You just felt a sense of worry and dread wash over you…even worse than that. You’ve never felt such awful anxiety before.

Did you just have an anxiety attack or a panic attack? As a Manhattan psychologist who has successfully treated thousands of New Yorkers with panic and anxiety, I’m happy to answer this question for you.

Allow me to explain.

(Please note that a “nervous breakdown” is something very different and often involves the complete inability to function after an extreme biological or environmental event. Chances are, if you’re able to read this article, you’re not having a nervous breakdown, but be sure to consult with a mental health professional to verify what you’re going through.)

The Difference Between Panic Attack and Anxiety Attack Symptoms

A panic attack is a different experience than an anxiety attack, although they do overlap. Allow me to explain what a panic attack is and that will help you understand much better.

  1. Panic attacks are not necessarily connected to a specific stressor. They may lead you to avoid certain places that bring on the horrific symptoms associated with a panic attack. Essentially, if you’re at home thinking about some event that may or will happen in the future and you’re freaking out, it’s probably an anxiety attack. If it feels like it came out of nowhere, it’s not connected to an event in the future and you need to escape a place you’re in, it’s probably panic.
  2. Panic attacks typically involve the need to escape a particular situation in which you’ve either already had a panic attack in the past or you’re in the situation when panic strikes and you must remove yourself immediately.
  3. Panic attacks are sudden and extreme, as opposed to an anxiety attack during which there is a build-up of anxiety.
  4. Panic attacks are often more disturbing for four reasons: (A) You feel like you’re going crazy while the panic attack lasts. It’s a sense that you’re losing your mind, which is an absolutely awful experience. (B) You’re aware on a rational and logical level how irrational your panic is. You totally understand that the place that brings out your panic attack is not dangerous, except for the belief/fear that going back to that place will bring about more panic attacks, which technically could happen. (C) Some people experience depersonalization, or the sense that you’re leaving your body, detached from yourself or watching yourself from a distance. (D) Some people experience derealization, or the sense that things aren’t real, almost like a cartoon. You may feel foggy-minded or spaced out. You may feel disconnected from your surroundings. The good news about the scary experiences of depersonalization and derealization is that they go away when you overcome your panic attacks.

In order to fully answer this question, you need to know the differences between anxiety and panic.

What Is Anxiety?

Anxiety is generally defined by a cluster of “anxiety disorders” as defined by the official Diagnostic Manual (DSM-5), but to simplify things, let’s just say that the primary difference between anxiety and panic is that you generally know what the stressor is and thinking about it makes you feel very nervous.

Anxiety has to do with the anticipation that a particular catastrophe will occur. The painful anticipation of danger can “build up” to the point where you have an “anxiety attack,” but this experience is not necessarily a panic attack, which is a more sudden and extreme form of anxiety. People living in New York City or other urban settings may be more prone to anxiety attacks.

What Are Anxiety Attack Symptoms?

An anxiety attack may include the following symptoms:

  1. Excessive worry
  2. Disturbed sleep
  3. Muscle tension
  4. Restlessness
  5. Fatigue
  6. Startle Response
  7. Repetitive worrying thoughts
  8. Difficulty with concentration
  9. Shortness of breath
  10. Rapid heart rate
  11. Dizziness
  12. Crying
  13. A sense that your mind is going blank

The anxiety feels like it’s building up and you’re freaking out. Anxiety is a natural response. We’re biologically wired to experience anxiety to keep us from potential danger. It’s just that many anxiety attacks are not on par with the actual risk involved in an anticipated situation.

The fast pace of the New York City lifestyle lends itself to promoting anxiety attacks. Therapy can certainly help to prepare you to handle future anxiety. Teaching anxiety management is one of my biggest strengths as a Manhattan psychologist. There are obvious lifestyle changes that can drastically reduce anxiety attacks, but therapy gets to a much deeper level in terms of helping you with the way you think about yourself, your commitments, abilities, relationships, ambitions, vulnerabilities, etc.

What Are Panic Attack Symptoms?

If it’s panic, you’re likely to feel something very sudden and intense . The key is that there’s no actual danger present, no negative event that you’re afraid of. If you’ve had multiple panic attacks, you might fear places in which or similar to one’s in which you’ve already panicked.

The following are symptoms of a panic attack:

  1. trembling
  2. rapid heart rate
  3. a sense of impending doom
  4. chest pain
  5. a sense of choking or suffocating
  6. dizziness
  7. nausea
  8. vomiting
  9. hyperventilating
  10. tunnel vision

Panic attacks are often associated with tight spaces, crowded places or gatherings where you perceive judgment or failure can take place.

The fear is often irrational, such as the idea that you’ll run out of air on the subway or crash on a plane.

Unfortunately panic attacks tend to repeat and they can come out of nowhere, but the sensations are often familiar (“Huh, I’ve had that feeling before last time I was this anxious.”)

The irrational element present when panicking allows many people to also say to themselves, “I totally know that there’s nothing to fear but I can’t help it.”

Panic attacks are often followed by a depressive experience, even a day later. There’s a strong correlation between panic disorder and depression, especially panic that is accompanied by agoraphobia, which is an anxiety disorder involving the fear of situations in which you might panic, such as a theater or on a bridge. Agoraphobia leads people to avoid these contexts to avoid potential panic attacks. A severe manifestation of agoraphobia is when you avoid leaving home in fear of having panic attacks.

New Yorkers may be more prone to panic attacks because of the number of crowded spaces and the ambitious personality types who are attracted to an intensely competitive environment such as Manhattan. New York City also attracts people who hold themselves to very high standards and who tend to be more controlling of their environment.

Treatment for Panic and Anxiety

I specialize in helping people overcome panic and anxiety. I’ve been doing this work for over 20 years and I love what I do. I can usually make a significant difference in your experience of panic attacks within the first three or four sessions.

Panic is usually even easier to treat if you’ve only had one or two panic attacks.

Don’t avoid getting help. You don’t have to feel ashamed. You don’t need to hide the problem, Feel free to contact me with your questions.