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Dr. Matthew Mandelbaum provides private psychotherapy services only. We are not currently enrolling participants for paid research studies or compensated clinical trials.
A panic attack is a sudden, intense surge of fear or physical distress that peaks quickly—often within minutes. An “anxiety attack” is an informal term people use to describe anxiety that builds gradually around a specific worry or stressor. Both are real, both can feel overwhelming, and both deserve to be taken seriously.
Safety note first: Having new, severe, or unexplained chest pain, trouble breathing, fainting, or symptoms that feel medically dangerous? Seek immediate medical help rather than assuming it is a panic attack. Panic attacks can produce chest pain, a racing heart, dizziness, and shortness of breath—symptoms that can resemble a heart attack or another medical problem. When in doubt, get evaluated promptly.
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When your heart is pounding, your breathing feels difficult, or your body suddenly seems out of control, it can be hard to think clearly. You may be asking yourself: Is this a panic attack? An anxiety attack? A medical emergency? Something else entirely?
Those questions make complete sense. Panic attacks and anxiety can create strikingly similar physical and emotional symptoms. But the terms do not mean the same thing—and understanding the difference can help you respond more effectively in the moment.
A panic attack is a sudden surge of intense fear or discomfort that reaches a high level quickly. An “anxiety attack” is an informal term people often use to describe anxiety that builds around a specific worry, stressor, or feared situation. Importantly, “anxiety attack” is not a separate diagnosis in the DSM-5-TR (the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision). People use the phrase commonly, but it describes an experience rather than a clinically defined condition.
Helpful resource: The American Psychiatric Association’s explanation of the DSM explains how the DSM-5-TR defines and organizes recognized mental health diagnoses.
Both experiences can feel intense. Neither is a sign of weakness. And neither should be dismissed.
In my work with highly sensitive and intelligent adults, I often meet people who understand logically that they may be anxious but still feel frightened and confused by the intensity of their body’s response. That gap—between what you know intellectually and what your body is doing—is real. And it is one of the most disorienting parts of living with panic or anxiety.
This guide will help you understand what distinguishes panic attacks from intense anxiety, recognize common symptoms, navigate physical symptoms that may need medical attention, and identify practical tools that may help—both in the moment and over time.
Panic Attack vs. Anxiety Attack: What Is the Main Difference?
Panic attacks usually begin suddenly and become intense very quickly. Anxiety often builds more gradually around a worry, threat, situation, or anticipated outcome.
That is the core distinction. But it is a helpful general framework, not a self-diagnostic rule.
A single person can experience all of the following:
- Anxiety without a panic attack
- A panic attack during a period of anxiety
- An unexpected panic attack without any clear trigger
- Panic symptoms connected to a specific feared situation
- Ongoing worry about having another panic attack
Experiences vary widely. What matters is that you notice what is happening, respond with care, and seek appropriate support when symptoms are frequent, severe, or interfering with your daily life.
Helpful resource: NHS Talking Therapies’ panic attack vs. anxiety attack guide explains that “anxiety attack” is an informal phrase, while panic attacks usually begin suddenly and peak quickly.
Panic Attack vs. Anxiety Attack: A Simple Comparison
Feature |
Panic Attack |
What People Call an “Anxiety Attack” |
|---|---|---|
|
Clinical term |
Recognized in the DSM-5-TR |
Common phrase; not a separate DSM-5-TR diagnosis |
|
Onset |
Often sudden |
Often builds gradually |
|
Intensity |
Frequently severe and overwhelming |
Can range from moderate to severe |
|
Trigger |
May occur with or without a clear trigger |
Often connected to an identifiable stressor or worry |
|
Common focus |
Immediate fear, danger, death, or losing control |
Anticipation, worry, tension, or feeling unable to cope |
|
Physical symptoms |
Often prominent and intense |
May be present but can develop more gradually |
|
Duration |
Usually peaks quickly, though symptoms may continue |
May last for hours or longer, depending on the stressor |
|
Aftereffects |
Exhaustion, fear of another attack, or avoidance |
Continued worry, tension, irritability, or mental fatigue |
A qualified health or mental health professional can help determine whether your symptoms are related to panic, another anxiety disorder, a medical condition, medication, substance use, or another concern. This chart is a general reference, not a diagnostic tool.
What Are Panic Attacks?
