What Is a Panic Attack?
Anxiety and panic are feelings that everyone has at times. It’s a natural reaction to threatening or stressful events. A panic attack, however, is pretty much the reverse.
A panic attack is a sudden onset of intense fear and anxiety when there is no real danger or obvious reason, often due to a mental health disorder.1 Common panic attack symptoms are heart palpitations, breathing problems, and sweating.2 Panic attacks, just like mental health disorders, can be terrifying because they may cause the feeling of losing control, suffering a heart attack, or even dying.
Attacks are classed as a cluster of symptoms that occur in the context of other mental diseases rather than as mental health disorders in and of themselves.3
Panic Attack vs. Panic Disorder
Although they might look similar, panic attacks and panic disorders are different. It is crucial to make the distinction clear. A panic attack is a single, isolated episode of intense fear and anxiety. On the other hand, a panic disorder, also known as anxiety disorder, is defined as recurrent, unexpected bouts of panic attacks.4 Anxiety disorder can be caused by continuous dread of panic attacks or their symptoms.
Many people have experienced a panic attack only once or twice in their lives; however, those with panic disorders have repetitive panic attack experiences for at least one month. According to a study published in 2019, 2% to 4% of persons who have panic disorder.4
Panic attack and panic disorder symptoms can be frightening and unsettling, but they can be managed and alleviated with treatment just as other mental health disorders. So, if you suffer from panic attacks or live in fear of one, you should know that seeking treatment is a crucial step in alleviating these attack symptoms and improving your quality of life.4
A Further Look at Panic Attacks
Types of Panic Attacks
Panic attacks can differ in several ways, ranging from the intensity of the attack to the duration. Additionally, the event that triggered the attack can vary. Based on this, the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) distinctly classifies panic attacks into two different types:
Expected Panic Attacks
Expected panic attacks are common, often associated with phobias. Expected panic attacks usually occur when a person is exposed to specific panic triggers, which are usually related to their phobias. This means that if a person is forced to partake in a task or activity linked to their phobia, chances are the person will experience a panic attack episode.
This is precisely what makes these kinds of panic attacks expected. For example, someone who has claustrophobia (a dread of enclosed places) will likely experience panic attacks in an elevator or other constricted spaces.
In addition, a person with a fear of flying (aerophobia) is likely to experience a panic episode while boarding a plane, during take-off, or at any other point throughout the journey. Knowing what is expected to cause a panic attack means, for the most part, people can avoid putting themselves in that situation. In cases where it is unavoidable, they can adequately prepare.
Unexpected Panic Attacks
Unexpected panic attacks are more troublesome as they cannot be predicted—they strike without warning and have no apparent cause. This sort of panic attack is characterized by the absence of any internal cognitive cues, such as anxious thoughts. Unexpected panic attacks are also not triggered by external cues, such as specific phobias or exposure to terrifying events or circumstances.
In other words, someone who suffers from unexpected panic attacks could appear to be very relaxed and fine in one minute and then suddenly begin to have a panic attack episode the very next minute.
What Are the Causes of Panic Attacks?
Knowing what causes panic attacks is usually difficult or even next to impossible. Nonetheless, several risk factors and triggers are associated with episodes of panic attacks.
One of the triggers or risk factors that have been repeatedly associated with panic attacks is stress. For example, the death of a loved one, job loss, or even divorce can trigger panic attacks.5 In addition, chronic stress resulting from several life pressures, such as work deadlines and too many changes in a short period, can also result in panic attack episodes, especially when anxiety begins to set in. So, if someone is in a position where they are constantly exposed to stressful situations for long periods, exploring stress relief options or other mental health treatments can be beneficial. It may also help to consider taking periodic breaks for personal well-being.
