Content Warning: Please be advised, the below article discusses prescription medication. The information found in the article is not a substitute for professional medical advice. Always seek the advice of your physician or other qualified health providers with any questions you may have.
If you suspect you've had a panic attack, it can be important to examine the incident, as this can help you identify the symptoms that indicate a panic attack is occurring (rather than a different medical emergency.) In some cases, knowing what is actually happening is necessary in order to have your panic disorder treated in a way that relieves your symptoms.
Emotions Associated With Panic Attacks
The overriding emotion at the center of unexpected panic attacks is normally fear. You might have a clear idea about what you're afraid of or the feeling of overwhelming fear may seem to come out of nowhere. After repeated panic attacks, you might begin to fear the attack itself. This fear of the attack can actually bring on an attack that might not otherwise have happened.
You may feel intense worry or the sensation of “looking on from outside yourself” while the attack is going on. You might also feel an overwhelming sense of impending doom or the fear that the attack might be life threatening.
Physical Sensations Of A Panic Attack
Signs of a panic attack can also be physical in nature. The first time you have a panic attack, you may think you are in physical danger of losing your life. However, with experience, you can learn to recognize what leads someone to develop panic disorder, as well as the symptoms that could be part of a panic disorder.
The following are some panic disorder symptoms that can mimic physical ailments.
Chest Pain Or Discomfort
Some people with panic disorder may feel chest pain. You might have other sensations in your chest that cause discomfort, too. Your heart may race, you may experience heart palpitations, you may feel pressure in your chest as if you were choking, or your chest can feel tight. While these feelings may indicate that something is wrong with your heart, they could alternatively mean that you are feeling intense anxiety and panic.
You may experience difficulty breathing or shortness of breath that can feel very physical in nature. You might gasp for air or feel your airways constrict. When these are symptoms of a panic attack, they are likely harmless. After the attack has subsided, your breathing will most likely return to normal.
Feelings Of Weakness
Several signs of panic attack may seem similar to what you might experience if you had a medical condition that causes weakness. You might feel dizzy or lightheaded. Losing control of your body and trembling is also common. The feeling of weakness can be so profound that you might fear you will fall before the attack is over.
The constant fear that comes with a panic attack can cause you great stomach discomfort. You might feel extreme nausea while the panic attack is going on, but it will likely subside when the attack is over.
Feelings Of Body Temperature Changes
Several symptoms of a panic attack can make you feel physically ill. You might sweat or have chills as if you had a fever. You may also experience hot flashes.
Often, people with panic attacks can feel numbness and tingling in their hands and feet. These are physical symptoms that can be generated by your nervous system in situations where a sense of fear overwhelms you.
How To Distinguish A Panic Attack From A Heart Attack
Because a panic attack can have symptoms that feel purely physical, it is important to be able to distinguish between a panic attack and a physical issue such as a heart attack.
You may not be able to tell at that moment whether you are experiencing the symptoms of panic disorder or a heart attack. If you are unsure, treat it like a medical emergency until you find out otherwise. An ER doctor can run tests to rule out a heart attack or other physical ailments.
If you don't or are unable to seek help at the time of the first attack, it is wise to go in for a heart checkup as soon as possible. The results can give you a rough estimate of how likely it is that future attacks will require medical attention. Still, you may never be able to know with 100% accuracy when you need to seek medical help during what may be a panic attack.
What Brings On A Panic Attack?
The source of the intense fear behind a panic attack can be either obvious or unclear. In fact, you may have no warning at all that you're about to have a panic attack. Stressful situations can initiate panic attacks, but the attacks can also happen when life seems otherwise peaceful.
Furthermore, you can push yourself into an attack if you anticipate that you'll have a panic attack. That anticipation can lead to overwhelming anxiety, which is a short step away from a full-blown panic attack for someone with panic disorder.