A panic attack is a sudden episode of intense fear or discomfort accompanied by strong physical or cognitive symptoms. During a panic attack, a person may feel as though something terrible is happening—even when there is no immediate external danger present.
According to the National Institute of Mental Health (NIMH), panic attacks are sudden waves of fear or discomfort that may include a sense of losing control, sometimes without a clear danger or trigger.
Helpful resource: NIMH’s Panic Disorder guide explains sudden panic symptoms, unexpected attacks, panic disorder, avoidance, medical evaluation, and evidence-supported treatment options.
Common Panic Attack Symptoms
Panic attack symptoms can include any combination of the following:
- A racing, pounding, or fluttering heart
- Sweating
- Trembling or shaking
- Shortness of breath
- A choking sensation
- Chest pain or discomfort
- Nausea or stomach distress
- Dizziness or feeling faint
- Chills or hot flashes
- Tingling or numbness
- Feeling detached from yourself (depersonalization)
- Feeling that the world around you is unreal (derealization)
- Intense fear of losing control
- Fear of dying
- A sudden sense of impending doom
Not everyone experiences every symptom, and symptoms can vary from one episode to the next.
What Does a Panic Attack Feel Like?
The thoughts that accompany panic attacks can be as distressing as the physical sensations themselves. In the middle of an episode, a person might think:
- “I cannot breathe.”
- “Something is seriously wrong with my heart.”
- “I am going to pass out.”
- “I need to escape right now.”
- “I am losing control.”
- “I am going to die.”
- “Nothing around me feels real.”
The body’s alarm system can activate rapidly and powerfully. The intensity of those sensations often makes it difficult to recognize them as panic while they are occurring—which is part of what makes panic attacks so frightening.
Photo by Ian Stauffer on Unsplash
How Quickly Does a Panic Attack Begin?
Panic attacks generally come on rapidly. Symptoms often reach their peak within 10 to 20 minutes, although some can persist longer. Every person’s experience is different. Avoid assuming your episode will follow a fixed timeline.
Do Panic Attacks Always Have an Obvious Trigger?
They do not. Some panic attacks appear to happen completely “out of the blue.” Others occur in connection with specific situations or sensations, such as:
- Crowded or enclosed spaces
- Driving or flying
- Medical appointments
- Public speaking or social situations
- Physical exertion
- Trauma reminders
- Sensory overload
- Significant or prolonged stress
The presence—or absence—of a trigger does not determine whether your symptoms are real or serious.
Why Panic Attacks Can Feel Like Medical Emergencies
Panic attacks can produce powerful physical sensations involving the heart, breathing, stomach, balance, temperature, and muscles. Because these symptoms overlap with several medical conditions, you should not assume that a first-time or unusual episode is “only anxiety.”
Seek medical evaluation when symptoms are:
- New or different from anything you have experienced before
- Severe or rapidly worsening
- Persistent and not resolving
- Accompanied by fainting or loss of consciousness
- Associated with significant chest pressure or a crushing sensation
- Connected to a known heart, lung, or neurological condition
- Occurring after a medication change or substance use
When in doubt, get checked out. A medical evaluation is not an overreaction.
What Are Anxiety Attacks?
“Anxiety attack” is a phrase people commonly use, but it does not carry one official medical definition. Someone may use the term to describe a period when anxiety becomes especially intense, difficult to redirect, or physically overwhelming.
This experience may include:
- Excessive worry or racing thoughts
- Muscle tension
- Restlessness or feeling on edge
- Irritability
- Difficulty concentrating
- Nausea
- Headaches
- Changes in breathing
- A racing heart
- Trouble sleeping
- A sense that something is about to go wrong
- Feeling unable to manage an upcoming demand
Anxiety Attacks Often Build Around an Identifiable Stressor
Escalating anxiety is frequently connected to something the person can name:
- Work pressure or a difficult deadline
- A strained relationship
- Financial concerns
- Health worries
- An upcoming presentation or exam
- Social situations
- Caregiving responsibilities
- A major decision with uncertain outcomes
- Several demands are occurring simultaneously
That said, the source of anxiety is not always immediately obvious—especially when stress has been building quietly for days or weeks.
Anxiety May Build More Gradually
Someone experiencing escalating anxiety may notice it developing in stages:
- They begin worrying about an upcoming event.
- Their thoughts become harder to redirect.
