Anxiety can make the future feel dangerous before anything has happened. A panic attack can make danger feel immediate, even when you are sitting still, driving home, or waking from sleep.
The symptoms can overlap. Both may include racing thoughts, chest tightness, nausea, dizziness, a pounding heart, trembling, and shortness of breath. Both can be frightening. Yet the pattern, timing, and intensity may be different.
At One Mind, we help carefully selected patients in Fort Lauderdale who are living with anxiety, depression, PTSD, chronic pain, addiction, and other complex concerns. Understanding what you are experiencing is often a useful first step. It can help you describe your symptoms more clearly to a physician, therapist, or mental health provider.
Anxiety often builds and stays
Anxiety is not always a sudden event. It may be a persistent state of worry, vigilance, tension, or dread that follows you through the day. You may anticipate a difficult conversation for hours. You may replay something you said last week. You may feel unable to settle, even during quiet moments.
For some people, anxiety is largely cognitive. Thoughts race ahead toward worst-case outcomes. For others, it is primarily physical. The stomach tightens. The shoulders remain raised. Sleep becomes lighter. A small task can feel disproportionately difficult.
When fear or worry begins to interfere with everyday activities, relationships, sleep, or your ability to function, it deserves attention. Clinical writing on anxiety and its treatment has long recognized that anxiety can have both emotional and physical dimensions (Edwards, 1991).
Anxiety can also fluctuate. It may rise before work, social events, medical appointments, travel, financial stress, or periods of uncertainty. Sometimes there is an obvious reason. Sometimes there is not.
Panic attacks tend to arrive in a surge
A panic attack is usually more abrupt. Symptoms may intensify quickly and create a powerful sense that something is terribly wrong. Many people fear they are having a heart attack, losing control, fainting, or dying.
Common features can include:
- A racing or pounding heart
- Chest discomfort or pressure
- Shortness of breath or a choking sensation
- Sweating, shaking, or chills
- Dizziness, numbness, or tingling
- Nausea or stomach distress
- Feeling detached from yourself or your surroundings
- A sudden fear of catastrophe
A panic attack is not a character flaw. It is a deeply physical experience. Research has long explored how bodily sensations can become connected with fear, including the role of learned interpretations of physical symptoms in panic attacks (Ehlers, 1993).
The experience can be brief but overwhelming. Afterward, you may feel exhausted, embarrassed, or preoccupied with whether it will happen again. That worry can itself lead to avoidance. You may stop driving, exercising, entering crowded places, or going somewhere alone because you fear another episode. Recent qualitative work has also examined the lived experience of panic disorder and the ways it can disrupt daily life for adolescents (Baker et al., 2022).
The body can become the focus of fear
One important difference is where attention goes. With ongoing anxiety, concern may center on events, responsibilities, relationships, health, or uncertainty. During a panic attack, attention often narrows sharply toward the body.
A fast heartbeat may feel alarming. Then the fear of the heartbeat makes it faster. A short breath may feel dangerous. Then the effort to control breathing can make the sensation feel even more intense.
This does not mean the symptoms are imagined. They are real sensations. Research on sensitivity to carbon dioxide and breathing sensations has examined why respiratory changes may be especially provocative for some people with panic symptoms (Vickers, 2012).
The cycle can feel immediate. Sensation, alarm, more sensation, more alarm.
Chest pain and breathing changes should not be dismissed
Anxiety and panic can cause chest discomfort and shortness of breath. They can also resemble symptoms of medical conditions that need prompt attention. It is not safe to assume that new, severe, or unusual symptoms are anxiety.
Seek urgent medical evaluation for chest pain, pressure, fainting, severe shortness of breath, new weakness, confusion, or symptoms that feel different from anything you have experienced before. This is particularly important if symptoms occur with exertion, spread to the arm, jaw, back, or neck, or if you have known heart or lung disease.
It is better to have a medical concern evaluated than to minimize something important.
Panic attacks do not automatically mean panic disorder
Having a panic attack does not automatically mean you have panic disorder. A clinician considers the broader picture, including repeated unexpected attacks, ongoing fear of future attacks, avoidance, medical history, medications, substance use, sleep, trauma history, and other mental health symptoms.
