined by how fast it arrives and what happens in your body while it is happening. The abruptness is not incidental detail; it is part of the definition, and it is what separates panic from anxiety that mounts over an afternoon.
The thirteen symptoms DSM-5 lists include a pounding or racing heart, sweating, trembling, shortness of breath, a feeling of choking, chest pain, nausea, dizziness, chills or heat sensations, numbness or tingling, a sense of unreality or detachment, fear of losing control, and fear of dying. [apa-2013-dsm5] Four or more, arriving abruptly and peaking within minutes, is the threshold.
Notice how physical that list is. Panic is largely an event in the body, which is why so many first attacks end in an emergency department with someone convinced they are having a heart attack. Getting that checked the first time is the right call.
A panic attack is also not a diagnosis on its own. In DSM-5 it functions as a specifier, something that can accompany any anxiety disorder, and many other conditions besides.
What people mean by an anxiety attack
Anxiety attack is ordinary English rather than clinical language, and it has no definition, no symptom list and no time course. When people use it they usually mean a period where anxiety became severe enough to feel like an event rather than a background state.
Because nothing standardises it, the same phrase covers very different experiences. Some people describe something that meets every criterion for a panic attack. Others describe three hours of escalating dread with no abrupt onset at all, which is a real and difficult experience that is simply not panic.
This matters most in a consulting room. Telling a GP you had an anxiety attack conveys less than describing what actually happened, so it is worth going in with the specifics: how quickly it started, how long the worst of it lasted, what your body did, and what you were afraid of while it was happening.
A schematic contrast of the two time courses described in this section, not measured data. Individual episodes vary widely, and the same person can experience both.
How common panic attacks actually are
Panic attacks are common and panic disorder is not, and the gap between those two numbers is larger than most people expect. In a survey of 142,949 people across 25 countries, 13.2% had experienced a panic attack at some point in their lives, while 1.7% met criteria for panic disorder. [dejonge-2016-panic]
The more striking finding sits inside that group. Of everyone who had ever had a panic attack, about two thirds went on to have recurrent attacks, but only 12.8% met the criteria for panic disorder. [dejonge-2016-panic] Having attacks, even repeatedly, is not the same as having the disorder.
Estimates run higher in some national samples. The US National Comorbidity Survey Replication put lifetime prevalence of panic attacks at 22.7%, against 3.7% for panic disorder. [kessler-2006-ncsr] The figures differ because the populations and interview methods differ; the ratio between them holds in both.
Panic disorder requires more than the attacks. It needs recurrent unexpected attacks plus at least a month of persistent worry about further attacks, or a meaningful change in behaviour because of them, such as avoiding places where one happened. [apa-2013-dsm5]
Why the distinction changes what helps
The two shapes respond to different things, which is the practical reason to be precise about which one you are having. Treatment for panic targets the fear of the physical sensations themselves, while treatment for sustained anxiety targets the worry driving it.
For panic, cognitive behavioural therapy works by testing the catastrophic prediction directly. If you believe a racing heart means you are about to collapse, the therapy involves deliberately producing that sensation, safely and repeatedly, until the prediction stops being credible. Exposure of this kind has strong evidence behind it across the anxiety disorders. [craske-2016-anxiety]
For anxiety that builds and stays, the same logic applied to sensations is beside the point, because the sensations are not what you are afraid of. The work is on the worry itself: what it is about, whether it is solvable, and what the worrying is doing for you.
Breathing techniques sit awkwardly between the two. They help many people during sustained anxiety. During a panic attack they can quietly become a safety behaviour, something you believe prevented the catastrophe, which leaves the underlying prediction intact and unchallenged. Our guide to breathing exercises for anxiety covers the techniques; the caveat here is about when to use them.
Which shape was it?
Think of the most recent episode and tick anything that was true of it. This is a reflection prompt rather than a test, and it produces no diagnosis.
0 of 8 ticked
The abrupt onset, the fast peak and the physical symptoms are what define panic. That does not mean you have panic disorder, which additionally requires recurrent unexpected attacks and a month or more of worry about them. It does mean the treatments aimed at panic are the relevant ones.
Some features fit panic and some do not, which is common and is one reason the everyday term exists. Writing down the next episode as it happens, including the time it started and the time the worst of it passed, will tell you more than trying to reconstruct it afterwards.
Without abrupt onset and a fast peak this does not match the panic pattern, which points the useful work at the worry rather than at the sensations. The anxiety screener below is the better starting point.
No screener on this site is specific to panic. The free anxiety screener uses the GAD-7, which measures generalised anxiety rather than panic, so treat it as a general reading rather than an answer to the question this article is about. It takes about two minutes and nothing is sent anywhere.
For how the pattern behaves over time, our guide to how often panic attacks happen covers frequency and what drives it, and the panic attacks pillar covers symptoms and treatment in more detail.
When to seek help
See a GP if you have had more than one unexpected attack and have spent a month or more worrying about the next one, or if you have started avoiding places or situations because of them. That combination is roughly the threshold for panic disorder, and it is the point at which treatment makes a clear difference.
Get chest pain, breathlessness or an irregular heartbeat assessed medically the first time it happens, particularly if you are over 40, have a heart condition in the family, or the symptoms came on during physical exertion. Panic and cardiac events share symptoms, and ruling out the second is part of taking the first seriously rather than a sign of overcaution.
Go urgently if you have thoughts of harming yourself. In the UK, Samaritans is free on 116 123 at any hour.
How MyFreud can help
Attacks are hard to describe accurately afterwards, and the details a clinician needs are exactly the ones that fade: how fast it started, how long the peak lasted, what came before it. MyFreud gives you daily mood tracking you can log an episode into in under a minute, so what you bring to an appointment is a record rather than a recollection.
Download MyFreud and start today: App Store or Google Play.