What is panic attack and panic disorder?
A panic attack is a sudden episode of intense fear that triggers severe physical reactions when there is no real danger or apparent cause. Panic attacks can be very frightening. When panic attacks occur, you might think you’re losing control, having a heart attack or even dying.
Many people have just one or two panic attacks in their lifetimes, and the problem goes away, perhaps when a stressful situation ends. But if you’ve had recurrent, unexpected panic attacks and spent long periods in constant fear of another attack, you may have a condition called panic disorder.
Although panic attacks themselves aren’t life-threatening, they can be frightening and significantly affect your quality of life. But treatment can be very effective.
How common is panic attack and panic disorder?
Panic attack and panic disorder are common. It can affect patients at any age. Please discuss with your doctor for further information.
What are the symptoms of panic attack and panic disorder?
The common symptoms of panic attack and panic disorder are:
- Sense of impending doom or danger
- Fear of loss of control or death
- Rapid, pounding heart rate
- Trembling or shaking
- Shortness of breath or tightness in your throat
- Hot flashes
- Abdominal cramping
- Chest pain
- Dizziness, lightheadedness or faintness
- Numbness or tingling sensation
- Feeling of unreality or detachment
Panic attacks typically begin suddenly, without warning. They can strike at any time — when you’re driving a car, at the mall, sound asleep or in the middle of a business meeting. You may have occasional panic attacks or they may occur frequently.
Panic attacks have many variations, but symptoms usually peak within minutes. You may feel fatigued and worn out after a panic attack subsides.
There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.
When should I see my doctor?
If you have panic attack symptoms, seek medical help as soon as possible. Panic attacks, while intensely uncomfortable, are not dangerous. But panic attacks are hard to manage on your own, and they may get worse without treatment.
Because panic attack symptoms can also resemble other serious health problems, such as a heart attack, it’s important to get evaluated by your health care provider if you aren’t sure what’s causing your symptoms.
What causes panic attack and panic disorder?
Panic attacks may start off by coming on suddenly and without warning, but over time, they’re usually triggered by certain situations. It’s not known what causes panic attacks or panic disorder, but these factors may play a role:
- Major stress
- Temperament that is more sensitive to stress or prone to negative emotions
- Certain changes in the way parts of your brain function
What increases my risk for panic attack and panic disorder?
There are many risk factors for panic attack and panic disorder, such as:
- Family history of panic attacks or panic disorder
- Major life stress, such as the death or serious illness of a loved one
- A traumatic event, such as sexual assault or a serious accident
- Major changes in your life, such as a divorce or the addition of a baby
- Smoking or excessive caffeine intake
- History of childhood physical or sexual abuse
Diagnosis & treatment
The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.
How is panic attack and panic disorder diagnosed?
Your doctor or other health care provider must determine if you have panic attacks, panic disorder or another condition, such as heart or thyroid problems, that resembles panic symptoms. To help pinpoint a diagnosis, you may have:
- A complete physical exam
- Blood tests to check your thyroid and other possible conditions and tests on your heart, such as an electrocardiogram (ECG or EKG)
- A psychological evaluation to talk about your symptoms, stressful situations, fears or concerns, relationship problems, and other issues affecting your life
You may fill out a psychological self-assessment or questionnaire. You also may be asked about alcohol or other substance use.
Not everyone who has panic attacks has a panic disorder. For a diagnosis of panic disorder, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, lists these points:
- You have frequent, unexpected panic attacks.
- At least one of your attacks has been followed by one month or more of ongoing worry about having another attack; continued fear of the consequences of an attack, such as losing control, having a heart attack or “going crazy”; or significantly changing your behavior, such as avoiding situations that you think may trigger a panic attack.
- Your panic attacks aren’t caused by drugs or other substance use, a medical condition, or another mental health condition, such as social phobia or obsessive compulsive disorder.
If you have panic attacks but not a diagnosed panic disorder, you can still benefit from treatment. If panic attacks aren’t treated, they can get worse and develop into panic disorder or phobias.
How is panic attack and panic disorder treated?
Treatment can help reduce the intensity and frequency of your panic attacks and improve your function in daily life. The main treatment options are psychotherapy and medications. One or both types of treatment may be recommended, depending on your preference, your history, the severity of your panic disorder and whether you have access to therapists who have special training in panic disorders.
