Classifying different types of anxiety attacks can be difficult. “Anxiety attack” is not an official clinical term. You won’t find it in the “Diagnostic and Statistical Manual of Mental Disorders,” the handbook most mental health professionals reference. There is also the issue of both mental health clients and professionals confusing anxiety attacks and panic attacks.
“Anxiety attack” is a colloquial term clients created to describe intense or extended periods of anxiety. On a scale of intensity, an anxiety attack is between mild feelings of anxiety and a panic attack. Because of its frequency, many mental health professionals adopted it. To learn more about what an anxiety attack is and dispel any confusion, read our piece on anxiety attacks vs. panic attacks.
Unlike repeated panic attacks, anxiety attacks are not necessarily a sign of a mental health condition. If you are experiencing a lot of stress or going through a rough patch in life, it’s natural to have intense anxiety that occurs frequently. Experiencing many anxiety attacks without an apparent cause, however, can be a sign of an anxiety disorder.
Despite it not being an official clinical term, there are types of anxiety attacks. Many therapists recognize they are legitimate mental health issues. We decided to classify them based on the factors that determine how people experience an anxiety attack.
The 5 Factors in Different Types of Anxiety Attacks
Here are the five factors that distinguish different types of anxiety attacks:
- Causes: Thoughts vs. Situations
- Expected vs. Unexpected
- Physiological Symptoms
Causes: Thoughts vs. Situations
Both thoughts and situations cause anxiety attacks. The experience is different, however.
The causes tend to point to different issues as well. Thought-based anxiety attacks can be signs of generalized anxiety disorder. Situation-based anxiety attacks might can be symptoms of social phobias or social anxiety disorder.
Some anxiety attacks happen regardless of immediate external stimuli. These usually start with chains of anxious thoughts that build in momentum until they cause physiological symptoms. The thoughts are often part of apprehension about the future.
Below are some examples of these thought patterns. Therapist Asta Klimaite documented common anxious thoughts her clients had. Below are the most common:
- People know I have anxiety and they judge me.
- I am sick with a terminal illness and my doctor just didn’t diagnose me correctly. I am going to die soon.
- I am going to be fired. If I will be fired, I won’t be able to support my family and we will be homeless. If we are homeless, I will be a bad parent/partner/daughter/child. If I am a bad person, I am a failure.
- I will get into a car accident and my insurance premium will go up. I am going to look like an idiot or I am going to kill myself in this car accident.
- I am a bad parent and everyone knows it.
These feelings of anxiety stem from specific situations rather than general concerns about life or health. Let’s say you have a public speech coming up. You might have anxious thoughts like: “I’m going to make a bad speech. I’m going to get nervous. People are going to notice how nervous I am.”
Therapist Ginger Poag offered the example of her clients worrying about a family reunion during Christmas or Thanksgiving. They worry about who is going to be there and who is going to say what. Repeatedly imagining how everything could go wrong builds a sense of dread.
These types of thoughts can snowball until anxiety is out of control. You might eventually come to expect these situations to induce anxiety attacks. This can create meta anxiety: anxiety about the possibility of experiencing anxiety, especially during certain situations. Anxiety can be a self-fulfilling prophecy.
Expected vs. Unexpected
Whether people expect an anxiety attack can shape how they process it. When anxiety attacks happen unexpectedly, they might be more frightening and difficult to cope with. Expecting the attack may cause a feeling of dread, but it can also make the coping process easier.
If you have an anxiety attack as part of a general pattern, you will most likely have a great deal of expectations around the attack before it happens. It might creep up as the anxious thoughts build upon each other — the aforementioned meta anxiety.
These expected anxieties are often situational. If you’re dreading a situation, you will start to feel anxious about it before and during the events.
An anxiety attack can also be about a general worry you have. It could be something you have ruminated upon so many times you now recognize it as a source of anxiety, something you expect to cause an anxiety attack.
Sometimes anxiety attacks happen without a clear source. When you don’t know what is causing them, they are almost impossible to predict. According to psychiatrist Gabby Farkas, unexpected anxiety attacks are often a sign of an anxiety disorder, including generalized anxiety disorder and panic disorder.
Here are some common symptoms of anxiety and anxiety attacks:
- Restlessness, feeling wound-up or on edge
- Being easily fatigued
- Difficulty concentrating or having your mind go blank
- Muscle tension
- Difficulty controlling worries
- Sleep problems (difficulty falling or staying asleep, or restless, unsatisfying sleep)
If you study these symptoms, you might discover which thoughts or situations trigger them. Maybe worries about your health make you irritable while anxieties regarding your career keep you up at night. Presentations or tests might make you feel restless while anxiety about dating causes fatigue. Learning the correlations can inform treatment and help you cope.
Anxiety attacks can last anywhere from minutes to hours, days, even weeks. They can also occur with varying frequencies. People can have several in one day or only one every couple of months.
Both duration and frequency depend on the causes of the anxiety attacks. For example, someone with an anxiety disorder might experience daily anxiety attacks that last at least an hour. On the other hand, someone who doesn’t have an anxiety disorder will most likely have attacks that are brief (maybe only 10 minutes) and less frequent.
Stress is a factor as well. Even if someone doesn’t have a diagnosable anxiety disorder, they may experience frequent and long anxiety attacks when there are extreme levels of stress in their life.
There are a few ways to measure the intensity of an anxiety attack. One is by looking at the number of symptoms that occur. Experiencing the combination of shortness of breath, muscle tension, and insomnia is obviously more intense than only experiencing one symptom.
Another measure is how debilitating the attack is. If the attack is so intense that it includes symptoms such as choking and a feeling of dying or having a heart attack, it might not be an anxiety attack, but a panic attack.
Understanding Yourself and the Different Types of Anxiety Attacks
Our minds are like oceans of causes and effects. Each memory, thought and emotion connects to one another and sends ripples through our bodies. When we experience anxiety attacks, these ripples become waves that disrupt our lives. By picking apart the factors that create them, you can find the sources of anxiety and identify the types of anxiety attacks you experience. Understanding more about anxiety will bring you one step closer to reducing it.