What is a Panic Attack?
A panic attack manifests as an episode of extreme fear, even when no danger is present. Panic attacks can affect you both mentally and physically.
An attack can range from mild to severe enough to be mistaken for a heart attack. These attacks can occur unpredictably or be triggered by certain stimuli (e.g. crowds). (1)
Anyone can suffer from a panic attack. Depending on the cause, these attacks can vary in frequency and length. (2)
Causes
Panic attacks can be caused by a variety of different factors. Illnesses, external stimuli and certain substances can all provoke a panic attack.
The potential causes of a panic attack can include: (3)
Panic Disorder
Panic disorder is a type of anxiety disorder. It manifests as frequent, unpredictable panic attacks.
This condition can occur alongside agoraphobia. This is another type of anxiety disorder that results in a fear of situations or locations that can provoke panic.
Individuals with panic disorder but who do not have agoraphobia are extremely concerned about suffering from future panic attacks.
The general behavior of the person may dramatically change after an attack. Most importantly, no other illness can account for the panic attacks.
Panic disorder with agoraphobia is the same, except for one additional criterion. The affected person may begin avoiding any and all situations that could cause an attack.
If the person is forced into a situation they want to avoid, they can become extremely anxious. This is caused by a powerful fear of suffering from a panic attack. (4)
Social Anxiety Disorder
Social anxiety disorder is a type of phobic disorder. It was previously known as social phobia.
Individuals with this disorder have a fear of social situations. It is often characterized by severe, disproportionate anxiety of embarrassment.
Depending on the person, this fear can range from mild to debilitating. Meeting new people, speaking in public or even eating in public can be difficult.
If a person with social anxiety disorder is forced into a social situation, they may become highly distressed. (5)
In turn, this distress can lead to a panic attack. Attacks that are caused by this condition are classed as social anxiety disorder with panic attacks. (6)
Narcotics Abuse
The abuse of certain narcotics can trigger a panic attack. Methamphetamines in particular can provoke panic attacks as well as a host of other negative effects. (7)
Withdrawal from narcotics can also cause panic attacks in some individuals. (8)
Post Traumatic Stress Disorder (PTSD)
Post-traumatic stress disorder (PTSD) usually occurs after situations of severe emotional or physical distress. Panic attacks can occur in individuals with PTSD. (9)
Life threatening injuries, assault, or surviving a natural disaster can cause PTSD. Military veterans are often diagnosed with this disorder.
Other situations that can cause this condition include the death of a beloved friend or family member, or witnessing another person go through a trauma.
PTSD can cause the affected person to feel frightened and stressed even when there is no direct danger. (10)
Symptoms
Panic attacks are typically caused by illnesses, particularly anxiety disorders. Many individuals will experience recurrent panic attacks.
However, some people can suffer from one panic attack and never have one again. A panic attack usually does not last for more than a maximum of 30 minutes.
Depending on the underlying cause, you can suffer a panic attack in any location. The attack can occur at home, at work, or even while driving. (11)
The symptoms of a panic attack can include: (12)
Heart Palpitations
Heart palpitations are the sensation of your heart is beating very fast, or fluttering. You may feel your heartbeat in your throat or neck.
Panic attacks typically cause heart palpitations. However, they can also be a sign of serious medical conditions such as a heart attack. (13)
If heart palpitations continue more than 20 minutes after you have settled down, seek medical attention. (14)
Sweating
If you are having a panic attack, it can cause you to sweat. You may begin sweating even if you have not been physically active.
Fear of Death
Despite the fact that a panic attack cannot cause you physical harm, it can be extremely unpleasant.
The physical sensations and loss of control over your body can cause you to believe that you are going to die.
You may be convinced that you have a serious physical problem, or are having a heart attack. These sensations will pass as the attack subsides.
Nausea
During the onset of the panic attack or during the attack itself, you may feel nausea.
Shortness of Breath
Sudden shortness of breath is a typical symptom of a panic attack. This may escalate into a feeling of being choked.
Trembling
A panic attack may be accompanied by trembling.
Ringing Ears
While you are in the throes of a panic attack, you might hear a ringing noise in your ears.
Diagnosis
A panic attack can be diagnosed based on a description of your symptoms after it occurs.
There are no specific medical tests (e.g. blood analysis) that can diagnose why you have had a panic attack.
The diagnostic process to determine the cause of a panic attack can include: (15)
Ruling out Medical Disorders
Your doctor will review your medical history. Certain physical ailments can cause symptoms that are similar to those of a panic attack.
For example, hyperthyroidism is a condition that affects your thyroid. It is caused by an excess production of hormones from your thyroid gland.
When your thyroid is overactive, it can cause sweating, weight loss, and tachycardia (irregular heartbeat). These symptoms can mimic those of a panic attack. (16)
Medications
Your doctor will likely ask if you take any narcotics or prescription medications. Certain diet pills and cold medications can cause similar effects to those of a panic attack. (17)
Determining the Cause
Your doctor will ask about the frequency and severity of your panic attacks. You will also be asked to describe the circumstances of your attack or attacks.
This can help your doctor determine what is provoking your panic attacks. For example, if you have very frequent recurrent panic attacks you may be diagnosed with panic disorder. (18)
FAQ
What is a panic attack? A panic attack is an episode of extreme fear that can affect you physically and mentally.
What causes a panic attack? Potential causes of a panic attack can include: panic disorder, social anxiety disorder, depression, and stimulants.
What are the signs of a panic attack? The signs include nausea, shortness of breath, sweating and heart palpitations. They also include sweating, nausea, and shortness of breath. Other symptoms are fear of a loss of control, fear of death, ringing in the ears, and trembling.
How do doctors diagnose a panic attack? Panic attacks are diagnosed based on a description of your symptoms.
When should you go to the doctor with a panic attack? Consult a doctor if your panic attacks are interfering with your daily life. This can include avoiding certain activities, places or stimuli for fear of a panic attack. (19)
Can you prevent a panic attack? Depending on the underlying cause of a panic attack, treatment can reduce the chances of having one in the future. (20)
What can relieve a panic attack? You can practice techniques such as slow breathing or mindfulness. For example, repeating the phrase “I will be okay” and acknowledging that your attack will eventually pass. (21)
Is a panic attack life threatening? No, panic attacks alone are generally not life threatening. However, some of the conditions that cause panic attacks – such as panic disorder – are associated with higher mortality risk. (22)
What is the best treatment for a panic attack? Treatment for a panic attack depends on the cause and ranges from pharmacological to non-pharmacological interventions. (23)
What are the long term complications of panic attack? Panic attacks can impact your quality of life. Fear of suffering panic attacks can cause you to avoid certain places and activities. (24)
Summary
If you are suffering from panic attacks, consult your doctor. It is important to discover the underlying cause of these episodes.
In some cases, a physical ailment could be mimicking the symptoms of a panic attack. If this is the case, diagnosis and treatment can alleviate your symptoms.
If you have a mental disorder that is causing panic attacks, identifying it is the first step towards reducing the attacks. (25)
When you experience a panic attack, keep in mind that the attack cannot physically hurt you and it will pass.
Reach out to your friends and family for support. Ensure that they understand that being reassuring and soothing when you have an attack may help it pass faster.
Hyperventilating (rapidly breathing) during a panic attack can make it worse. Breathe in through your nose, and out slowly through your mouth.
Over time, you can learn to identify which triggers and stressors worsen your panic attacks.
Excessive alcohol and caffeine consumption as well as smoking can exacerbate the attacks.
Depending on what these triggers are (e.g. meeting new people) you may have to learn to confront them . (26)