You might hear the words anxiety attack and panic attack used interchangeably as if they mean the same thing. In fact, panic and anxiety have different features, and behavioral health professionals use the terms for specific symptoms and disorders. Panic attacks are often associated with sudden fear and anxiety with high-stress levels or excessive worrying. Some of the symptoms are similar, including rapid heart beat, shortness of breath, and dizziness. Each also has other symptoms that are unique. Everyone can experience panic attacks and anxiety, they are apart of the emotional and protective response hardwired into the human body. It's when either occurs frequently that there is cause for concern. No matter which you experience, it's important to understand their definitions, symptoms, and treatments.
Professionals who treat mental health conditions base diagnosis on definitions found in the "Diagnostic and Statistic Manual of Mental Disorders, 5th edition," known as the DSM-5. Though anxiety and panic attacks may feel the same at times, the subtle differences outlined in this handbook help identify each. The DSM-5 uses the term panic attack to describe the hallmark features associated with the condition known as panic disorder. However, panic attacks may occur in other psychiatric disorders and it is possible to have a panic attack with no disorder. The term "anxiety attack" is not defined in the DSM-5. Rather, "anxiety" is used to describe a core feature of several illnesses identified under the headings of anxiety disorders, obsessive-compulsive disorder, and trauma- and stressor-related disorders. Some of the most common disorders under these three headings include:
A panic attack is a sudden and intense feeling of fear, terror, nervousness, or apprehension. The symptoms are often so extreme that they cause a severe disruption during your day. Panic attacks usually occur out of the blue without an obvious, immediate trigger. In some cases, they are "expected" because the fear is caused by a known stressor such as a phobia. Panic attack symptoms peak within 10 minutes and then they subside. However, some panic attacks may last longer or may occur in succession, making it difficult to determine when on attack ends and the other begins. Following an attack, it is not unusual to feel stressed, worried, out-of-sorts, or "keyed up" for the remainder of the day. According to the DSM-5, a panic attack is characterized by four or more of the following symptoms:
In contrast, anxiety generally intensifies over a period of time and is highly correlated with excessive "worry" about some potential danger- whether real or perceived. If the anticipation of something builds up and the high amount of stress reaches a level where it becomes overwhelming, it may feel like an "attack". The symptoms of anxiety may include:
Depression (major depressive disorder or clinical depression) is a common but serious mood disorder. It causes severe symptoms that affect how you think, feel, and handle daily activities, such as sleeping, eating, or working. To be diagnosed with depression, the symptoms must be present for at least two weeks. Some forms of depression are slightly different, or they may develop under unique circumstances, such as:
Signs & Symptoms:
If you have been experiencing some of the following signs and symptoms most of the day, nearly every day, for at least two weeks, you may be suffering from depression:
Depression is one of the most common mental disorders in the U.S. Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. Depression can happen at any age, but often begins in adulthood. Depression is now recognized as occurring in children and adolescents, although it sometimes presents with more prominent irritability than low mood. Many chronic mood and anxiety disorders in adults begin as high levels of anxiety in children. Depression, especially in midlife or older adults, can co-occur with other serious medical illnesses, such as diabetes, cancer, heart disease, and Parkinson's disease. These conditions are often worse when depression is present. Sometimes medications taken for these physical illnesses may cause side effects that contribute to depression. A doctor experienced in treating these complicated illnesses can help work out the best treatment strategy.
Risk Factors Include:
Depression, even in the most severe cases, can be treated. The earlier that treatment can begin, the more effective it is. Depression is usually treated with medications, psychotherapy, or a combination of the two. If these treatments do not reduce symptoms, electroconvulsive therapy (ECT) and other brain simulation therapies may be options to explore.
Antidepressants are medications that treat depression. They may help improve the way your brain uses certain chemicals that control mood or stress. You may need to try several different antidepressant medications before finding the one that improves your symptoms and has manageable side effects. A medication that has helped your or a close family member in the past will often be considered. Antidepressants take time - usually 2 to 4 weeks- to work, and often, symptoms such as sleep, appetite, and concentration problems improve before mood lifts, so it is important to give the medication a chance before reaching a conclusion about its effectiveness. If you being taking antidepressants, do not stop taking them without the help of a doctor. Sometimes people taking antidepressants feel better and then stop taking the medication on their own, and the depression returns. When you and your doctor have decided it is time to stop the medication, usually after a course of 6 to 12 months, the doctor will help you slowly and safely decrease your dose. Stopping them abruptly can cause withdrawal symptoms. You may have heard about an herbal medication called St. John's wort. Although it is a top selling botanical product, the FDA has not approved its use as an over-the-counter or prescription medicine for depression, and there are serious concerns about its safety (it should never be combined with a prescription antidepressant) and effectiveness. Do not use St. John's wort before talking to your health care provider. Other natural products such as dietary supplements, including omega-3 fatty acids and S-adenosylmethionine (SAMe), remain under study but have not yet been proven safe and effective for routine use. For more information on herbal and other complementary approaches and current research, please visit the National Center For Complementary and Integrative Health website.
Several types of psychotherapy (also called "talk therapy", or in a less specific form, counseling) can help people with depression. Examples of evidence based approaches specific to the treatment of depression include cognitive-behavioral therapy (CBT), interpersonal therapy (IPT), and problem-solving therapy. More information about psychotherapy is available on the NIMH website and in the NIMH publication Depression: What You Need To Know.
Brain Stimulation Therapies
If medication does not reduce the symptoms of depression, electroconvulsive therapy (ECT) may be an option to explore. Based on the latest research:
Beyond Treatment: Things You Can Do
Here are other tips to help you or a loved one during treatment for depression: