Panic attacks can stop you in your tracks with overwhelming fear, anxiety, and debilitating physical symptoms. Your body's nervous system is impacted by anxiety, which can cause physical symptoms during panic attacks to keep you alert and aware of potential dangers when threats are perceived. However, when you struggle to process emotions effectively, those effects can linger and worsen over time. If you think you might be experiencing panic attacks, knowing what criteria is involved in panic disorder, common symptoms of panic attacks, and how to find relief may be helpful.
What Is A Panic Attack?
According to the American Psychological Association (APA), panic attacks are sudden and overwhelming surges of fear, often without an apparent cause, that far exceed typical stress reactions and may make you feel like you're dying.
Panic attacks often happen without warning and severely interfere with your ability to function at home, school, work, or anywhere else until the episode passes. Experiencing a panic attack can cause intense fear and anxiety about future occurrences. You may notice that you avoid places where you've had an episode or situations that may incite your panic. Staying home where it's "safe" may feel more manageable and desirable over time, causing you to socially withdraw to prevent incidents.
Panic attacks may be expected or unexpected. Unexpected attacks can involve intense and sudden feelings of fear, extreme nervousness, or panic without warning. Reactions to the perceived threat are often disproportionate to actual danger. Expected panic attacks occur in response to a real threat or known inciting event.
When Do Panic Attacks Signify Panic Disorder?
A panic attack is a single instance of debilitating and overwhelming fear or anxiety interfering with the ability to function. While many experience one or two panic attacks throughout their lives, often related to drastic or unexpected life changes, some people develop a panic disorder characterized by recurring episodes and constant fear of another incident.
Recognizing Panic Attack Symptoms
While panic attacks can present in many variations, symptoms are usually short-lived, peaking and fading away within approximately 30 minutes. People often feel extreme fatigue after an episode. Symptoms of these attacks can include the following:
A racing or irregular heartbeat or pounding in the heart
The sense that one is having a heart attack
Shortness of breath or difficulty breathing
A sense of choking
Nausea or stomachache
Dizziness, unsteadiness, lightheadedness, or faintness
Alternating hot and cold sensations
Numbness or tingling
Feelings of dissociation or detachment
Fear of losing control, "going crazy," or dying
Panic attacks generally peak at 10 minutes and fade around 30 minutes. However, they may last longer.
Panic Attacks In Children And Adolescents
Children and adolescents often don't have the ability to understand or express their emotional reactions, so panic attacks may present more as physical symptoms like head and stomach pain. However, they may also have many of the typical adult symptoms. As they experience more panic attacks, children and teens may become anxious most of the time, constantly fearing another episode.
What Causes Panic Disorder?
While the medical community hasn't conclusively named a cause for panic disorders, some common risk factors are often seen in people who experience panic attacks, including the following:
A family history of panic disorder or panic attacks
Major life stressors, like death or illness
Physical or sexual abuse during childhood
Drastic life changes, like divorce or childbirth
Excessive caffeine use
If you are facing or witnessing abuse of any kind, the National Domestic Violence Hotline is available 24/7 for support. Call 1-800-799-SAFE (7233) or text "START" to 88788. You can also use the online chat.
Panic Disorder Comorbidity
Panic attacks often occur alongside, or comorbid to, other mental health conditions. Alcohol and substance use disorders are common, as many people with mental illnesses self-medicate to cope with symptoms. Other anxiety disorders, like agoraphobia or social anxiety disorder, mood disorders like depression, and increased stress frequently develop comorbidly with panic disorder.
If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources.
Complications Related To Untreated Panic Disorder
Untreated panic attacks may cause significant difficulty in caring for oneself. Fear of a panic attack can lead to new worries, contributing to the constant state of anxiety and difficulty relaxing. Below are a few other potential complications of untreated panic disorder:
The development of specific phobias
A physical health condition
Intense avoidance of social situations where you may have a panic attack, sometimes to the point of the development of agoraphobia
Difficulty at home, work, or school
Mood disorders, anxiety disorders, or other psychological conditions
An increased risk of suicidal thoughts or behaviors
Alcohol or substance use disorders
If you are experiencing suicidal thoughts or urges, call the 988 Suicide & Crisis Lifeline at 988 or text 988 to talk to a crisis provider over SMS. They are available 24/7 to offer support. 988 also offers an online chat for those with an internet connection.
Treatments For Panic Disorder
Psychotherapy, also called talk therapy, is often considered the most effective treatment to manage the effect of panic attacks and panic disorder. Your doctor or psychiatrist can determine if medication would be a helpful addition to your treatment plan.
Cognitive-behavioral therapy (CBT) is the preferred treatment for adults' and children's panic attacks and anxiety disorders. CBT helps clients tolerate the physical symptoms of their attacks as they reshape their thinking patterns to gain a more productive perspective and build healthy ways to cope with symptoms.