- Their muscles tighten and their breathing shifts.
- Sleep and concentration become difficult.
- They begin to feel overwhelmed and physically unwell.
This gradual escalation can eventually feel like an “attack”—even though the experience developed more slowly than a typical panic attack.
How Long Can Intense Anxiety Last?
Because “anxiety attack” is not a formally defined event, there is no official duration attached to it. The strongest symptoms may ease when a stressful situation ends, or the tension and worry may continue for several hours, an entire day, or longer—particularly when connected to an ongoing stressor or anxiety disorder.
Key Differences Between Panic Attacks and Anxiety
Sudden Fear vs. Building Worry
- Panic often feels immediate and overwhelming, arriving without warning.
- Anxiety typically involves anticipation—worrying about what might happen and whether you will be able to cope.
- Panic may generate a sharp fear of dying or losing control in the moment.
- Anxiety tends to center more on future-oriented worry and a sense of dread about what lies ahead.
Unexpected Episodes vs. Identifiable Triggers
A panic attack can occur unexpectedly—even during a calm or ordinary moment. Intense anxiety is more often linked to a concern the person can identify, though this is not always the case.
Intense Physical Symptoms vs. Sustained Tension
Panic attacks tend to involve a rapid surge of noticeable physical symptoms. Anxiety produces physical discomfort too, including muscle tension, headaches, stomach problems, sleep difficulties, restlessness, fatigue, shallow breathing, and a pounding heart. The meaningful difference often lies in the speed and intensity of escalation, rather than in whether physical symptoms are present at all.
A Short Peak vs. Longer-Lasting Distress
The strongest phase of a panic attack commonly peaks quickly. Anxiety may remain elevated for much longer because the worry, stressor, or feared situation has not been resolved.
Can You Experience Panic Attacks and Anxiety at the Same Time?
Yes. Panic and anxiety can and do overlap.
A person may:
- Feel anxious for hours and then experience a panic attack
- Develop anxiety specifically about having another panic attack
- Avoid places or situations associated with a previous episode
- Experience panic during a feared social situation
- Feel anxious after noticing physical sensations such as a rapid heartbeat
One of the more difficult patterns I see clinically looks like this:
- The person notices a physical sensation—a flutter in their chest, a wave of dizziness.
- They interpret it as a sign of danger.
- Fear intensifies the physical sensation.
- The stronger sensation seems to confirm that something is wrong.
- Panic escalates.
This cycle can feel inescapable. The good news is that therapy can help you understand it and interrupt it—without dismissing genuine physical symptoms that deserve medical attention.
Photo by Lina Trochez on Unsplash
When Do Panic Attacks Become Panic Disorder?
Having one panic attack does not automatically mean you have panic disorder. Panic disorder involves recurring, unexpected panic attacks along with ongoing concern or significant behavioral changes related to future attacks.
NIMH notes that not everyone who experiences a panic attack develops panic disorder. Signs that a professional evaluation may be helpful include:
- Repeated unexpected panic attacks
- Persistent fear of another attack occurring
- Avoiding exercise because it raises your heart rate
- Avoiding driving, crowds, stores, or public spaces
- Staying close to home or near medical facilities
- Frequently checking physical symptoms
- Changing your daily routine to prevent panic
- Missing work, school, or social activities because of fear
- Relying on another person to feel safe in ordinary situations
This list is a guide for reflection, not a diagnostic checklist.
Helpful resource: MedlinePlus’ Panic Disorder overview explains panic symptoms, unpredictable attacks, panic disorder diagnosis, possible physical testing, CBT, and medication.
How Anxiety Disorders Differ From Temporary Stress
Anxiety is a natural human response. Everyone experiences it. An anxiety disorder may be present when fear or worry:
- Happens frequently or feels nearly constant
- Feels difficult or impossible to control
- Persists well beyond a temporary stressor
- Causes significant distress
- Disrupts sleep
- Affects performance at work or school
- Damages relationships
- Leads to avoidance of important activities
- Limits your ability to function in daily life
According to the American Psychiatric Association, anxiety may warrant professional evaluation when it regularly disrupts routines, sleep, or daily activities.