Panic experiences can occur alongside many circumstances. They may arise during major stress, after poor sleep, during illness, after stimulant use, or during changes in alcohol, benzodiazepine, or other substance use. Benzodiazepine withdrawal, for example, can involve anxiety and other significant symptoms, which is one reason medication changes should be discussed with a qualified prescriber. Clinical research on benzodiazepine withdrawal describes the complexity of this syndrome (Pétursson, 1994).
Past experiences may matter as well. A recent study found associations between early trauma patterns, anxiety symptoms, and suicidal ideation among people diagnosed with panic disorder. Research on trauma and panic symptoms does not mean trauma explains every person’s experience, but it supports a fuller clinical conversation (Kim et al., 2023).
Treatment begins with the full clinical picture
There is no benefit in forcing every episode into a label before you have been heard. The more useful question is often, what is happening, how often, what makes it worse, and what is affecting your ability to live your life?
A thoughtful evaluation may include your medical history, psychiatric history, current medications, prior treatment, sleep, substance use, physical symptoms, and support system. Therapy, medication management, skills for responding differently to physical sensations, and medical evaluation can each have a role depending on your needs.
At One Mind, our anxiety-focused care begins with a detailed assessment of whether treatment is appropriate. We also recognize that anxiety may overlap with depression, trauma-related symptoms, chronic pain, or addiction, and those concerns deserve to be considered rather than separated into isolated boxes.
We provide physician-led IV ketamine therapy for carefully selected patients. Ketamine for psychiatric uses, including anxiety, is an off-label use. It is not a substitute for emergency care, and it is not presented as a one-size-fits-all answer. Patients considering IV ketamine for anxiety disorders should understand the potential benefits, limitations, safety considerations, and need for coordinated care.
What can help in the moment
When panic rises, the goal is not always to force it away. Fighting every sensation can sometimes add another layer of fear. Instead, try to orient yourself to the present.
- Name five things you can see around you.
- Put both feet firmly on the floor.
- Loosen your shoulders and jaw.
- Breathe slowly without forcing a deep breath.
- Remind yourself that intense sensations can pass.
- Contact someone you trust if you do not want to be alone.
These steps are not a cure. They can create a little space during a difficult moment.
If you are having thoughts of harming yourself, feel unable to stay safe, or are in emotional crisis, call or text 988 to reach the 988 Suicide and Crisis Lifeline. If there is immediate danger, call 911 or go to the nearest emergency department.
Frequently asked questions
Can anxiety cause a panic attack?
It can. Ongoing stress and anxiety may leave the nervous system more reactive, and a physical sensation or stressful event can become a tipping point. But panic attacks can also feel unexpected, which is one reason they can be so unsettling.
How long does a panic attack last?
The most intense symptoms often peak within minutes, though the aftereffects can linger. You may feel tired, shaky, emotionally raw, or concerned that another attack will occur.
When should I talk with a professional?
Consider reaching out when worry, fear, avoidance, sleep disruption, or physical symptoms are affecting work, relationships, school, health, or your ability to do ordinary things. You do not need to wait until symptoms become unbearable.
If anxiety or panic has begun to narrow your life, we invite you to contact One Mind at (954) 870-4768. We can help you begin with a careful conversation about your symptoms, medical needs, and whether our physician-led approach may fit within your broader care plan.
Works Cited
1. Edwards JG. Clinical anxiety and its treatment. https://pubmed.ncbi.nlm.nih.gov/1679207/
2. Ehlers A. Somatic symptoms and panic attacks: a retrospective study of learning experiences. https://pubmed.ncbi.nlm.nih.gov/8476401/
3. Baker HJ, et al. Adolescents’ lived experience of panic disorder: an interpretative phenomenological analysis. https://pubmed.ncbi.nlm.nih.gov/35668509/
4. Vickers K. Hypersensitivity to hypercapnia: definition/(s). https://pubmed.ncbi.nlm.nih.gov/22401967/
5. Pétursson H. The benzodiazepine withdrawal syndrome. https://pubmed.ncbi.nlm.nih.gov/7841856/
6. Kim HJ, et al. Early Trauma Subtypes are Differentially Related to Anxiety Symptomatology and Suicidal Ideation in Panic Disorder. https://pubmed.ncbi.nlm.nih.gov/38163660/
Disclaimer
This article is for educational purposes only and is not a substitute for individualized evaluation, diagnosis, or treatment from a qualified healthcare professional.