Fear is closely associated with the occurrences of panic attacks. In cases where individuals may have experienced some form of trauma or the other, that fear usually stays with them. Usually, this leads to the development of post-traumatic stress disorder (PTSD). PTSD is also a panic attack risk factor. In fact, it is not uncommon for people who have PTSD to experience sudden episodes of panic attacks, especially when confronted with a situation or circumstance that reminds them of the trauma they have previously suffered.6
High-stress and upsetting situations, especially early in life, raise the likelihood of panic attacks by diminishing one’s ability to manage emotions successfully throughout one’s life properly. This is how trauma could make a person increasingly prone to anxiety and panic attacks.7
Some people develop hypersensitivity—they become very aware or focused on every sensation and change in their bodies, including those that most people don’t notice or dismiss. These people often suffer a torrent of worry when these sensations occur, leading to a panic attack. 8
Health anxiety (a common type of anxiety) can intensify these panic attack triggers. For example, many people with anxiety disorder acquire health anxiety or discover that health anxiety (hypochondriasis) triggers their panic attacks 8.
Understanding Panick Attack Causes
What Are the Symptoms of Panic Attacks?
Panic attacks are usually characterized by varying intensities of physical and emotional symptoms. Sometimes these symptoms could be so intense that they could even cause those experiencing them to think they’re having a heart attack. In addition, these symptoms could be challenging to cope with.
Physical symptoms that have been associated or linked with panic attack episodes include the following:
- Feeling light-headed, dizzy, or faint
- Chest aches and shortness of breath (pressure in the chest and difficult breathing)
- Hammering or racing heartbeats
- Feeling as if about to choke
- Stomach discomfort/irritation
- Palpitations and muscle spasms
- Shaking or trembling
- Sweating excessively
- Numbness and tingling (such as tingling lips and numbness in the fingers and toes)
- Changing bodily temperature (feeling extremely hot or chills)
- Changes in appetite (appetites could either increase or decrease)
- Weight fluctuations
It is important to note that while some people suffering from panic attacks may experience two or more of these symptoms, there may well be others who have experienced other symptoms not on this list. This is not unexpected since the symptoms of panic attacks experienced vary from person to person. 9
As mentioned earlier, panic attacks are also accompanied by several emotional (psychological) symptoms that could significantly impact one’s quality of life. These symptoms could include:
- A sense of being out of control and cut off from surroundings
- Feelings of a heart attack
- High anxiety levels
- Reduced self-confidenc e
- Concerned about becoming insane
- Mental stress
- Personality disorder
- Concentration difficulties
- Constant worry and fear of the possibility of further panic attack episodes
- Any pre-existing mental health issues, such as anxiety, depression, stress, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD), will likely be aggravated.
These emotional and physical symptoms often result in social and behavioral changes in people with panic disorder. These social and behavioral changes could include:
- Social withdrawal and isolation (hiding to avoid contact with family and friends and lessen the likelihood of a panic attack)
- Reduced involvement in academic or occupational activities (results in poor outcomes)
- Inability to efficiently handle day-to-day activities and tasks
- Increased visits to emergency rooms to report perceived illnesses (due to increased anxiety levels) 9
How to Deal With Panic Attacks
Contrary to popular belief, panic attack treatment doesn’t necessarily have to be complicated. In fact, individuals have some measure of control and power. The approaches listed below can help people calm down during a panic attack or avoid one if they identify early signs. 10
- Make sure to do breathing exercises every day.
- Practice muscle relaxation exercises every day. This will help the person know exactly what to do in case of a panic attack episode.
- Proper stress management exercises are also important. This is because they will help prevent stress buildup, thereby eliminating the chances of a stress-induced episode.
- Consider staying away from alcohol, caffeine, and smoking as they may exacerbate panic attack symptoms.
- Try cognitive-behavioral therapy (CBT). This therapy type can help isolate and correct those negative thought patterns that may be contributing to panic attacks. 11
- Grounding exercises (such as the 54321 method) help restore calm in panic attack situations.
- Try to communicate with a family member or friend during the panic attack episode, so they can help reassure and reduce the attack.
- Focus on carrying out previously practiced muscle relaxation techniques.
- Taking deep, full breaths.
- Calm down. For example, one could employ calming techniques like self-reassurance and positive self-talk.
- Take care of oneself. Eat healthily and make sure to relax.