Evaluating Symptoms Of Panic Attack
A doctor's first job is to rule out medical conditions that might cause the same symptoms as panic attacks and panic disorder. To do this, the doctor typically orders blood work, an EKG, and other tests that might show a physical connection. They will ask about your medical and family history, inquiring as to whether anyone in your family has suffered from medical conditions that could cause the symptoms. They listen to your heart and perform a complete physical examination to find any potential source of medical problems.
If all these results come back negative for medical conditions, the doctor will likely move on to conducting a mental health examination or refer you to a mental health professional for such an assessment. This evaluation is based on conversations between you and the person conducting the interview. They may ask you about the symptoms you experience and what situations or experiences preceded the symptoms.
Once the doctor or therapist determines that you have panic disorder, they may recommend a course of treatment to help you deal with or overcome the situation.
Treatments For Panic Attacks
While methods like exposure therapy have proven to be effective in some cases, the two main types of treatment for panic attacks may be medication or cognitive behavioral therapy. Medications like serotonin-norepinephrine reuptake inhibitors (SNRIs) and selective serotonin reuptake inhibitors (SSRIs), which are often used to treat depression, may be prescribed for panic disorder and panic attacks. These and other medications may need to be taken regularly, or in some cases, as needed when the triggers that have caused your panic in the past are present. They may have to be taken as the panic attack begins (as would be the case with medications like benzodiazepines). The doctor can prescribe the medication to be taken safely and effectively in a way that they deem best for you.
Cognitive behavioral therapy is a therapy that consists of talking about the symptoms, triggers, and after-effects of your panic attacks, and devising ways to deal with them. Because they often have a genetic basis, you may not be able to prevent panic attacks. However, with the therapist's help, you can reduce the symptoms and the stressors that seem to set off the attacks.
One of the most important things you can learn through cognitive behavioral therapy is that a panic attack typically comes and goes without causing you any harm at all. You also may learn to deeply understand that the attack will eventually end and that soon you will return to the way you normally feel in everyday life. Reminding yourself of this heartfelt realization can diminish your symptoms even while you are in the midst of a panic attack.
A part of cognitive behavior therapy may be changing your way of thinking. Just as important, you can practice the behaviors that come from your new perspective. This can take time, but the end result might be that your panic attacks become less frightening and more manageable if they don't end altogether.
Finding Help For The Symptoms Of Panic Attack
If you do find out that what you are experiencing are panic attacks, the next step may be to get help from a qualified professional. Your doctor may prescribe medications, but they'll likely suggest that you see a therapist for cognitive behavioral therapy (CBT) as well. CBT may be able to help you learn what commonly triggers an episode., as well as ways to deal with your next panic attack.
You can decide for yourself who you will see for CBT. You need to talk to someone who is trained in this method and who understands panic attacks and how to treat them effectively. Paid licensed/certified counselors are available online at BetterHelp.com to help you where you are, at times that work best for your schedule.
Clinical studies have demonstrated that online clinical behavioral therapy is effective in treating panic disorder, anxiety disorders, and specific phobias. Reviews have also shown that online therapy is cheaper than in-person talk therapy, especially when you consider added costs like childcare, time off work, and transportation costs.
What are coping thoughts for panic attacks?
Coping thoughts can be helpful during panic attacks to manage anxiety and bring a sense of calm. Here are some coping thoughts you can use to help alleviate panic while experiencing symptoms of a panic attack:
- "This will pass": Remind yourself that panic attacks are temporary and usually last for a short period of time.
- "I've been through this before": Reflect on past experiences when you successfully managed panic attacks or stressful situations.
- "I am safe right now": Ground yourself in the present moment by acknowledging that you are safe and not in immediate danger.
- "It's just anxiety": Recognize that the physical sensations you're experiencing are a result of anxiety, and they are not harmful.
- "I can handle this": Trust in your ability to cope with the situation, even if it feels uncomfortable.
- "Breathe deeply": Focus on your breathing, taking slow and deep breaths to help modulate your body's response.
