Anxiety Attack vs Hyperventilation: How to Tell the Difference

When it comes to knowing the difference between an anxiety attack vs hyperventilation, many people are understandably confused, because they are often experienced together but not always, and are distinct experiences.

In this article, we will offer some clarity on the differences and commonalities of anxiety attacks and hyperventilation. Both panic attacks and hyperventilation are manageable with proper understanding, techniques, and treatment. We will use the terms panic attack and anxiety attack interchangeably throughout this article. 

What Is an Anxiety Attack?

Panic attacks are often called “anxiety attacks,” and these are episodes of severe anxiety. During a panic attack, one’s overall nervous system is impacted, and people can experience physical symptoms such as shortness of breath, chest pain, rapid heart rate, and dizziness. People can also experience psychological symptoms, such as feelings of fear and thoughts that may make sense at the time but are actually unhelpful. 

Panic attacks can be caused by several things, including experiencing trauma or a threat to one’s safety, flashbacks and reminders of trauma, exposure to a perceived threat that evokes fear, certain medical conditions, and they are associated with several mental health disorders, such as panic disorder. Some people experience them for no clearly identified reason.

People experience panic attacks differently. They can last from 10 minutes to several hours, while some people may experience them more often than others. 

What Is Hyperventilation?

Hyperventilation is a breathing pattern where one “overbreathes,” or one takes more breaths than needed. This can lead to the carbon dioxide levels in the blood getting too low and oxygen levels becoming too high. When this happens, blood vessels narrow, which can cause many distressing symptoms.

Psychological factors, such as trauma, fear, or discomfort, are the most common causes of hyperventilation. Additionally, many medical conditions can cause hyperventilation, including injuries, infections, diseases, and certain medications.

How Anxiety Attacks and Hyperventiliation Overlap

Hyperventilation is a common symptom of panic attacks. When one experiences severe anxiety and feels as if one’s safety is in danger, our bodies want to prepare us to ensure our safety with the“fight or flight” response, which requires extra oxygen. Therefore, one’s body begins to hyperventilate to obtain extra oxygen.

However, if it isn’t actually needed, as in the case of many people’s experience of anxiety-induced hyperventilation, too much oxygen builds up and carbon dioxide drops, which causes uncomfortable symptoms.

These symptoms can add to someone’s existing level of stress, thereby creating a vicious cycle that increases anxiety, which can then make the hyperventilation worse. Many of the physical symptoms of hyperventilation and panic attacks overlap, making them something that is a related experience for many people.

Hyperventilation syndrome is a recognized medical condition in which one hyperventilates due to feelings of fear or for an unidentifiable reason. It is something many people who experience panic attacks experience, but not all. When caused by psychological factors, neither condition is dangerous, though they can feel very frightening. 

Recognizing the Symptoms

Understanding the symptoms of both panic attacks and hyperventilation can help to show how they are distinct but have many shared characteristics. 

Anxiety Attack Symptoms

If one experiences four or more of the symptoms below, one is likely having a panic attack:

• Feelings of fear, dread, and panic
• Chest tightness or pain, pounding or increased heartbeat, and heart palpitations
• Sense of losing control or impending doom
• Chills or hot flashes, including sweating
• Shortness of breath or hyperventilation 
• Feeling as if one is being suffocated or choked
• Feeling dizzy or unsteady
• Numbness or tingling sensations, especially in one’s limbs
• Lightheadedness or as if one is about to faint
• Nausea or digestive distress
• Shaking or tremors
• Feelings of unreality 
• Feeling detached from oneself
• Fears about death or dying
• Feeling as if one is losing control 

Hyperventilation Symptoms

Hyperventilation symptoms can include some, but not all, of the following: 

• Rapid, shallow breathing pattern or shortness of breath

• Tingling or numbness in the extremities or around the mouth
• Lightheadedness, dizziness, or weakness
• Muscle spasms or cramping
• Feeling of not getting enough air (air hunger)
• Trouble focusing
• Dry mouth
• Headaches
• Digestive upset
• Chest pain
• Pounding or accelerated heartbeat

Distinguishing Between the Two

As you can see from above, differentiating between hyperventilation vs panic attacks is often difficult because there is considerable overlap.

However, a key difference between an anxiety attack and hyperventilation is the presence or absence of psychological distress. Hyperventilation alone is an isolated breathing issue, while a panic attack is a full-body anxiety response. Context also matters, and situations that trigger hyperventilation alone differ from those that trigger a panic attack.

What Causes Each Condition

In the next section, we will outline some of the most common contributing factors and causes to both panic attacks and hyperventilation.

Anxiety Attack Triggers

Panic attacks are often caused by significant stress and anxiety, as well as emotional overwhelm. It is often experienced during or after a traumatic event.

Some people experience them due to a specific phobia or when exposed to a situation that evokes fear. Many people who have underlying anxiety disorders are more prone to experiencing anxiety attacks. 

Hyperventilation Triggers

Hyperventilation is most commonly caused by severe anxiety and occurs during a panic attack. Medical conditions can also cause it, and in addition to what we discussed above, people with asthma, pain, breathing pattern disorder, and metabolic issues are at an increased likelihood of experiencing hyperventilation. It can also be triggered by high altitude or exercise, and sometimes there is no identifiable cause. 

Immediate Response Strategies

Managing Anxiety Attacks

Move to a safe, quiet space to reduce sensory and social stimuli. Acknowledging and accepting the experience can take some of the power away from the helplessness severe anxiety can cause. Using helpful self-talk and reassurance can help to de-escalate the situation.

Progressive muscle relaxation can be very helpful since it’s a physical intervention, and the experience or anxiety is highly physical.

Try tensing and relaxing muscles while taking slow, deep breaths; start at the head, working one’s way down through the torso, all the way to the feet.

Breathing during a panic attack is especially important, and taking slow, controlled breaths can help regulate one’s nervous system.

The 5-4-3-2-1 exercise is a simple yet effective grounding technique that can shift one’s focus away from the trigger of the anxiety attack back to the present moment. Use your five senses to name:

• 5 things you see
• 4 things you hear
• 3 things you feel or touch
• 2 things you smell
• 1 thing you taste 

Stopping Hyperventilation

If one experiences hyperventilation, during a panic attack or not, the best strategies are those that focus on controlling the breath. In all the exercises below, focus on exhaling fully to receive maximum benefit. Here are several strategies to try if one is hyperventilating:

• The 4-7-8 technique, which includes breathing in for 4 seconds, holding one’s breath for 7 seconds, and exhaling for 8 seconds.
• Box breathing, which includes breathing in for 4 seconds, holding in the breath for 4 seconds, exhaling for 4 seconds, and pausing for 4 seconds.
• Breathing slowly through pursed lips can help control the amount of air inhaled.
• The paper bag method, when appropriate and safe, involves breathing into and out of a paper bag to help re-regulate the balance of oxygen and carbon dioxide in the blood.

When Both Are Present

When experiencing both an anxiety attack and hyperventilation, prioritize breath regulation first. Then try the physical calming techniques in addition to the self-talk strategies discussed above. Many people experience increased anxiety about their feelings of panic. If that is true for you, remind yourself that panic isn’t dangerous and that these feelings and sensations will pass. Try your best to stay grounded and patient. 

When to Seek Medical Help

Occasional experiences of hyperventilation are mostly harmless and not a threat to one’s health. However, there are some circumstances where it’s best to see a healthcare provider:

• If you are experiencing a first-time episode of hyperventilation, this could be a sign of a medical emergency, so going to your nearest urgent care or emergency room is advised. 
• If you are hyperventilating after experiencing a head injury, if you are bleeding, if you are in pain, or have a fever. 
• If the hyperventilation increases in frequency or severity, and doesn’t improve with the home remedies discussed above. 
• If you have other symptoms, such as chest pain.

Takeaway

Recovery from panic attacks and hyperventilation is possible. Accurate diagnosis by a licensed healthcare clinician matters for effective treatment and management of both conditions. Professional support is available and effective. Treatment can include talk therapy, medications, peer support, and lifestyle changes. 

If you or your loved one is looking for mental healthcare or crisis support and prevention, reach out to us at Willow Health today. We offer same-day or next-day appointments with both a psychotherapist and a psychiatric medication clinician, who can assess your needs and identify a plan for individualized care. 

Sources 

Symptoms of Panic Disorder 

Panic Disorder: MedlinePlus 

Hyperventilation: MedlinePlus Medical Encyclopedia 

Hyperventilation Syndrome: Why Is It Regularly Overlooked? - The American Journal of Medicine