Panic Attack vs Anxiety Attack: What’s the Difference? (And Why It Matters)

If you’ve ever sat in your parked car with your heart pounding, wondering whether you were having a heart attack or losing your mind, you’re in the right place. I’m Lindsey, a Registered Clinical Counsellor in Kelowna, and this question comes up in my practice all the time. Clients want to know what happened to them, and whether it has a name.

A panic attack is a sudden surge of intense fear that peaks within minutes, with strong physical symptoms like a racing heart and shortness of breath. An anxiety attack builds gradually in response to a stressor and can last hours or days. Panic attacks are defined in the DSM-5; “anxiety attack” is an everyday term, not a diagnosis.

What’s the difference between a panic attack and an anxiety attack?

The main differences are speed and duration. A panic attack is an abrupt surge of fear that peaks fast and passes within about 30 minutes. An anxiety attack is a slower build of worry and physical tension, usually tied to something specific, that can stretch across hours or days.

One thing that surprises most of my clients is that “anxiety attack” isn’t a clinical diagnosis. The DSM-5, the manual clinicians use, defines panic attacks in detail but leaves anxiety attacks out entirely. Your experience is still real. The term simply describes a common experience rather than a formal category, as Michigan Medicine explains.

In practice, the two can overlap. A long stretch of anxiety can tip into panic. A panic attack can leave anxious residue for days. The label matters less than noticing the pattern, because the pattern tells you what your nervous system needs.

What does a panic attack feel like?

A panic attack feels like your body has pulled a fire alarm without asking you first. It’s a sudden peak of intense fear with at least four of thirteen recognised symptoms: a pounding heart, chest pain, shortness of breath, trembling, dizziness, a sense of unreality, fear of losing control, or fear of dying, among others.

The DSM-5 lists all thirteen symptoms, and the Cleveland Clinic has a full plain-language overview. The physical intensity is the defining feature. Many people having a first panic attack end up in the emergency room convinced something is wrong with their heart. That’s a reasonable response to what the body is doing, and it’s worth ruling out medical causes. But when the tests come back clear, the answer is often panic.

Panic attacks can be unexpected, arriving out of nowhere, or situational, triggered by something specific like driving, crowds, or a particular memory. Both kinds are real, and both respond well to support.

What does an anxiety attack feel like?

Anxiety is a slower burn. Where panic explodes, anxiety accumulates. You might notice racing thoughts, a knot in your stomach, tight shoulders, irritability, trouble sleeping, and a sense of dread that follows you through the day. The intensity rises and falls, but it rarely disappears completely while the stressor is active.

Read more about why anxiety shows up in your gut.

Most of the women I work with describe anxiety as a background hum that occasionally gets loud. Before a difficult conversation, a medical appointment, or a family visit, the hum builds. Sometimes it crests into something that feels attack-like: a rush of overwhelm, tears, a need to escape. HelpGuide describes this build-up pattern well.

If this kind of anxiety is your daily baseline rather than an occasional visitor, that’s worth paying attention to. Persistent, hard-to-control worry across many areas of life is the core of generalized anxiety, and counselling can make a real difference with it.

Why does your body do this?

Both panic and anxiety are your nervous system doing its job too enthusiastically. When your brain perceives threat, real or imagined, the amygdala sounds an alarm and your body mobilizes: heart rate up, breathing fast, muscles primed. That’s fight-or-flight, and it evolved to keep you alive.

With panic, the alarm fires suddenly and at full volume, often without an obvious trigger. With anxiety, the alarm hums at a lower level for much longer. Both mean your threat-detection system has become oversensitive, usually for understandable reasons such as chronic stress, past experiences, loss, or a long season of carrying too much.

This is why I lean on somatic approaches in my practice. My Somatic Experiencing training taught me that panic and anxiety live in the body first, and thinking your way out of a body-level alarm rarely works. Learning to work with your nervous system directly, rather than arguing with it, changes the whole experience.

What helps in the moment?

Grounding techniques work by giving your nervous system evidence that you’re safe right now. They anchor your attention in the present, in your senses and your surroundings, which interrupts the alarm loop. A few that my clients find helpful:

A word about what tends to make things worse: fighting the panic, holding your breath, and telling yourself to calm down usually amplify the alarm. Panic peaks and passes on its own, typically within minutes. Riding the wave, uncomfortable as it is, teaches your body that the alarm ends and you survive it.

When should you get support?

Reach out if panic attacks keep returning, if you’ve started avoiding places for fear of having one, or if dread of the next attack has become its own constant worry. That pattern is what clinicians call panic disorder, and it responds well to counselling. The same goes for anxiety that has settled in as your daily default.

In my practice, counselling for panic and anxiety is client-led and body-aware. We move at your pace. Some sessions we track what your nervous system is doing and build your capacity to stay grounded. Some sessions we explore what your anxiety is protecting you from, because it’s almost always protecting something. I bring warmth and, when it fits, humour, because talking about scary things is easier when you don’t feel judged.

I hold a Masters in Counselling Psychology and I’m a Registered Clinical Counsellor with the BCACC. I see clients in person in Kelowna and West Kelowna, and virtually across British Columbia. You don’t need a referral, and you don’t need to have it figured out before you come.

FAQ

Can anxiety turn into a panic attack?

Yes. A long build-up of anxiety can cross a threshold and tip into panic. Many people experience both: chronic anxiety as the baseline, with occasional panic attacks layered on top. Counselling can address both patterns together.

How long does a panic attack last?

Most panic attacks peak within about 10 minutes and pass within 20 to 30 minutes. The after-effects, like shakiness and exhaustion, can linger for hours. If intense symptoms persist much longer, it may be waves of anxiety rather than a single panic attack.

Is a panic attack dangerous?

A panic attack is not medically dangerous, though it can feel terrifying. The racing heart and chest tightness come from your body’s alarm response rather than a heart problem. That said, first-time or unusual symptoms are worth checking with a doctor to rule out medical causes.

Why do panic attacks happen at night?

Nocturnal panic attacks can wake you from sleep with a pounding heart and a sense of doom. They’re thought to reflect the same oversensitive alarm system, firing while your guard is down. They’re common, treatable, and not a sign of anything more serious.

Do I need a diagnosis to start counselling?

No. You don’t need a diagnosis, a referral, or even certainty about what you’re experiencing. Many of my clients arrive saying “something happened and I don’t know what it was.” That’s a perfectly good starting point.

What kind of counselling helps with panic attacks?

Body-based approaches like Somatic Experiencing help you regulate the nervous system responses that drive panic. Cognitive approaches can also help with the fear of the next attack. In my practice, we combine nervous system work with exploring what’s underneath the anxiety, at your pace.

Can you have a panic attack for no reason?

It can feel that way. Unexpected panic attacks arrive without an obvious trigger, which is part of what makes them so unsettling. Usually there’s a build-up under the surface, like chronic stress or unprocessed loss, that primes the nervous system to fire. Counselling helps you find and work with those underlying patterns.

Is counselling for anxiety covered in BC?

Registered Clinical Counsellor services aren’t covered by MSP, but many extended health plans in BC cover RCC sessions. Check your plan for “Registered Clinical Counsellor” coverage. I can provide receipts for reimbursement.