A panic attack is a sudden rush of fear and anxiety that causes both physical and psychological symptoms. The level of fear experienced is unrealistic and out of proportion to the events or circumstances that trigger the panic attack. Anyone can have a single panic attack, but frequent and ongoing episodes may be a sign of a panic or anxiety disorder that requires close medical attention and treatment.
The physical symptoms of a panic attack can include:
- Fast breathing
- Shortness of breath
- Severe perspiration
- Dizziness, feeling faint
- Numbness or tingling
- Chills or sensations of heat, hot flashes
- Tightness in the chest, throat
- Increased heart rate
- Disconnection from oneself
- Loss of control
- Imminent danger
- A strong desire to flee or avoid the situation
These symptoms, which often resemble the symptoms of a heart attack or respiratory disorder, may be accompanied by a fear of dying. The onset of symptoms is sudden and can develop from either a calm or anxious state. Some people experience limited-symptom panic attacks, which consist of less than four of the common symptoms listed above. Panic attacks last from about five to 20 minutes, generally peaking within 10 minutes. A panic attack can occur several times within the span of a few hours and, for some people, every day or once a week. Those who have frequent panic attacks often come to recognize the situations that trigger an attack and learn to be prepared.
In a heart attack or a panic attack, an individual may feel symptoms like chest pain, shortness of breath, and sweating. However, the chest pain in a panic attack can be sharp and stabbing, while a heart attack may feel like squeezing or pressure in the chest. Stress induces the symptoms of a panic attack, but physical exertion can bring on a heart attack. Also, vomiting may accompany a heart episode. Symptoms of a panic attack will subside, but symptoms worsen in a heart attack.
The cause of panic attacks is unknown but there are several theories, including a chemical imbalance in the brain or a genetic predisposition. They can be triggered by a variety of conditions and situations, including the presence of a mood disorder, such as anxiety or depression; extreme stress over a long period of time; a physical health problem such as a heart, respiratory, or thyroid condition; overuse of alcohol, nicotine, or caffeine; and the side effects of some medical and recreational drugs. Frequent panic attacks generally indicate panic disorder.
Panic attacks can occur while an individual is sleeping, causing them to wake up suddenly with feelings of fear and dread.
Adolescents and young adults who have panic attacks often have other mental health issues or are at significant risk of developing other conditions, such as obsessive-compulsive disorder, anxiety, other mood disorders, eating disorders, or substance use disorder.
In the fight-or-flight response, the sympathetic nervous system is stimulated, and the adrenal glands release stress hormones including cortisol, adrenaline, and epinephrine. This response evolved for evolutionary reasons when dangerous animals preyed on ancient man. Some research finds that this reaction to stress is involved with panic disorder, even though there is no apparent danger present.
People who have panic disorder and experience frequent panic attacks often make lifestyle changes, like trying to avoid events and settings where symptoms are more likely to occur. Unfortunately, this can lead them to develop specific phobias, like agoraphobia, and avoid social situations for fear of triggering an attack. Cognitive-behavioral therapy can help change the way one thinks and reacts to situations that create fear. Relaxation and mindfulness exercises, such as deep breathing, meditation, yoga, massage, guided imagery, and progressive muscle relaxation, can help reduce the anxiety and stress that lead to a panic attack. Antidepressant and anti-anxiety medications can also control symptoms.
Desensitization and or visualization are used often for anxiety and its related conditions, including phobias. These methods can help a person unlearn or desensitize or visualize him or herself away from a triggering situation or event that causes discomfort and suffering.
Frequent panic attacks are diagnosed as panic disorder. If left untreated, the individual may develop phobias such as agoraphobia or the fear of leaving the home. The individual may also develop mood disorders including depression and anxiety, or even suicidal ideation. He or she will want to avoid social situations and may turn to substance use or alcohol use.