Have you ever experienced a sudden surge of overwhelming fear or anxiety that feels like it's taking over your body? Perhaps you have felt your heart rate increase, your palms become sweaty, and your breath becomes shallow and quick, all without a discernible cause. If so, it is possible that you have undergone a panic attack.
Panic attacks and panic disorder can be debilitating and disruptive to a person's life. Understanding the symptoms and seeking professional help can be the first steps toward managing and overcoming this condition.
What Is a Panic Attack?
Imagine feeling like you're on a rollercoaster, but instead of being strapped in and excited, you're gripped with fear and completely out of control. That's what a panic attack can feel like.
A panic attack is a sudden and terrifying experience that can leave a person feeling out of control and helpless. It can be set off by stress, trauma, or a phobia, and can strike at any moment, leaving you feeling like you're in a nightmare you can't escape. Physically, a panic attack can bring on heart palpitations, sweating, shaking, and a tightness in your chest that makes it hard to breathe. The sense of impending doom can be so intense that you feel like you're facing mortal danger.
What Is Panic Disorder?
While some individuals may experience panic attacks infrequently, for those with panic disorder, these episodes can be a frequent, persistent, and overwhelming challenge. Panic disorder is classified as an anxiety disorder marked by recurrent and unpredictable panic attacks, coupled with an ongoing apprehension of future attacks. This fear can be so intense that it can trigger avoidance behaviors, including social withdrawal and steering clear of specific situations, which can ultimately curtail a person's ability to enjoy a fulfilling life.
For example, imagine a person who experiences panic attacks while driving. They may begin to avoid driving altogether, which can limit their ability to work, attend social events, or even run errands. This avoidance behavior can become a vicious cycle, as it reinforces the fear and anxiety associated with panic attacks.
What Are the Symptoms of a Panic Attack?
Panic attacks typically begin suddenly, without warning. They can strike at any time — when you're driving a car, at the mall, sound asleep, or in the middle of a business meeting. You may have occasional panic attacks, or they may occur frequently. Most panic attacks last somewhere from 5 minutes to half an hour, but some people have reported attacks lasting up to an hour.
The symptoms of a panic attack include:
- Chest pain.
- Racing heart.
- Difficulty breathing, such as hyperventilation.
- Trembling or shaking.
- Tingling or numbness in your fingers or toes.
- Intense terror.
- A choking or smothering sensation.
- Fear of losing control.
- Feeling like you’re going to die.
- Derealization (feeling detached from reality) or depersonalization (feeling detached from yourself).
How Common Are Panic Attacks And Panic Disorder?
Panic attacks are common. Every year, up to 11% of people in the United States experience a panic attack1 and an estimated 2.7% of U.S. adults had panic disorder in the past year. Additionally, an estimated 4.7% of U.S. adults experience panic disorder at some time in their lives.2
What Causes Panic Attacks Or Panic Disorder?
While the specific cause of panic attacks and panic disorder is unclear, experts believe that the brain and nervous system play a crucial role in how individuals respond to feelings of fear and anxiety. Studies suggest that abnormalities in the amygdala, a part of the brain responsible for processing emotions like fear, may contribute to these conditions. Chemical imbalances in neurotransmitters such as GABA, cortisol, and serotonin may also be involved in the development of panic attacks and panic disorder. However, more research is necessary to fully understand the underlying causes and mechanisms of these conditions.
Complications of Panic Attacks and Panic Disorder
Left untreated, panic attacks and panic disorder can affect almost every area of your life.
Complications that panic attacks may cause or be linked to include:
- Development of specific phobias, such as fear of driving or leaving your home.
- Frequent medical care for health concerns and other medical conditions.
- Avoidance of social situations.
- Problems at work or school.
- Depression, anxiety disorders, and other psychiatric disorders.
- Increased risk of suicide or suicidal thoughts.
- Alcohol or another substance misuse.
- Financial problems.
For some people, panic disorder may include agoraphobia — avoiding places or situations that cause you anxiety because you fear being unable to escape or get help if you have a panic attack. Or you may become reliant on others to be with you in order to leave your home.
How Are Panic Attacks Diagnosed?
It is important to seek professional medical guidance if you suspect that you are experiencing panic attacks.
