Anxiety Attack vs. Panic Attack: How to Spot the Difference in Teens
Anxiety disorders are the most common of all mental disorders. They're so common that they affect up to 30 percent of adults at one point or another. It's not just a grownup issue, either.
About a third of adolescents will experience an anxiety disorder before graduating from high school. Symptoms can be mild or debilitating, leaving parents wondering what's normal, school-related stress and what's something more. Panic attacks and anxiety attacks are more common than you might think. Let's break down what the difference is between the two, and how to help your teen cope.
What's the Difference Between an Anxiety Attack and a Panic Attack?
Panic attacks and anxiety attacks are both unpleasant, and the terms are often used interchangeably. They aren't quite the same, however. As a rule of thumb, panic attacks tend to be more intense and don't always have an obvious trigger, while anxiety attacks occur in response to a stressor.
In a panic attack:
- Symptoms usually appear abruptly
- Symptoms can be intense, disruptive and lead to a sense of detachment
- Symptoms usually have a trigger, but not always
- They usually fade in intensity after a few minutes
In an anxiety attack:
- Symptoms can build gradually over time
- They vary in intensity from mild to debilitating
- They're always a response to a perceived threat
- They may persist for longer spans of time
Panic disorders are a type of anxiety disorder, and they come with their own set of symptoms. These include a rapid heart rate, dizziness, nausea, hot flashes, chest pain, shaking, shortness of breath, sweating, numbness in the extremities and stomach aches.
When you're experiencing a panic attack, you might feel like you don't have any control or have an intense fear that you're about to die. You might also feel like you're not in your body, instead feeling detached and emotionally removed.
Anxiety attacks, on the other hand, are not a diagnosable condition. They're a product of other anxiety disorders, particularly generalized anxiety disorder (GAD). They often follow prolonged periods of intense worry or stress. Instead of appearing suddenly, anxiety attacks manifest as the intensity of existing anxiety symptoms increases. These include nervousness, difficulty focusing, irritability, elevated heart rate, rapid breathing, shaking, trouble sleeping and a sense of impending danger.
At the end of the day, both panic attacks and anxiety attacks have similar, distressing symptoms. Which one your teen is experiencing matters less than developing a strategy to keep anxiety symptoms at bay.
How Does Anxiety Look Different in Teens?
Anxiety symptoms are very similar in teens as they are in adults, but how they appear from the outside can be very different. Younger kids are likely to share their worries with parents, but teens tend to do the opposite. The issues that often trigger anxious feelings in teens can feel embarrassing or private.
Entering puberty before or after their peers can trigger social anxiety. Challenging subjects at school or the pressure to get into a good college are other common stressors, but teens aren't always comfortable being vulnerable with their parents. Teens with new or worsening anxiety may:
- Withdraw socially
- Become more irritable
- Become very sensitive to criticism
- Seem distracted
- Avoid activities that are new or challenging
- Skip school
- Have frequent headaches or stomachaches
- Have an irregular sleep schedule
- Beginning to rely on alcohol or other substances for stress relief
It's important for parents to recognize that these reactions are not indicators that your child is lazy, unmotivated or intentionally disobedient. Kids, even in their teen years, don't want to disappoint their parents. They may feel weak or or overly sensitive for struggling to cope. Asking for help can feel like a sign of failure, particularly in perfectionistic, high-achieving teens.
If you notice a shift in your child's behavior, there's likely a reason. Before assuming they're acting out just because they've hit a rebellious phase, talk to them to see if something else is going on. Be openminded, reassuring and calm, not accusatory. You can't help them get back on track if they won't open up to you, right? The easier you make it for them to do so, the better.
Some Anxiety Is Normal
It's important to note that feeling anxious from time to time is no big deal. Anxiety is a normal, healthy emotion. Its purpose is to alert the body that a potential threat is on the horizon, allowing it time to prepare to react accordingly. Feeling anxious before the first day of school or a big track meet is completely par for the course.
To keep mild, intermittent anxiety at bay can be simple for teens. Staying involved in extracurricular activities they love, spending time with good friends on a regular basis, and having support and encouragement at home is usually enough to keep first-day-on-varsity-cheer jitters to a minimum.
Anxiety Is a Problem When It Becomes Chronic
Maintaining a healthy balance between school and fun, plus having a solid support system is usually enough, but what happens when it's not? When stressors become too much for teens to cope with, their anxious response can become exaggerated and ongoing.
Mild stress is common, but it can snowball into being chronically on high alert. If they feel stressed and on edge 24/7, even when there's no mid-term or event coming up, it may be a sign that they have a problem with anxiety.
Why Your Reaction as a Parent Matters
When anxiety spirals out of control, it makes it harder to continue with the activities that normally ease it. Making and keeping friends, participating in sports and staying close with family become more difficult. As the anxiety builds, your teen may become increasingly withdrawn, leading to feelings of isolation, self-doubt and even depression.
If your usually bubbly teenager is suddenly rude and never wants to leave their room, don't brush it off as "normal teenage stuff." Punishing them for skipping school, faking an illness or refusing to come to a family get-together is often the worst thing you can do.
Put yourself in their shoes. Imagine you're 15. You're struggling to understand your homework, and you can't sleep because you're so worried about it. You go to school exhausted and bomb a test, so you ditch the next day in hopes of catching up on your own. Instead, it's so overwhelming that you avoid it instead and feel even worse about yourself as a result. Your friends want to know what's going on, but you don't know what to say, so you just stop texting back. Then, your mom sees your last test score and blows up about it. Would you tell her what's really going on, or would you feel even more anxious?
Run-of-the-mill moodiness is a possibility, but so is an anxiety disorder, and that isn't something they can nap and TikTok their way out of. Avoid jumping to conclusions. Kids are rarely trying to behave badly. Even when you do have to enforce consequences, do so with compassion and reassurance. That way, they'll see mom or dad as someone they can trust to help them with the tough stuff, not another person they have to put on a brave face for.
Worried About Medication? It's Not the Only Treatment Option
Anxiety disorders can sometimes require antidepressant medication, but that's not always the case. Cognitive behavioral therapy (CBT) is usually the first line of defense against anxiety in teens, and it's incredibly effective. It teaches kids how to think about their anxiety in a different way, learn to tolerate it better and reduce their anxious responses to triggers.
CBT is often an effective treatment all on its own. If it's not, a combination of CBT and an SSRI (selective serotonin reuptake inhibitor) antidepressant may be a better option. That said, going on medication is always a choice. If it doesn't work for your teen, stopping it is no big deal. Some people also find they only need their medication during especially stressful periods, like starting at a new school or moving.
There is no one-size-fits-all anxiety treatment, but the key is to start somewhere. If your child shows any signs or symptoms that suggest they may have an anxiety or panic disorder, ask their doctor for a referral to a psychiatrist or cognitive behavioral therapist who specializes in adolescent mental health.
For more reading on supporting your child's mental health: