In a moment of intense panic, it can be terrifyingly hard to tell what’s happening to your body. Is your racing heart and shortness of breath just a severe anxiety attack, or is it something more serious, like a seizure? The symptoms can be startlingly similar, leading to confusion, fear, and even misdiagnosis.
This article breaks down the key distinctions between an anxiety or panic attack and a seizure, so you can better understand what you’re experiencing and, more importantly, get the right help.
Anxiety Attack vs. Seizure: A Quick Comparison
While both can cause intense physical and psychological symptoms, they originate from different places. An anxiety attack is a mental health event, a misfiring of your body’s “fight or flight” response. A seizure is a neurological event, caused by a sudden, abnormal electrical discharge in the brain.
Here’s a simple table to help you spot the immediate differences:
| Symptom | Anxiety/Panic Attack | Seizure (Epileptic) |
|---|---|---|
| Consciousness & Awareness | Usually remains aware of surroundings, though may feel “detached.” | Often involves a loss or impairment of consciousness. |
| Duration | Typically peaks within 10 minutes and resolves within 20–30 minutes. | Usually lasts less than 2–3 minutes. |
| Repetitive Movements | Shaking or trembling is common, but movements are generally not rhythmic or repetitive. | Often involves rhythmic, uncontrolled jerking, shaking, lip smacking, or staring spells. |
| Aftermath | May feel exhausted, drained, or embarrassed. Awareness and memory are intact. | May be confused, disoriented, or sleepy for several minutes or hours after. Memory of the event is often missing. |
| Triggers | Often triggered by stress, fear, or specific situations, but can also occur spontaneously. | Can be triggered by stress, sleep deprivation, flashing lights, or illness, but is caused by abnormal brain activity. |
Detailed Symptoms: How to Tell Them Apart
Let’s dig a little deeper into the specific symptoms for each. Knowing these nuances is crucial.
Symptoms of an Anxiety or Panic Attack
These symptoms are rooted in your body’s exaggerated response to a perceived threat.
- Physical Symptoms: Rapid heart rate, chest pain, sweating, trembling, shortness of breath, dizziness, nausea, and hot flashes or chills.
- Psychological Symptoms: An intense feeling of impending doom, fear of dying, losing control, or going crazy. Many people also report feelings of unreality or detachment (derealization or depersonalization).
- Movement: Shaking and trembling are common but are not the sustained, rhythmic movements seen in a seizure. The individual can usually be comforted or spoken to.
Symptoms of an Epileptic Seizure
A seizure can manifest in many different ways, depending on which part of the brain is affected.
- Physical Symptoms: Sudden stiffening of the body (tonic), uncontrolled jerking of the limbs (clonic), staring spells (absence), or a sudden loss of muscle tone (atonic).
- Loss of Consciousness: This is a key differentiator. During a generalized tonic-clonic seizure, the person will fall to the ground and be completely unconscious and unresponsive.
- Repetitive Movements: These are often automatic, uncontrolled, and rhythmic. Examples include lip smacking, chewing, hand rubbing, or repetitive leg movements.
- Post-Seizure State (Postictal Phase): The person may be confused, drowsy, or disoriented for minutes or even hours after the seizure ends. They will often have no memory of the event.
What About Psychogenic Non-Epileptic Seizures (PNES)?
This is where things can get more complicated. A psychogenic non-epileptic seizure (PNES) is a seizure-like episode that is not caused by abnormal electrical activity in the brain. Instead, it is a physical manifestation of psychological distress, such as severe stress, trauma, or anxiety.
PNES can look very similar to epileptic seizures, but a key difference is what a doctor sees on an EEG (a test that measures brain waves). A person with PNES will not show the abnormal brain activity that a person with epilepsy does. These episodes are real and can be just as frightening, but they require psychological and psychiatric treatment, not anti-seizure medication.
When to See a Doctor
If you or someone you know is experiencing these episodes, it’s essential to seek medical help for an accurate diagnosis.
- It’s your first time having such an episode.
- The episode involves a loss of consciousness.
- You experience confusion or memory loss afterward.
- The episodes are becoming more frequent or severe.
- You have a history of head injuries or neurological conditions.
Your doctor will likely conduct a thorough examination and may order tests like an EEG or an MRI to determine the underlying cause. Getting an accurate diagnosis is the first and most important step toward finding effective treatment and managing your health.
The Takeaway
While an anxiety attack and a seizure can both be terrifying and share some surface-level symptoms, their origins and key characteristics are different. A panic attack is a psychological event with physical symptoms, while a seizure is a neurological one. Pay close attention to factors like duration, loss of awareness, and the presence of rhythmic movements. This can help you and your medical team find the right path to relief.