Anxiety disorders include conditions such as generalized anxiety disorder, panic disorder, social anxiety disorder, specific phobias, agoraphobia, and separation anxiety disorder. According to NIMH, an estimated 19.1% of U.S. adults experienced an anxiety disorder in the previous year, based on National Comorbidity Survey data—making it among the most common mental health conditions in the country.
Helpful resource: The American Psychiatric Association’s anxiety-disorders overview explains the emotional, physical, and behavioral symptoms of anxiety and distinguishes panic disorder from generalized anxiety, phobias, and related conditions.
Chest Pain, Shortness of Breath, and Other Medical Conditions
This point is important enough to state directly: several panic symptoms can also occur with medical conditions.
Possible causes of symptoms like chest pain, dizziness, shortness of breath, and heart palpitations may include:
- Heart conditions
- Breathing or lung conditions
- Thyroid problems
- Blood sugar changes
- Anemia
- Inner-ear or balance conditions
- Medication side effects
- Substance use or withdrawal
- Caffeine or stimulant effects
- Hormonal changes
- Dehydration
This is not an exhaustive list. It is a reminder that physical symptoms are not automatically caused by anxiety—and that assuming they are can delay important care.
When to Seek Immediate Medical Attention
Call emergency services or go to an emergency room for:
- New or severe chest pain
- Crushing, squeezing, or persistent chest pressure
- Severe trouble breathing
- Fainting or loss of consciousness
- Sudden weakness or numbness
- Confusion or sudden disorientation
- Blue or gray lips
- Chest pain accompanied by sweating, nausea, dizziness, or shortness of breath
- Any symptoms that feel different from your usual anxiety experience
- Any situation in which you believe you may be having a medical emergency
Do not wait for symptoms to pass when emergency warning signs are present.
Why a Medical Evaluation Can Be Genuinely Useful
A medical professional can evaluate whether your symptoms are connected to panic, another mental health condition, a physical health problem, medication, caffeine or another substance, or several factors occurring together. Seeking appropriate evaluation is not an overreaction. It is a responsible and caring step—especially when symptoms are new, unexplained, or changing.
Helpful resource: MedlinePlus’ Panic Disorder Test guide explains why providers may use physical exams, heart tests, blood tests, and mental health assessments to distinguish panic symptoms from medical conditions.
Coping Strategies for a Panic or Anxiety Attack
You do not need to use every strategy at once. Choose one simple action and give your mind something steady to focus on.
Before continuing, these coping tools are not substitutes for emergency medical care. If you are experiencing symptoms that feel medically urgent, seek help immediately.
1. Orient Yourself to the Present Moment
Look around and slowly name:
- Where you are
- The current date and time
- What you can see
- What you can hear
- What is physically supporting your body
- Who is nearby
A grounding thought that some people find helpful: “I am in my office. It is Wednesday afternoon. My feet are on the floor. I can see the desk and the window. I am noticing a strong alarm response.”
VA resources on grounding recommend looking around, noticing where you are, and gently reminding yourself that you are in the present moment—not in the feared scenario your mind is generating. You may also find it helpful to explore relaxing meditations and DBT-focused podcasts that support anxiety and panic coping skills.
2. Try the 5-4-3-2-1 Grounding Exercise
Move through your senses deliberately:
- 5 things you can see
- 4 things you can physically feel
- 3 things you can hear
- 2 things you can smell
- 1 thing you can taste
The goal is not to force the symptoms away. The goal is to give your mind concrete sensory information from the world around you right now.
3. Slow the Breath Gently
The NHS advises breathing gently and regularly without forcing the breath:
- Let your shoulders loosen slightly.
- Breathe in gently through your nose.
- Breathe out slowly without forcing the air.
- Make the exhale slightly longer than the inhale if that feels comfortable.
- Continue at a steady, unhurried pace.
A note worth making: some people become more anxious when asked to focus intensely on breathing. If that is true for you, try grounding through sight, touch, sound, or gentle movement instead.
4. Press Your Feet Into the Floor
Notice:
- The pressure under your feet
- The support of the chair beneath you
- The temperature of the room
- The texture of an object in your hand
You can also slowly stretch your hands, roll your shoulders, or walk calmly in a safe space. Physical anchoring gives the nervous system something immediate and concrete to orient toward.
