A panic attack is an episode of extreme fear that results in a physical response in the body when there is no understandable cause. People often feel like they have no control during a panic attack. Panic attacks are alarming, and people can become overwhelmed with fear and symptoms, leading them to believe they have physical symptoms. When these episodes occur repeatedly, it's considered panic disorder.
What causes panic attacks?
Panic attacks are a common mental health problem. There is no single clear cause for panic attacks or panic disorder. Several factors may be involved, including:
- High stress.
- Being more sensitive to high stress or poor emotions.
- Family history.
- Potential overstimulation of the body's survival instincts or fight response for no reason.
- Hormone imbalances like cortisol, dopamine, norepinephrine, and others.
Who’s at risk of developing panic attacks?
Panic attacks and panic disorder typically begin in the late teens or early 20s for those who are affected. Women are more likely to have these episodes than men.
Other factors can contribute to the development of panic disorder or attacks:
- Childhood abuse.
- Traumatic events.
- Major stressors like a death or serious loss.
- Family history of panic attacks or panic disorder.
- Serious life changes such as having a baby, divorce, or unexpected job loss.
- Smoking or too much caffeine intake.
Symptoms of panic attacks and panic disorder
Panic attacks are often sudden and do not come with warnings. People often do not expect them, and they seem to occur for no reason. Symptoms usually begin quickly and without warning.
Symptoms may only last a few minutes but can be quite intense. Panic attacks symptoms include:
- Shortness of breath.
- Rapid heart rate.
- Feeling of danger.
- Fear of death.
- Feelings of loss of control.
- Tightness in the chest or throat.
- Hot flashes.
- Abdominal pain.
- Chest pain.
- Dizziness, lightheadedness, or fainting.
- Sensations of altered reality.
- Numbness or tingling in hands or face.
Panic disorder includes repeated episodes of these symptoms and may also include:
- Repeated episodes of fear.
- Fear of impending panic attacks.
- Need to avoid places where panic attacks have occurred in the past.
Diagnosing panic disorder
If you have concerns about symptoms of panic attacks, discuss them with your healthcare or mental health provider. Your provider can diagnose panic attacks based on the symptoms you report. They will ask questions about your symptoms and anything that may be causing stress, fears, or concerns. They will also ask about your history, family history, relationships, caffeine, alcohol, drug, and medication use.
Your provider will complete a physical exam and rule out other causes for symptoms like heart, thyroid, or lung problems that may have similar symptoms. This may involve blood tests and an electrocardiogram (ECG or EKG).
If you have more than four panic attacks or continuously fear having the next attack, and if this has lasted more than one month, you will likely be diagnosed with panic disorder. Be sure to let your healthcare provider know if you are having multiple episodes and how often the episodes occur. This will help them make the correct diagnosis. They will need to be sure you do not have another mental health disorder causing these symptoms.
How are panic attacks and panic disorders treated?
Treatment is available to decrease the frequency of panic attacks. Medication and therapy can improve daily living and reduce symptoms.
Psychotherapy, or talk therapy, is the primary choice for panic attacks and panic disorder. Talk therapy can help you learn to cope with the attacks and gain a better understanding of them. This can make living and dealing with them easier when they occur.
Cognitive behavioral therapy can help you understand that symptoms are not dangerous. Your therapist will help you repeatedly recreate the attack until the symptoms feel less threatening. This can help reduce attacks and potentially overcome the fears that cause them.
Medications are also available to reduce symptoms.
- Selective serotonin reuptake inhibitors (SSRIs) are antidepressants that are generally safe with a low risk of side effects. These are often the first choice medication for treating panic attacks and panic disorder. These include fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft).
- Serotonin and norepinephrine reuptake inhibitors (SNRIs) are antidepressants also used to treat panic disorder. These include venlafaxine (Effexor XR).
- Benzodiazepines are central nervous system depressants that are short-term treatments. These include alprazolam (Xanax) and clonazepam (Klonopin). These medications can be addictive if not used with caution. People with alcohol or drug problems should not use these medications.
If a medication does not work well for you, discuss it with your provider. There are other options available, and they can recommend switching to another. It may also be necessary to try combining medications to reach the effect that works for you.
Be aware that medications can interact with other medicines, alcohol, and drug. Be sure your provider knows what medications you take and if you use alcohol or drugs that could interact and cause serious problems.
As with any illness, the more you know, the better you can care for yourself. Learning about panic attacks and panic disorder will provide you with knowledge and support. You’ll better understand warning signs, treatment options, and where to turn when you need help. You will also understand how to discuss your feelings and concerns with your providers and those around you.
Complications of panic disorder
All medications have the potential to have side effects. Medicines can affect each person differently. It is essential to discuss warnings with your healthcare provider and be aware of what to watch for if you receive new medications.
Some people who struggle with panic disorder find that it can become harder to deal with the attacks and the fear associated with them as time goes on. This makes living everyday life challenging. Some people lose the ability to function normally if they do not maintain control of their illness. Seeking help is crucial for this reason.
Panic attacks can begin with intense feelings of fear that appear to come out of nowhere. At times, this can lead to panic disorder. Contact your healthcare provider if you suspect you have symptoms of panic attacks or are concerned about panic disorder. Treatments are available and can help prevent symptoms from worsening or becoming debilitating.
Mayo Clinic. Panic attacks and panic disorder.
National Institute of Mental Health. Panic Disorder: When Fear Overwhelms.
Medscape. Panic Disorder.