Panic Attack or Anxiety Attack: What Is the Difference
May 02, 2025
As the school year approaches and social situations evolve, stress and anxiety can affect both children and adults. When these feelings build up, they may lead to physical symptoms that feel overwhelming. Racing heartbeats, tense muscles, difficulty breathing, shaking, and even tunnel vision are common signs that something may be wrong. But what exactly is happening? Are these symptoms caused by a panic attack or an anxiety attack? And is there a difference between the two?
Panic attacks and anxiety attacks are often used interchangeably because they share many similarities. Both involve the activation of the nervous system, triggering a "fight or flight" response, which leads to intense physical symptoms. However, important differences exist – especially regarding what happens before the attack.
Note: While “anxiety attack” is a common phrase, it is not an official diagnosis. Only “panic attacks” are formally recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR).
Additionally, factors such as the ongoing effects of the COVID-19 pandemic, changes in school routines, and social reintegration following the COVID-19 pandemic have contributed to higher rates of anxiety and panic symptoms among children and adolescents.
Panic Attacks vs. Anxiety Attacks: Key Differences
Here’s a quick side-by-side comparison to help clarify:
Feature
Panic Attack
Anxiety Attack
Onset
Sudden and often unpredictable
Gradual build-up in response to stress or worry
Triggers
May occur with or without an obvious trigger
Typically linked to an ongoing stressor
Duration
Peaks within minutes; short-lived
May last longer; can persist as long as stress remains
Physical Symptoms
Intense: rapid heart rate, shaking, shortness of breath
Similar symptoms but often less intense and more variable
Emotional Impact
Feeling of losing control, fear of dying or "going crazy”
Feelings of worry, dread, or fear about a specific concern
Parental Response
May lead parents to seek immediate medical attention for their child
Parents may notice their child’s anxiety building up over time, which makes anxiety attacks less surprising when they occur
Managing Panic and Anxiety Attacks
When a child experiences a panic or anxiety attack, several strategies can help them regain control and calm their body. Mental health professionals often recommend these techniques:
Grounding Techniques:
Focus on the present moment and surroundings to create a sense of safety and control. Encourage your child to notice the feeling of the chair they’re sitting on or identify five things they can see, four they can feel, three they can hear, two they can smell, and one they can taste.
Breathing Exercises:
Slow, deep breathing can help regulate the nervous system. Teach your child to breathe in slowly through the nose, counting to four or five, and then exhale slowly through the mouth, counting to four or five. Visualizing activities like blowing up a balloon or moving a ball around a track can make it easier for younger children to focus on their breathing.
Positive Self-Talk and Distraction:
Help your child practice reassuring thoughts, such as reminding themselves that they are safe and that the attack will pass. If they struggle to calming thoughts distraction games, like naming all the U.S. States or singing a favorite song, can shift their focus away from the distressing feelings they are experiencing.
Technology Supports:
Some children may find mindfulness or breathing apps helpful for managing anxiety symptoms. Simple breathing pacer apps offer many guided exercises that children and adolescents can use during or after an attack. These apps can also be used for maintenance, helping children and adolescents prevent future attacks.
When to Seek Help
It is important for parents to know that panic and anxiety attacks are common, with around 40% of people experiencing at least one in their lifetime. However, fear of future attacks can itself become a source of stress, sometimes leading children to avoid certain activities.
While occasional attacks are normal, frequent or severe attacks may signal an underlying anxiety disorder. If your child’s symptoms persist, worsen, or interfere with daily life, consider reaching out to a therapist or counselor. Early support can help your child build skills to manage anxiety more effectively and feel more confident navigating stressful situations, which will benefit them in the long term.
Laura Cook, PhD, is a pediatric psychologist at Nationwide Children's Hospital.
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