5. Reduce Extra Stimulation When Possible
If it is safe to do so:
- Move to a quieter or less crowded area
- Lower the bright lights
- Step away from noise
- Loosen restrictive clothing
- Sit somewhere stable
- Take a slow sip of water
- Ask someone nearby to speak calmly and slowly
Avoid abrupt exits from situations where leaving could create risk—such as pulling over a vehicle safely before stepping out, rather than opening a door while moving.
6. Use Simple and Accurate Self-Talk
Phrases that acknowledge the experience without amplifying it:
- “My body’s alarm system is activated right now.”
- “I can take this one moment at a time.”
- “I do not have to solve everything right now.”
- “I can notice this feeling without immediately reacting to it.”
- “I have experienced intense anxiety before, and I know what steps help me.”
- “I can seek medical help if these symptoms feel new or unsafe.”
Avoid absolute promises to yourself—like “nothing bad can happen” or “this will be over in five minutes.” When those promises do not hold, they can increase distress rather than reduce it.
7. Reach Out to Someone You Trust
Tell them clearly what would help right now:
- “Please stay on the phone with me.”
- “Can you speak slowly?”
- “Please help me find a quiet place.”
- “I do not need advice right now. I just need company.”
- “Please help me decide whether I need medical attention.”
Being specific about what you need makes it easier for others to actually help.
What to Do After the Symptoms Ease
After an intense episode, you may feel exhausted, shaky, embarrassed, tearful, or mentally foggy. That is a common response to a nervous-system activation of that magnitude. Be gentle with yourself.
Practical recovery steps include:
- Resting in a safe, comfortable environment
- Drinking water
- Eating something if you have not eaten recently
- Reducing caffeine for the remainder of the day
- Writing down what happened while it is still fresh
- Noting possible triggers and what helped
- Recording approximately how long symptoms lasted
- Contact a healthcare professional if symptoms are new or severe
- Rescheduling unnecessary demands when possible
Keep a Brief Symptom Record
Tracking your episodes—concisely and without obsessing—can give a health or mental health professional valuable information and can make it easier to know what to expect in a therapy appointment. Consider noting:
- What happened before symptoms began
- Whether the onset was sudden or gradual
- Physical symptoms present
- Thoughts and fears you noticed
- Approximate duration
- Caffeine, food, sleep, and medication at the time
- Current stressors
- Hormonal factors when relevant
- What helped ease the symptoms
One important caveat: tracking should not become constant body monitoring. That kind of hypervigilance can actually increase anxiety. Keep your notes brief, purposeful, and occasional.
Coping Strategies That May Reduce Future Anxiety
In-the-moment coping is only one piece of the picture. Longer-term support may include working with a therapist who offers personalized, evidence-based services:
- Consistent sleep routines
- Regular physical movement
- Balanced meals throughout the day
- Reducing excessive caffeine or stimulants
- Practicing grounding before distress reaches its peak
- Creating realistic schedules with built-in recovery time
- Learning emotional regulation skills
- Addressing patterns of avoidance
- Understanding personal triggers over time
- Seeking professional evaluation and treatment
These habits can support overall well-being. They do not replace individualized care for panic disorder or other anxiety disorders, such as the personalized psychotherapy offered through Groundbreaker Therapy.
How Mental Health Treatment Can Help With Anxiety and Panic
Effective treatments exist for panic disorder and other anxiety disorders. Treatment may involve psychotherapy, medication, or a combination of both—alongside medical evaluation, lifestyle adjustments, and skills practice between sessions, and can incorporate emerging trends in counseling and psychotherapy.
The right approach depends on your specific symptoms, health history, preferences, and goals. What works well for one person may not be the best fit for another.
Cognitive Behavioral Therapy and Exposure Therapy for Panic
Cognitive behavioral therapy (CBT) helps people examine the relationship among physical sensations, thoughts, fear, avoidance, and behavior. For panic disorder specifically, treatment may include interoceptive exposure—a structured process of working with a qualified professional to gradually face feared bodily sensations in a controlled, therapeutic setting.
NIMH identifies CBT as a commonly used and evidence-supported treatment for panic disorder and notes that exposure methods may address both feared situations and panic-related bodily sensations.
Do not attempt intensive exposure exercises on your own. This work is most effective—and safest—when guided by a trained clinician.
How DBT Skills May Support Emotional Regulation
Dialectical Behavior Therapy (DBT) is not the primary treatment for all forms of panic or anxiety, and it should not be framed as a replacement for panic-focused CBT when that treatment is indicated. However, DBT skills can be genuinely helpful for some clients who experience intense emotional responses alongside panic or anxiety.
