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What are panic attacks?

Panic attacks occur when a person is struck with a sudden feeling of terror. These attacks are characterized by the individual’s disproportionate reaction to the situation at hand. Individuals suffering from panic attacks may feel they are going insane or suffering a heart attack or other serious physical ailment. Episodes can arise at any time, even during sleep.

Panic attacks are usually brief in nature, but lingering symptoms may persist longer than the attack itself. The panic disorder develops when a person experiences repeated panic attacks and lives in a state of constant anxiety, wondering when the next episode will occur.

Are panic attacks common?

Panic attacks are fairly common when compared to some other ailments. It is estimated that each year, over 10% of adult Americans experience a panic attack. Around 2-3% of these individuals will go on to develop panic disorder.

Causes

What causes panic attacks?

Anyone can experience a panic attack. A panic attack mimics your body’s natural reaction to a dangerous situation. This reaction is commonly known as the fight-or-flight response. In the case of panic attacks, though, there is oftentimes no external stimulus grave enough to warrant such a reaction.

Anyone’s mind can give rise to such a seemingly irrational response. However, some factors may predispose an individual to experience panic attacks and to develop panic disorder. Some of these factors include:

Age: While people of all ages can experience panic attacks, they usually first arise during adolescence and early adulthood.
Gender: Men are half as likely to develop the panic disorder as women.
Family history: Those born into a family with a history of anxiety disorders are also more prone to develop panic attacks and panic disorders.
Personal mental health history: If you’ve been diagnosed with other mental health conditions, such as depression or anxiety, you are more likely to experience panic attacks.
Drug usage: Those with a history of abusing drugs or medications are more likely to display signs of panic disorder.
Life stressors: Trauma, such as the death of a loved one, abuse, or an accident, can also leave you vulnerable to panic attacks. Major changes can also bring about stress, even if they are positive. For example, the birth of a new child can cause a buildup of stress.

Are panic attacks hereditary?

They can be. As mentioned above, a family history of anxiety disorders may predispose you to panic attacks. Medical experts are still unsure of exactly why this might be, but it is common in a number of anxiety disorders. However, genetics is not the only factor that influences panic attacks.

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Symptoms

What are the symptoms of a panic attack?

The onset of a panic attack is usually sudden, and once the attack comes, there’s no way to stop it. Fortunately, episodes are relatively short in duration, usually lasting 10 minutes or less. Some individuals may become so entrenched in the symptoms of their panic attack that they continue to experience panic attack symptoms after the episode itself. The most common symptoms of a panic attack are:

Breathing struggles
Chills
Detachment from reality
Chest pain and racing heart
Nausea
Numbness in extremities
Hot flashes
Trembling
Fear of losing control
A sense of impending doom
A feeling of dying

How do panic attacks affect your life?

If not treated, panic attacks can lower a person’s quality of life. Those with panic disorder may live with an underlying sense of fear and anxiety that affects their ability to perform daily tasks. Examples of areas that may be impacted include work, school, and interpersonal relationships. Some people with panic disorder may feel the need to avoid certain trigger locations/situations or otherwise structure their lives around their fears.

Diagnosis

How are panic attacks diagnosed?

When it comes to panic attacks, it’s extremely important to seek a professional diagnosis from a medical professional. This is because certain medical conditions, such as thyroid disease and respiratory problems, can easily be mistaken for panic attacks. You want to ensure you rule out any potential physical causes with your provider so that you can receive the appropriate treatment for your condition.

Treatment

Who treats panic attacks?

First, you’ll want to speak with your doctor about your symptoms. They can help you rule out any physical causes and refer you to the appropriate mental health professional, if necessary. A psychiatrist or psychologist can help you find the best treatment option so that you can find relief from your panic attack symptoms.

How are panic attacks treated?

Panic attacks are generally treated through a combination of psychotherapy and medication. Your doctor can recommend treatment options for you:

Psychotherapy: Cognitive behavioral therapy (CBT) is a first-line defense against panic attacks. By working with a trained psychologist, you can slowly restructure your negative thought patterns. Once you are able to adopt a different attitude toward your panic attacks, which takes time and patience, you should be able to exert better control over your thoughts and emotions during an attack. This ultimately allows you to better control your symptoms and find relief.
Medication: A number of medications are routinely prescribed for people experiencing panic attacks. The most commonly prescribed types of medication for panic attacks are:

Beta-blockers
Benzodiazepines
Selective serotonin reuptake inhibitors (SSRIs)
Serotonin-norepinephrine reuptake inhibitors (SNRIs)

SSRIs and SNRIs take weeks to build up in your system and are more effective for treating long-term symptoms of panic disorder. Beta-blockers and benzodiazepines, on the other hand, are to be used more sparingly and in specific instances, as indicated by your doctor. For instance, a benzodiazepine may rapidly reduce the effects of a panic attack from the onset but may lead to tolerance over time and is too powerful to be used with frequency. Your mental health professional will be able to guide you toward one or more medications that work for you.

Will panic attacks ever go away?

Once you begin to seek diagnosis and treatment, you’ve taken the first step to improving your mental health and getting rid of your panic attacks. However, it’s important to keep in mind that if you want your panic attacks to disappear completely, you’ll have to work to restructure your negative thought patterns. With the help of psychotherapy and medication, you may begin to experience immediate relief, but restructuring your thoughts won’t happen overnight. Over the course of several weeks and months, though, you may notice the frequency of your attacks decreasing and an overall improvement in your mental health. With proper treatment, panic disorder can go away in an individual.

References

Mayo Foundation for Medical Education and Research. (2018, May 4). Panic attacks and panic disorder. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/panic-attacks/symptoms-causes/syc-20376021

Panic Attacks: Panic Disorder, Anxiety Disorder, Symptoms, Causes. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/4451-panic-disorder#:~:text=How%20common%20are%20panic%20attacks,on%20to%20develop%20panic%20disorder

U.S. Department of Health and Human Services. Panic Disorder: When Fear Overwhelms. National Institute of Mental Health. https://www.nimh.nih.gov/health/publications/panic-disorder-when-fear-overwhelms/#:~:text=Left%20untreated%2C%20panic%20disorder%20can,or%20school%2C%20and%20social%20isolation

WebMD. Panic Attack Symptoms: Shortness of Breath, Racing Heart, & More. WebMD. https://www.webmd.com/anxiety-panic/guide/panic-attack-symptoms

Information

Medically reviewed by:

Dr Roy Kedem, MD

Dr Roy Kedem started his premedical studies at Harvard, and research in genetics and gene sequencing at Harvard, Beth Israel. He attended medical school in the UK at the Cambridge Overseas Medical Program in 1998. Dr Kedem then completed his residency in Internal Medicine at Columbia College of Physicians and Surgeons in Stamford, Connecticut and his fellowship in Hospital Medicine at the Cleveland Clinic in Cleveland, Ohio.

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