Definition

What is a panic attack?

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 a panic attack?

Please discuss with your doctor for further information.

Symptoms

What are the symptoms of a panic attack?

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.

Panic attacks typically include some of these symptoms:

  • Sense of impending doom or danger
  • Fear of loss of control or death
  • Rapid, pounding heart rate
  • Sweating
  • Trembling or shaking
  • Shortness of breath or tightness in your throat
  • Chills
  • Hot flashes
  • Nausea
  • Abdominal cramping
  • Chest pain
  • Headache
  • Dizziness, lightheadedness or faintness
  • Numbness or tingling sensation
  • Feeling of unreality or detachment

One of the worst things about panic attacks is the intense fear that you’ll have another one. You may fear having a panic attack so much that you avoid situations where they may occur.

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.

Causes

What causes a panic attack?

It’s not known what causes panic attacks or panic disorder, but these factors may play a role:

  • Genetics
  • Major stress
  • Temperament that is more sensitive to stress or prone to negative emotions
  • Certain changes in the way parts of your brain function

Panic attacks may start off by coming on suddenly and without warning, but over time, they’re usually triggered by certain situations.

Some research suggests that your body’s natural fight-or-flight response to danger is involved in panic attacks. For example, if a grizzly bear came after you, your body would react instinctively. Your heart rate and breathing would speed up as your body prepared itself for a life-threatening situation. Many of the same reactions occur in a panic attack. But it’s not known why a panic attack occurs when there’s no obvious danger present.

Risk factors

What increases my risk for a panic attack?

Symptoms of panic disorder often start in the late teens or early adulthood and affect more women than men.

Factors that may increase the risk of developing panic attacks or panic disorder include:

  • 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 a panic attack 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.

How is a panic attack 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

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

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 a panic attack?

The following lifestyles and home remedies might help you cope with a panic attack:

  • Learn about panic and anxiety. Simply knowing more about panic can go a long way towards relieving your distress. So read up on anxiety, panic disorder, and the fight-or-flight response experienced during a panic attack. You’ll learn that the sensations and feelings you have when you panic are normal and that you aren’t going crazy.
  • Avoid smoking, alcohol, and caffeine. These can all provoke panic attacks in people who are susceptible. As a result, it’s wise to avoid alcohol, cigarettes, coffee, and other caffeinated beverages. Also be careful with medications that contain stimulants, such as diet pills and non-drowsy cold medications.
  • Learn how to control your breathing. Hyperventilation brings on many sensations (such as lightheadedness and tightness of the chest) that occur during a panic attack. Deep breathing, on the other hand, can relieve the symptoms of panic. By learning to control your breathing, you develop a coping skill that you can use to calm yourself down when you begin to feel anxious. If you know how to control your breathing, you are also less likely to create the very sensations that you are afraid of.
  • Practice relaxation techniques. When practiced regularly, activities such as yoga, meditation, and progressive muscle relaxation strengthen the body’s relaxation response—the opposite of the stress response involved in anxiety and panic. And not only do these relaxation practices promote relaxation, but they also increase feelings of joy and equanimity. So make time for them in your daily routine.
  • Connect face-to-face with family and friends. Anxiety thrives when you feel isolated so regularly reach out to people who care about you. If you feel that you don’t have anyone to turn to, explore ways to meet new people and build supportive friendships.
  • Exercise regularly. Exercise is a natural anxiety reliever so try to get moving for at least 30 minutes on most days (three 10-minute sessions is just as good). Rhythmic aerobic exercise that requires moving both your arms and legs—like walking, running, swimming, or dancing—can be especially effective.
  • Get enough restful sleep. Insufficient or poor quality sleep can make anxiety worse, so try to get seven to nine hours of quality sleep a night. If sleeping well is a problem for you, these tips to getting a good night’s sleep can help.

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.

Review Date: November 9, 2017 | Last Modified: November 9, 2017

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