DBT skills may help you:
- Recognize when emotions are beginning to escalate
- Stay connected to the present moment
- Tolerate short-term distress without reacting impulsively
- Communicate your needs more clearly
- Reduce shame about having strong emotional reactions
- Develop a personalized plan for moments of crisis
Medication and Medical Support
Medication may be part of treatment for some people. All medication decisions should be discussed with an appropriate prescribing professional who can consider your full picture—including symptoms, medical history, other medications, substance use, pregnancy, and personal treatment preferences.
No specific medication will be recommended here. That conversation belongs with a clinician who knows you.
Photo by William Farlow on Unsplash
How Groundbreaker Therapy Can Help With Anxiety and Panic
I Understand That Insight Does Not Always Stop the Body’s Response
Many of my clients are highly intelligent people who can clearly articulate what anxiety is, explain why a particular situation is not genuinely dangerous, and still feel completely overwhelmed by their body’s physical response.
You might know that a work meeting is not life-threatening. You might know that a mistake would not ruin everything. Your body may respond as though immediate danger is present, regardless.
That gap is not a character flaw. It reflects how the nervous system works—and it is exactly where therapy can help.
I do not assume that explaining anxiety to an intelligent person will make it disappear. My role is to help you understand the pattern while also building practical emotional and behavioral skills that reduce its hold on your life.
I Work With Highly Sensitive and High-Achieving Adults
The clients I work with often hold demanding professional roles in fields such as business, technology, law, healthcare, education, and the arts. I also work with university students and emerging adults navigating significant life transitions.
These individuals often appear highly capable externally while privately managing:
- Recurring panic or intense anxiety
- Chronic worry and fear of failure
- Emotional overload that feels disproportionate to the situation
- Perfectionism and difficulty resting
- Sensitivity to criticism
- A persistent, low-level sense of being on alert
- Difficulty making decisions without significant distress
If any of that resonates, you are not alone—and you are not beyond help.
I Take a Personalized, Evidence-Based Approach
I do not assume every panic attack has the same cause or requires the same response. In my work with each client, I consider:
- Personal and family history
- Current stressors and life context
- Emotional sensitivity and nervous-system patterns
- Physical health factors
- Thought patterns and core beliefs
- Avoidance behaviors
- Relational dynamics
- Professional demands
- Trauma history
- Existing strengths and coping tools
- Individual treatment goals
I integrate DBT, CBT with trauma-informed care, and other therapeutic approaches based on what the individual actually needs—not a pre-packaged protocol.
I Help Clients Replace Shame With Understanding
Panic and anxiety often come wrapped in beliefs that add a second layer of suffering:
- “I am weak.”
- “I should be able to control this.”
- “I am making a big deal out of nothing.”
- “Something is wrong with me.”
- “I cannot trust my body.”
- “I will embarrass myself.”
These beliefs are common. They are also, in many cases, inaccurate—and they make recovery harder. Part of our work together involves examining where those beliefs come from, challenging the ones that do not hold up, and developing more effective and compassionate responses to distress.
Secure Telehealth Therapy Across 43 States
I provide sessions through secure telehealth for eligible clients across 43 states as a member of PsyPact. Telehealth may be a good fit if you:
- Have a demanding schedule with limited flexibility
- Travel frequently for work
- Prefer the privacy of connecting from a familiar space
- Feel anxious about traveling to in-person appointments
- Live outside a major metropolitan area
- Want access to specialized care without geographic limitations
You are welcome to contact Groundbreaker Therapy to confirm availability in your state or explore additional mental health resources and crisis services if you need other options.
When to Seek Professional Support
You do not need to wait until panic or anxiety feels unbearable before reaching out. Consider connecting with a mental health professional when:
- Panic attacks are recurring
- Anxiety feels difficult to manage or control
- Symptoms are interfering with work, school, or relationships
- Sleep is consistently disrupted
- You are avoiding activities that matter to you
- Fear of another episode has become a constant presence
- You are frequently seeking reassurance about physical symptoms
- Coping requires alcohol or other substances
- Your current tools are not enough
Seek medical evaluation when physical symptoms are new, unexplained, or changing. Seek immediate emergency or crisis assistance when you may harm yourself or someone else, when you cannot remain safe, or when you believe you may be having a medical emergency.