To exclude medical conditions that may mimic panic attack symptoms, such as heart disease, thyroid disease, or respiratory issues, tests may be conducted. These evaluations may include electrocardiograms, blood tests, or pulmonary function tests, depending on the specific symptoms presented. If no underlying physical cause is identified, your provider may diagnose you based on your symptoms and risk factors. This may involve a thorough discussion of your mental health history, your current stress levels, and any other relevant factors that could contribute to the development of panic attacks.
How Is Panic Disorder Diagnosed?
Medical or mental health providers can diagnose panic disorder based on criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a manual of mental health conditions utilized by medical or mental health providers to diagnose panic disorder.
Your provider may diagnose panic disorder when you have repeated, unexpected panic attacks as well as one month or more of:
- Persistently worrying about having more panic attacks or their consequences.
- Changing your behaviors to avoid situations that you think may trigger an attack.
In addition, the attacks can’t be due to the direct effects of a substance or general medical condition. And they can’t be better accounted for by another mental health condition, like a phobia or Post-Traumatic Stress Disorder (PTSD).
How Are Panic Attacks and Panic Disorder Treated?
Psychotherapy, medications or a combination of both are very effective in treating panic attacks and panic disorder. How long you’ll need treatment depends on the severity of the condition and how well you respond to treatment.
Specific types of psychotherapy that can help with panic attacks and panic disorder include:
Cognitive behavioral therapy (CBT). In this type of therapy, you discuss your thoughts and emotions with a mental health professional, such as a licensed counselor or psychologist. This specialist helps identify panic attack triggers so you can change your thinking, behaviors and reactions. As you start to respond differently to triggers, the attacks may decrease and ultimately stop.
Exposure therapy. This involves exposing you gradually and repeatedly — in your imagination and/or in reality — to whatever triggers a panic attack. Over time, you learn to become comfortable with the situation instead of it causing anxiety and panic. You’ll learn relaxation techniques, such as breathing exercises, to manage your anxiety throughout the process.
Medications that can help treat panic attacks and panic disorder include:
Antidepressants. Certain antidepressant medications can make panic attacks less frequent or less severe. Healthcare providers may prescribe serotonin-selective reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs).
Anti-anxiety medications. Providers most commonly prescribe benzodiazepines to treat and prevent panic attacks. They help with anxiety but have addiction potential, so it’s important to take them with caution.
How Can I Stop A Panic Attack?
While there’s no way to immediately stop a panic attack right after it starts, there are steps you can take to manage the symptoms until the attack resolves, including:
Practice deep breathing. Hyperventilating is a symptom of panic attacks that can increase fear. Deep breathing can reduce symptoms of panic during an attack. Breathe in as slowly, deeply and gently as you can through your nose and breathe out slowly through your mouth. Close your eyes and focus on your breathing.
Acknowledge that you’re having a panic attack. Knowing that you’re having a panic attack — and not a dangerous health episode — can help manage the fear you’re experiencing. Remind yourself that the attack is temporary and will pass.
Relax your muscles. Anxiety attacks can cause you to tense your muscles. Focus on relaxing one muscle group at a time to reduce tension and stay present.
Practice mindfulness. A panic attack can make you feel detached from reality or your body. Practice mindfulness and focus on the present to center your thoughts and ground yourself.
When to See a Health Professional
Panic attacks are very unpleasant and can be frightening. If you’ve had symptoms of a panic attack, it’s important to see a healthcare provider. They can give you an official diagnosis and ensure there’s no underlying physical cause.
If you have panic attack symptoms, seek medical help as soon as possible. Panic attacks, while intensely uncomfortable, are not dangerous. But panic attacks are hard to manage on your own, and they may get worse without treatment.
Panic attack symptoms can also resemble symptoms of other serious health problems, such as a heart attack, so it's important to get evaluated by your primary care provider if you aren't sure what's causing your symptoms.
More Resources About Panic Attacks
Visit the No Panic website for another breathing exercise to calm panic.
Panic Disorder: When Fear Overwhelms. National Institute of Mental Health. https://www.nimh.nih.gov/health/publications/panic-disorder-when-fear-overwhelms
- American Psychiatric Association (2013), Diagnostic and Statistical Manual of Mental Disorders (5th ed.), Arlington: American Psychiatric Publishing, pp. 214–217.
- National Institute of Mental Health. https://www.nimh.nih.gov/health/statistics/panic-disorder
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