While panic attacks and anxiety attacks are terms that are often used interchangeably, they are very different. Panic attacks are recognized in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
Panic attacks are sudden, usually consisting of intense and overwhelming fear. While anxiety attacks are not recognized in DSM-5, they are defined as a feature of various common psychiatric conditions. Panic and anxiety attacks share a lot of physical and emotional symptoms and can feel very similar.
While it may be difficult to differentiate an anxiety attack from a panic attack, patients should note that anxiety is usually triggered by a stressful or threatening situation while panic attacks can occur out of the blue. Anxiety can be mild, moderate, or severe, and can build gradually.
Anxiety Attack Symptom #1: Depersonalization
Depersonalization occurs when there is a detachment from one’s body or mind. In this situation, patients often feel that the world has become less real, vague, and dreamlike. It is often described as if they are on the outside looking in.
It can occur in individuals who have conditions such as anxiety disorders, clinical depression, schizophrenia, bipolar disorder, borderline personality disorder, obsessive compulsive disorder, sleep deprivation, migraines, and more.
Anxiety Attack Symptom #2: Nausea and Vomiting
Nausea refers to a feeling of discomfort causing an urge to vomit. Nausea can be transient or chronic. It can also precede or accompany the sensation of anxiety. Other causes of nausea include pregnancy, motion sickness, poisoning, indigestion, stress, food poisoning, indigestion, and more.
Vomiting refers to emesis or the act of throwing up where there is the involuntary expulsion of food through the mouth or nose. Both nausea and vomiting can occur during an anxiety attack. It can be managed using antiemetics such as promethazine, ondansetron, or metoclopramide.
Anxiety Attack Symptom #3: Light-Headedness
Light-headedness is an unpleasant and common sensation where one may feel dizzy or faint. It can be a short-lived or prolonged sensation. It is also a term that many individuals use interchangeably with vertigo, which refers to the feeling where the room or their surroundings are spinning.
Causes of light-headedness can be due to lack or oxygen or blood to the brain as seen in rapid dehydration, hyperventilation, low blood sugar, panic attacks, anxiety, anemia, and more.
Anxiety Attack Symptom #4: Palpitations
Palpitations refer to the perceived abnormality of the heartbeat where it may be thought of as too fast, too hard, or irregular. It can be intermittent or continuous and is usually associated with shortness of breath, dizziness, headaches, chest pain, sweating, and more.
Palpitations can be observed among patients with hyperthyroidism, asthma, emphysema, cardiovascular issues, anxiety, substance abuse, and electrolyte deficiencies.
Anxiety Attack Symptom #5: Tachycardia
Tachycardia refers to a heart rate that is abnormally or excessively high. In definition, tachycardia occurs when the heart rate is more than 100 beats per minute. Some causes of tachycardia include atrial fibrillation, use of amphetamines, alcohol consumption, caffeine consumption, fever, hyperthyroidism, infection, anemia, anxiety, and more.
The management of tachycardia depends on the type of tachycardia. It may involve intravenous adenosine or cardioversion.
Anxiety Attack Symptom #6: Chest Pain
Chest pain is defined as pain that is felt anywhere in the region of the chest. It can be a symptom of serious disorders and should be considered a medical emergency. Chest pain can be cardiac related or non-cardiac related. Some causes of chest pain include myocardial infarction, cocaine abuse, aortic stenosis, aortic dissection, cardiac tamponade, myocarditis, lung malignancy, pneumonia, hemothorax, anxiety, gastroesophageal reflux disease, and more.
Management of chest pain depends on the underlying cause. Patients with chest pain should seek medical attention immediately to rule out serious conditions such as heart attack.
Anxiety Attack Symptom #7: Shortness of Breath
Shortness of breath or dyspnea is the feeling when the individual is unable to breathe well enough. This may be due to the extra effort required to breathe, air hunger, or chest tightness. It is a symptom that can be observed in congestive heart failure, pneumonia, asthma, interstitial lung disease, cardiac ischemia, or psychogenic causes like anxiety and panic disorder.
Patients who experience breathlessness during an anxiety attack are recommended to focus on their breathing in an attempt to get it under control. This can be done using a breathing technique known as diaphragmatic breathing where it helps to decrease the respiratory rate, lower the oxygen demand, and lessens the effort needed to breathe.
Anxiety Attack Symptom #8: Sweating
Sweating is a common symptom in anxiety. While sweating may be a normal physiological process, it becomes abnormal when it is excessive and profuse without exertion. Patients who experience sweating during anxiety often experience hot or cold episodes and sweating that can be temporary or persistent.
The sweating can accompany symptoms of anxiety or episodes of nervousness. This occurs as the stress hormones are released when one is anxious. This results in an increase of perspiration, so fluids can be eliminated through the skin instead of the kidneys reducing the need to micturate.
Anxiety Attack Symptom #9: Paresthesia
Paresthesia or numbness refers to abnormal sensation on the skin without an obvious physical cause. The sensation can be chilling, burning, pricking, or tingling. It can be transient, chronic, and can have various causes. The most common form of paresthesia is often known as “pins and needles”.
Paresthesia can occur during hyperventilation, panic attacks, herpes simplex virus infection, shingles, reactive hyperemia, vitamin deficiency, and more. Patients who experience this issue regularly should talk to their healthcare provider to find a coping mechanism to reduce the reoccurrence of paresthesia.
Anxiety Attack Symptom #10: Headache
Headaches refer to pain that is felt anywhere in the region of the head or neck. While headaches are a common symptom of various conditions such as dehydration, hunger, infection, and more, it can also be a symptom of anxiety. While it is still unclear how anxiety can cause headaches, experts have found that there is a link or connection between anxiety and headaches.
It is recommended that patients who have anxiety and experience frequent headaches should talk to their doctor. With proper medication for anxiety, it may reduce and frequency and severity of the headaches. Cognitive behavioral therapy can also be particularly effective.