- "I can slow this down": Remind yourself that you have the power to slow down your racing thoughts and heart rate.
- "I'm not alone": Reach out to someone you trust for support, whether in person or through a phone call.
These coping thoughts can serve as anchors during panic attacks, helping you stay grounded and manage anxiety in the moment. It's also beneficial to practice relaxation techniques and seek professional help if panic attacks are frequent or interfering with your daily life.
What physically happens to your body during a panic attack?
During a panic attack, physical symptoms may occur as your body experiences a surge of intense physical and psychological changes due to the body's "fight or flight" response being triggered. This response is designed to prepare the body to respond to perceived threats, but in the case of a panic attack, it's triggered without an actual threat being present. Some common physical symptoms of a panic attack include:
- Rapid Heartbeat (Palpitations)
- Shortness of Breath
- Chest Pain or Discomfort
- Dizziness or Lightheadedness
- Tingling or Numbness
- Trembling or Shaking
- Nausea or Upset Stomach
- Hot or Cold Flashes
- A Feeling of Impending Doom
- Rapid Thoughts
- Muscle Tension
These physical symptoms can be frightening and overwhelming, and they often contribute to the feeling of panic and anxiety during an attack. Panic attacks are not physically dangerous, even though they may feel extremely distressing. If you experience sudden attacks frequently or they are interfering with your daily life, you may need to seek professional help to learn coping strategies and address the underlying causes of the attacks.
Do panic attacks always have physical symptoms?
Yes, panic attacks typically involve both physical and psychological symptoms. The physical symptoms of a panic attack are a result of the body's "fight or flight" response being triggered in response to perceived danger or stressful situations, even if no actual threat is present. These physical symptoms are a hallmark of panic attacks and can vary from person to person.
Panic attacks can also include psychological symptoms, such as intense fear, a sense of impending doom, feelings of unreality or detachment, and difficulty concentrating. These psychological symptoms often contribute to the overall distress and anxiety experienced during a panic attack.
It's possible for panic attacks to vary in their presentation, and some individuals may experience primarily psychological symptoms without as many pronounced physical symptoms. Each person's experience with panic attacks can differ, and seeking professional help can provide a better understanding of your specific symptoms and ways to manage them effectively.
Can you have a physical panic attack without fear?
Yes, it is possible to experience a physical panic attack without a strong sense of fear. While panic attacks are often associated with intense fear or anxiety, some individuals may have panic attacks that are primarily characterized by overwhelming physical sensations with less pronounced feelings of fear or anxiety. This variation can be influenced by factors such as individual differences in how the body and mind respond to stress and anxiety.
Panic attacks can manifest in different ways for different people. Some individuals may experience physical symptoms without experiencing an intense emotional response, while others may experience a combination of both physical and psychological symptoms.
What is a coping strategy you can use to address stress anxiety in your life?
Managing stress and anxiety may prevent more panic attacks from occurring. While there is no single strategy for reducing stress and anxiety, there are a few steps that you can take that may improve your mental health. Eating a healthy diet, getting a good night’s sleep, and exercising are all strategies that may reduce stress and anxiety in your life. In addition to these lifestyle changes, incorporating mindfulness, meditation, and reflection may also help to reduce stress.
Seeking professional help may also be beneficial for those experiencing stress and anxiety. Therapists or mental health professionals may use techniques such as cognitive behavioral therapy or exposure therapy to help manage fears that may cause anxiety. A mental health professional may also be aware of any upcoming clinical trial or a new technique for treating stress or anxiety, offering new treatment methods that may reduce panic attacks or the symptoms of panic disorder.
How can you help someone with panic disorder?
