The Difference Between an Anxiety Attack and a Hot Flash

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Hot flashes and anxiety attacks can feel remarkably similar, so similar that you may not be sure if you are having a hot flash or an anxiety attack. While neither one is a pleasant experience, it is comforting to know what is going on when your body breaks out in a sudden sweat, develops a rapid heartbeat and perhaps even dizziness. There are some differences between the two that will help you to distinguish between anxiety and hot flashes and decide how to treat each.


One difference between hot flashes and anxiety attacks are the ages at which they occur. According to the National Institute on Aging, menopause typically begins during a woman’s 40s or 50s.The onset of anxiety attacks can occur at any age, with early adulthood being a common time for people to experience a first anxiety attack. If you are flushing and sweating, and you are not in your middle to late 40s, with rare exceptions, it is safe to assume that you are having an anxiety attack and not a hot flash.


Anxiety attacks originate in a part of the brain called the amygdala. The amygdala is where the “fight or flight” reaction is housed. An overactive amygdala can set off the fight or flight reaction at inappropriate times. This causes the release of ephedrine, also known as adrenalin. The adrenaline is what causes the symptoms of anxiety.

Hot flashes are caused when the part of your brain that regulates heat gives off false signals that your body needs to cool down. Hence, sweating and flushing. This reaction is triggered by the hormonal fluctuations that take place during menopause.


Symptoms of an anxiety attack that most likely are not present during a menopausal hot flash are feelings of impending danger, trembling, nausea and hyperventilation. Sufferers of anxiety attacks may also experience a feeling of choking. If these symptoms are present along with sweating and flushing, it is likely an anxiety attack and not a hot flash.

Secondary Anxiety

Some people can have a hot flash that turns into an anxiety attack. The reason for this is secondary anxiety. Secondary anxiety is having “anxiety about anxiety.” What happens is that the person feels alarmed at the sensations from the hot flash. This fear creates additional bodily sensations, such as nausea, trembling or hyperventilation. Now the person is having a hot flash and an anxiety attack at the same time. The way to combat this is to recognize the symptoms of a hot flash, realize that they are harmless and will pass within a few minutes. This way, fear about hot flashes will not trigger an anxiety attack.


According to the North American Menopause Society, systemic estrogen therapy is the treatment of choice to stop hot flashes, although it has been shown to have its own health ramifications. A Medline Plus publication points out that estrogen therapy has been shown to increase the risk of stroke, cancer and heart disease. If you are having anxiety attacks, estrogen therapy is unlikely to have any beneficial effect at all. Treatment for anxiety attacks includes cognitive-behavioral therapy, anti-anxiety medications and antidepressants.