You Do Not Have to Navigate This Alone
Panic attacks usually begin suddenly and reach a high intensity quickly. What people call an anxiety attack is an informal term often used for anxiety that builds around stress, worry, or a feared situation. Both can involve uncomfortable physical and emotional symptoms. Physical symptoms should not automatically be attributed to anxiety. And effective professional support is available.
When your body feels out of control, it can be difficult to remember that there are ways to understand what is happening and respond more effectively. You do not have to shame yourself for having a strong nervous system response, and you do not have to manage recurring panic or anxiety alone.
If panic, intense anxiety, or fear of another attack is beginning to shape your decisions, relationships, or daily routine, I invite you to reach out.
At Groundbreaker Therapy, I work with highly sensitive and intelligent adults through secure telehealth across 43 states. Together, we can explore the patterns behind your symptoms, strengthen emotional regulation, and develop practical tools that reflect your individual needs.
Contact Groundbreaker Therapy to confirm availability in your state and determine whether working together may be the right fit, or review additional mental health and crisis resources if you need support in another setting.
Frequently Asked Questions
What is the main difference between a panic attack and an anxiety attack?
A panic attack is a clinically recognized episode defined in the DSM-5-TR, characterized by a sudden onset of intense fear or discomfort that peaks quickly—often within 10 to 20 minutes. An “anxiety attack” is an informal term people use to describe a period of intense anxiety that typically builds gradually around a specific stressor or worry. Both involve real, often distressing symptoms, but they differ in onset, intensity, and clinical definition.
Can you have a panic attack without knowing what triggered it?
Yes. Some panic attacks occur completely without an obvious trigger—sometimes called unexpected or spontaneous panic attacks. Others are connected to specific situations, sensations, or stressors. The presence or absence of a trigger does not determine whether the experience is real or significant.
Are chest pain and shortness of breath always signs of a panic attack?
No. Chest pain, shortness of breath, heart palpitations, and dizziness can accompany panic attacks, but they can also indicate medical conditions involving the heart, lungs, thyroid, blood sugar, or other systems. Never assume new, severe, or unexplained chest pain is caused by anxiety. Seek medical evaluation promptly for new symptoms, worsening symptoms, or if you feel medically urgent.
How long does a panic attack typically last?
Panic attacks generally reach their most intense point within approximately 10 to 20 minutes, though some symptoms may continue longer. Individual experiences vary, and assuming a fixed endpoint can increase distress when the timeline does not match expectations.
What is the difference between a panic attack and panic disorder?
A single panic attack does not mean a person has panic disorder. Panic disorder involves recurring, unexpected panic attacks along with persistent worry about future attacks or significant behavioral changes—such as avoiding situations associated with previous episodes. A mental health professional can help determine whether a diagnosis of panic disorder is appropriate.
What are effective treatments for panic disorder and anxiety disorders?
According to NIMH, cognitive behavioral therapy (CBT)—including exposure-based methods—is a well-supported treatment for panic disorder. DBT skills may support emotional regulation in some clients. Medication may also be part of a treatment plan for some individuals. The right approach depends on your specific symptoms, health history, and treatment goals and should be determined with a qualified professional.
When should I seek professional help for panic or anxiety?
Consider reaching out when panic attacks are recurring, anxiety is difficult to control, symptoms are interfering with work or relationships, sleep is consistently disrupted, or current coping tools are not enough. You do not need to reach a crisis point before seeking support. Connecting with a professional earlier may help you understand your symptoms, reduce avoidance, and access appropriate care before anxiety becomes more disruptive.
What is interoceptive exposure, and should I try it on my own?
Interoceptive exposure involves gradually and deliberately experiencing feared bodily sensations—such as a racing heart or shortness of breath—in a controlled, therapeutic context. It is a component of CBT for panic disorder. This work is most effective and safest when guided by a trained clinician. It is not recommended as a self-directed practice.
Can telehealth therapy help with panic attacks and anxiety?
Yes. Secure telehealth therapy can be an effective and accessible option for adults managing panic, anxiety, and related conditions. At Groundbreaker Therapy, Dr. Matthew G. Mandelbaum provides telepsychology services to eligible clients across 43 states. Contact Groundbreaker Therapy to confirm availability in your state.