- After experiencing a first panic attack, it is recommended to see a doctor. 12
How to Stop Panic Attacks
Although there is no 100% guaranteed method of stopping panic attacks from occurring, several methods could prove helpful in the management and prevention of these attacks.
Counseling is a very viable option for panic attack treatment. After an interaction and evaluation, a therapist could suggest hypnotherapy or exposure therapy techniques. These therapies are usually aimed at helping one feel more comfortable and relaxed. In some of these therapy techniques, panic is deliberately introduced to help people grow more accustomed to the feelings and sensations accompanying panic attacks.
The doctor may also prescribe several medications to take care of anxiety attack symptoms. They may include antidepressants such as selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), beta-blockers, and benzodiazepines. The rationale behind the prescription of a beta-blocker is likely to control some symptoms, e.g., rapid heart rate. Benzodiazepine is a sedative that can produce a calming effect on panic attack treatment patients.
It should be noted that benzodiazepines can only be prescribed for a short duration of time because they can cause addiction with long-term use.
Lifestyle changes such as improved nutrition, better sleep habits, avoiding substances that can worsen panic attack episodes (e.g., alcohol and smoking), improved exercise habits, and support groups could also help keep panic attacks at bay.
Coping Mechanisms for Panic Attacks
As mentioned earlier, there is no 100% effective cure for a panic attack; however, several coping mechanisms can be employed to manage panic attacks.
Keeping Panic Attacks at Bay
Concentrate on Deep Breathing Exercises
People with panic disorders automatically tend to breathe deeper and quicker during a panic episode (hyperventilation). This can result in chest aches and dizziness, adding to the dread and discomfort.
To counteract this, focus on taking a deep breath in for three seconds, holding it for two seconds, and then gently exhaling for another three seconds. This will help with focus, calmness, and keeping oxygen levels in check.
The 5 4 3 2 1 Technique
Mindfulness is a powerful mental technique that can help people halt panic episodes in its tracks. When one starts to feel the signs of a panic attack, they can apply various mindfulness techniques, with many of the more effective ones being taught by professional therapists. The 54321 method is one such mindfulness technique.
The 54321 method is a simple grounding activity that uses sensory organs to help people relax, feel calm, and think clearly.13 It is a very effective method for reducing anxiety, particularly in extremely stressful situations.
The five steps of the 54321 technique include: 13
- See any 5 things around you
- Notice 4 things that you can feel
- Identify 3 things that you hear
- Notice 2 things that you can smell
- Taste any 1 thing that you like
The best thing about this grounding technique is that it is very easy to do, and it can be done practically anywhere without attracting notice.
Also, there are several muscle relaxation techniques and exercises that people suffering from panic disorder can use to experience relief and relaxation.
Treatments for Panic Attacks
Aside from the coping mechanisms discussed above, some other panic attack treatment options that have proven successful include:
Psychotherapy is a popular option for many mental health disorders, and it’s especially effective in treating panic attacks. It is also used for the effective management of anxiety disorder. It can assist in gaining a better understanding of panic attacks and panic disorder and learning how to cope with them.
Cognitive-behavioral therapy (a type of psychotherapy) can help someone learn from their own experiences that panic episodes are not things to be afraid of. The therapist will guide the person through a safe, repetitive process of re-creating the symptoms of a panic attack. These panic attack symptoms should begin to subside once the bodily sensations of panic no longer feel frightening.1 Panic attack treatment can also help people confront situations and circumstances they’ve avoided, probably because they may have triggered panic episodes.
CBT can be a powerful technique in treating mental health disorders like depression, PTSD, and eating disorders, whether used alone or in combination with other therapies. Though, it is not just a panic attack treatment method. It can also be a helpful technique for anyone who wants to learn how to better manage stressful events in their life.
Combination of Therapy and Medication
Therapy and medication are the two most common methods for panic attack treatment. Although these two techniques are used separately, they may be combined depending on one’s preferences, history, the severity of the panic disorder, and whether they have access to panic attack treatment specialists. Usually, panic attack treatment and medication often give the best results.
There are also some uncommon methods of panic attack treatment without medication, such as herbal remedies; however, these methods haven’t been approved for treatment yet.