Psychotherapy, also called talk therapy, is considered an effective first choice treatment for panic attacks and panic disorder. Psychotherapy can help you understand panic attacks and panic disorder and learn how to cope with them.
A form of psychotherapy called cognitive behavioral therapy can help you learn through your own experience that panic symptoms are not dangerous. During therapy sessions, your therapist will help you gradually re-create the symptoms of a panic attack in a safe, repetitive manner. Once the physical sensations of panic no longer feel threatening, the attacks begin to resolve. Successful treatment can also help you overcome fears of situations that you’ve been avoiding because of panic attacks.
Seeing results from treatment can take time and effort. You may start to see panic attack symptoms reduce within several weeks, and often symptoms decrease significantly or go away within several months. You may schedule occasional maintenance visits to help ensure that your panic attacks remain under control or to treat reoccurrences.
Medications can help reduce symptoms associated with panic attacks as well as depression if that’s an issue for you. Several types of medication have been shown to be effective in managing symptoms of panic attacks, including:
- Selective serotonin reuptake inhibitors (SSRIs). Generally safe with a low risk of serious side effects, SSRI antidepressants are typically recommended as the first choice of medications to treat panic attacks. SSRIs approved by the Food and Drug Administration (FDA) for the treatment of panic disorder include fluoxetine (Prozac), paroxetine (Paxil, Pexeva) and sertraline (Zoloft).
- Serotonin and norepinephrine reuptake inhibitors (SNRIs). These medications are another class of antidepressants. The SNRI drug called venlafaxine hydrochloride (Effexor XR) is FDA approved for the treatment of panic disorder.
- These sedatives are central nervous system depressants. Benzodiazepines may be habit-forming, causing mental or physical dependence, especially when taken for a long time or in high doses. Benzodiazepines approved by the FDA for the treatment of panic disorder include alprazolam (Xanax) and clonazepam (Klonopin). If you seek care in an emergency room for a panic attack, you may be given a benzodiazepine to help stop the attack. Benzodiazepines are generally used only on a short-term basis. Because they can be habit-forming, these medications aren’t a good choice if you’ve had problems with alcohol or drug abuse. They can also interact with other medications, causing dangerous side effects.
If one medication doesn’t work well for you, your doctor may recommend switching to another or combining certain medications to boost effectiveness. Keep in mind that it can take several weeks after first starting a medication to notice an improvement in symptoms.
All medications have a risk of side effects, and some may not be recommended in certain situations, such as pregnancy. Talk with your doctor about possible side effects and risks.
Lifestyle changes & Home remedies
What are some lifestyle changes or home remedies that can help me manage panic attack and panic disorder?
The following lifestyles and home remedies might help you cope with panic attack and panic disorder:
- Stick to your treatment plan. Facing your fears can be difficult, but treatment can help you feel like you’re not a hostage in your own home.
- Join a support group. Joining a group for people with panic attacks or anxiety disorders can connect you with others facing the same problems.
- Avoid caffeine, alcohol, smoking and recreational drugs. All of these can trigger or worsen panic attacks.
- Practice stress management and relaxation techniques. For example, yoga, deep breathing and progressive muscle relaxation — tensing one muscle at a time, and then completely releasing the tension until every muscle in the body is relaxed — also may be helpful.
- Get physically active. Aerobic activity may have a calming effect on your mood.
- Get sufficient sleep. Get enough sleep so that you don’t feel drowsy during the day.
- An oral supplement called inositol, which influences the action of serotonin, possibly may reduce the frequency and severity of panic attacks. However, more research is needed. Talk with your doctor before trying any supplements. These products can cause side effects and may interact with other medications. Your doctor can help determine if they’re safe for you.
If you have any questions, please consult with your doctor to better understand the best solution for you.
Hello Health Group does not provide medical advice, diagnosis or treatment.
- Panic attacks and panic disorder. http://www.mayoclinic.org/diseases-conditions/panic-attacks/basics/definition/con-20020825. Accessed 6 Feb 2017
- Panic Disorder. http://www.healthline.com/health/panic-disorder. Accessed 6 Feb 2017
- Panic Disorder. http://www.webmd.com/anxiety-panic/guide/mental-health-panic-disorder. Accessed 6 Feb 2017
Review Date: July 6, 2017 | Last Modified: September 12, 2019