Coping skills for a panic attack may include the following:
Deep breathing exercises
Desensitization and building tolerance through controlled exposure
Progressive muscle relaxation
Positive visualization of a relaxing setting
Focusing on panic as a symptom of a medical condition that will pass
Keeping essential oils handy for their calming effects
Getting away from the stressor and finding a peaceful spot
Focusing your attention on an object to distract your mind
Repeating a mantra or positive affirmation
Recentering your mind by going for a walk or getting light exercise
Talking to someone
Learning what incites panic and using coping skills when it occurs
"Treatment for panic disorders is usually quite effective. Treatment will help you learn to recognize that the symptoms are not life-threatening. You will also learn coping skills and ways to relax to decrease the intensity and length of the panic attack." — Johns Hopkins Medicine
How To Help Someone Through A Panic Attack
If a friend or loved one experiences a panic attack and you want to help, remain calm, guide them to a quiet space, and try the following strategies:
Speak calmly and soothingly, reminding them they are safe and not alone.
Narrate taking deep breaths, breathing in and out for three seconds each. "In, two three. Out, two, three." This strategy can help them focus on their breathing.
Remind them that this is a real symptom and will pass soon.
Avoid showing or validating negative statements.
Try initiating a lighthearted conversation about something positive to offer distraction.
Avoid telling them to calm down or devaluing their experience.
Stay with them. If they request time alone, retreat but stay in contact or nearby.
When To Reach Out For Help
If your panic attacks occur frequently or significantly interfere with your functional ability in several aspects of your daily life, it may be beneficial to contact a medical or mental health professional for help. If you face barriers to traditional treatment, like social anxiety, you can also work with a provider online.
Through an online platform like BetterHelp, you can connect with a therapist through phone, video, or chat sessions. In addition, some platforms offer the option of messaging your therapist throughout the week as needed for advice and support. If you are having a panic attack, contacting your therapist may be quicker online.
According to a recent study, online therapy offers effective results as a treatment for panic attacks and other anxiety challenges. The study participants reported high satisfaction with virtual treatment, and many participants saw fewer symptoms.
What is the biology of a panic attack?
The biology behind panic attacks involves an autonomic nervous system response. Panic attacks are often triggered by external factors, but biological reactions are often internal. Panic attacks can also lead to biological symptoms, including shortness of breath, chest compression, and elevated heart rate.
What happens in the brain that causes panic attacks?
The association between brain activity and panic attacks is not fully understood. Researchers believe that panic attacks may in part be caused by a failure of different parts of the brain to communicate with each other, namely the prefrontal cortex (known as the brain’s “logic center”) and the amygdala, the section of the brain responsible for primal emotions like fear.
What is the pathophysiology of a panic attack?
Again, the pathophysiology of a panic attack needs more research before conclusions can be drawn. However, current scientific evidence indicates that inflammation within the brain may be activated during a panic attack and may serve to make a patient more susceptible to future panic attacks and other negative impacts of anxiety disorders.
Is panic disorder biological or psychological?
According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V), panic disorder has both biological and psychological components. Patients with panic disorder experience recurrent panic attacks, which activate the sympathetic nervous system into a fight or flight response. Panic symptoms can be triggered by life events, anxiety sensitivity, and other psychological aspects, but reactions like increased blood pressure and cerebral blood flow in various brain regions are based on the body’s biology.
What biologically causes anxiety?
According to the American Psychiatric Association, anxiety disorders are the most common form of mental illness. Feelings of anxiety are caused by the production of stress hormones, including adrenaline and cortisol. Some people may be more predisposed towards overproduction of these chemicals than others.
What is the biological perspective of anxiety?
Panic disorder, generalized anxiety disorder, obsessive-compulsive disorder, and other forms of anxiety disorders have biological as well as psychological impacts. Repeated stressing of the autonomic nervous system by overproduction of stress hormones can raise a person’s baseline levels of anxiety and make them more susceptible to anxious reactions and unhealthy coping mechanisms that can develop into many types of anxiety disorders.
Can panic attacks happen for no reason?
Panic attacks can be triggered by seemingly nothing at all. In these situations, a person may be coping with chronic anxiety and stress, and the body’s stress response may be activated as a reaction to the buildup of stress hormones over time, as opposed to a specific event that precipitates the attack.
Do panic attacks hurt your brain?
While certain brain regions are activated during panic attacks, there is currently no evidence that panic attacks can cause brain damage. Chronic stress and anxiety, however, can have long-term impacts on the brain and nervous system.
Are panic attacks triggered by thoughts?
Panic attacks can be triggered by thoughts and rumination over situations that have been causing a person stress, although they can also be triggered by other factors.
Why do anxiety attacks happen?
Anxiety attacks can be caused by stress, overconsumption of caffeine, biological factors such as thyroid issues, drug or alcohol use or withdrawal, some illnesses or medications, experiences with trauma, and other triggers.
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