Panic disorder is a type of anxiety disorder characterized by recurring and unexpected panic attacks. For individuals with a panic disorder, when fear overwhelms the body be accompanied by various physical symptoms, such as a racing heartbeat, shortness of breath, dizziness, trembling, and a sense of impending doom. There are treatment options available to improve symptoms and to treat panic disorder, often this includes working with a mental health professional. Some ways to help someone with a panic disorder include:
- Listen and Validate: Be a supportive listener. Validate their feelings and experiences without judgment.
- Be Patient: Recovery takes time. Be patient and understanding as the person works through their challenges.
- Create a Safety Plan: Work together to develop a plan for managing panic attacks, including grounding techniques and coping strategies.
- Encourage Self-Care: Emphasize the importance of self-care, including regular exercise, a healthy diet, adequate sleep, and stress management.
- Avoid Triggers: Learn about the person's triggers or risk factors and help create a supportive environment that minimizes exposure to those triggers.
- Stay Calm: During a panic attack, remain calm and offer reassurance. Avoid pressuring them to "calm down" or dismiss their feelings.
- Be Flexible: Understand that plans might need to change due to panic attacks. Be flexible and accommodating.
- Offer Distractions: During heightened anxiety, offering distractions such as engaging in activities or conversations can help redirect focus.
- Respect Boundaries: Respect their need for space or alone time when necessary.
- Promote Positive Lifestyle Changes: Encourage healthy habits like regular exercise, adequate sleep, and mindfulness practices.
Every person's experience is unique, and what works for one individual might not work for another. Be open to communication and adjust your approach based on their needs. Encourage them to seek professional help to develop a treatment plan and be their ally on their journey to managing panic disorder.
How long does it take to recover from a panic attack?
The duration of recovery from a panic attack can vary from person to person and from one episode to another. Generally, a single panic attack might last for a few minutes to around 20-30 minutes. However, the recovery process—meaning the time it takes for the intense symptoms to subside and for the person to return to a state of relative calm—can vary.
After a panic attack, it might take some time for physical symptoms like rapid heartbeat and shortness of breath to gradually ease. The emotional and psychological impact of the panic attack can linger for a while as well. Some individuals might find that they feel emotionally drained or anxious even after the most intense physical symptoms have subsided.
Factors that can influence the duration of recovery include the individual's coping skills, familiarity with panic attacks, the severity of the attack, the presence of support, and whether the person engages in calming techniques or activities.
Can panic attacks occur without triggers?
Yes, panic attacks can occur without any apparent triggers. While some panic attacks are triggered by specific situations, events, or stimuli, others can seemingly arise out of nowhere and without any obvious cause. These are often referred to as "unexpected" or "spontaneous" panic attacks.
In cases of panic disorder, individuals may experience both triggered and unexpected panic attacks. Triggered panic attacks are tied to specific triggers, such as being in crowded places or confined spaces, or may be linked to a traumatic event, whereas unexpected panic attacks occur seemingly out of the blue and are not directly linked to any external trigger.
The unpredictability of unexpected panic attacks can contribute to the anxiety and fear associated with panic disorder. Individuals might start to worry about when the next attack might occur and become preoccupied with trying to prevent or avoid it.
Does everyone experience panic attacks differently?
Yes, everyone can experience panic attacks differently. While panic attacks have common features, such as intense fear and physical symptoms, the way they manifest and the specific sensations individuals experience can vary widely from person to person. Some of the variations include:
- Physical Symptoms: The physical sensations during a panic attack can differ. Some people might experience a racing heart, while others might feel lightheadedness or nausea more prominently.
- Intensity: The intensity of panic attacks can vary. Some individuals might have milder episodes, while others might experience more severe and intense attacks.
- Duration: Panic attacks can range in duration. Some might be relatively brief, lasting a few minutes, while others can last longer.
- Triggers: Some people might experience panic attacks only in specific situations or due to certain triggers, while others might have unexpected panic attacks without a clear trigger.
- Psychological Experience: The emotional and psychological experience during a panic attack can differ. Some individuals might feel extreme fear or a sense of impending doom, while others might experience more specific fears or worries.
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