Reviewed by Dr. Kalman Khodik, PsyD, Licensed Psychologist (NY & NJ), Founder and Clinical Director
People who experience even one panic attack are more likely to experience recurrent panic attacks, worry about future panic attacks, or change their behavior in an attempt to avoid future panic attacks.
Key points
- The physiological symptoms of a panic attack can make it feel like a cardiac event or asthma attack.
- Effective treatment can help reduce the frequency and intensity of panic attacks.
- Cognitive Behavior Therapy (CBT) is often a useful treatment for panic attacks and general anxiety.
- Deep breathing, mindfulness, and other techniques can help mitigate panic attacks.
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Overview
A panic attack is a sudden, intense surge of fear that can come on unexpectedly, sometimes triggered by known stressors, and other times seemingly out of the blue. During a panic attack, you may experience rapid heartbeats, trouble breathing, or other physical symptoms that feel overwhelming. Panic attacks can occur at any time—whether you’re driving, shopping, asleep, in a meeting, or at school. They can happen frequently, infrequently, or sometimes just once.Symptoms
Panic attacks can vary in how they manifest, but the symptoms typically reach their peak within a few minutes. Once the attack subsides, you may feel drained and fatigued. Common physical signs or symptoms of a panic attack include:- Rapid heartbeat or the sensation of your heart racing
- Shaking or trembling
- Chest discomfort or tightness
- Stomach cramps
- Difficulty breathing or shortness of breath
- Excessive sweating
- Lightheadedness or feeling faint
- Nausea
- Hot flashes or chills
- Tingling or numbness
Panic attack symptoms also often include:
- A sense of lurking or near danger.
- Feeling a loss of control or fear of death.
- Feeling detached from reality.
When a panic attack occurs, the nervous system releases adrenaline and other stress hormones as part of the fight-or-flight response. This often leads to intense anxiety, and the person may feel as though they are about to die. Many people confuse a panic attack with a heart attack or another medical emergency.
Causes
While it can be difficult to determine why a particular individual has a panic attack, there are known risk factors for panic disorder.
- Genetics: Panic disorder tends to run in families, suggesting a genetic predisposition.
- Brain chemistry or brain function: Imbalances in the neurotransmitters, such as serotonin and norepinephrine, can trigger panic attacks.
- Stressful events: Divorce, loss, or major life changes (such as the birth of a child) can trigger panic attacks.
- Phobias: The fear of specific objects or situations can trigger panic attacks in some people.
Risk factors
Panic disorder symptoms typically appear in late adolescence or early adulthood and affect more women than males.
Specific exposures have been found to increase the risk of experiencing panic attacks.
- Trauma: Traumatic experiences (such as experiencing sexual assault, violence, or a serious accident), as well as a history of physical or sexual abuse in childhood.
- Substance use: The abuse of drugs or alcohol can trigger panic attacks.
- Caffeine or nicotine: Stimulants like caffeine or nicotine can exacerbate panic attacks.
- Stressful life events or major life changes.
Diagnosis
Not everyone who experiences a panic attack will have all the symptoms listed, and some individuals may encounter additional signs.
Panic attacks can sometimes feel similar to a heart attack or asthma. It’s important to consult with your doctor to rule out any other potential medical conditions.
The following criteria help identify a panic attack:
- A sudden onset of intense fear or discomfort, peaking within minutes.
- Four or more of these symptoms are present: sweating, trembling, shortness of breath or a sensation of choking, chest tightness (pain or discomfort), nausea or abdominal discomfort, dizziness, unsteadiness, lightheadedness or faintness, chills or hot flashes, and a racing heart.
The symptoms are not caused by a medical condition, medication, or substance use.
Treatment
Effective treatment can help reduce the frequency and intensity of panic attacks.
Panic disorder can often be treated effectively with therapy, medication, or a combination of therapy and medication. Treatment may include cognitive-behavioral therapy (CBT), which can help you learn to manage and cope with panic attacks.
- Cognitive Behavior Therapy (CBT) is an effective treatment for panic attacks and general anxiety. CBT can help you to identify and modify problematic thought patterns.
- Learning and practicing relaxation techniques can help you mitigate panic episodes. Deep breathing decreases the activity of your fight or flight system.
Reach out today
Panic disorders can feel overwhelming, but you don’t have to face them on your own. With compassionate, evidence-based therapy, you can learn tools to manage and even overcome the intense fear and physical symptoms associated with panic attacks.
Please reach out today to schedule an appointment. We look forward to hearing from you.
Related information
“Cognitive-behavioral therapy (CBT) is a highly effective treatment for panic disorder, with approximately 70% of patients responding favorably to treatment.” – Craske, M.G., Treanor, M., Conway, C.C., Zbozinek, T.D., & Vervliet, B. (2014). Maximizing exposure therapy: An inhibitory learning approach. Behaviour Research and Therapy, 58, 10-23.
“Mindfulness-based interventions have shown promise as an adjunctive treatment for panic disorder, with some studies suggesting that they may be effective in reducing panic symptoms and improving quality of life.” – Arch, J.J., & Craske, M.G. (2010). Mechanisms of mindfulness: Emotion regulation following a focused breathing induction. Behaviour Research and Therapy, 48(8), 741-746.
“Physical exercise has been shown to be an effective adjunctive treatment for panic disorder, with some studies indicating that it may be as effective as medication in reducing symptoms.” – Hofmann, S.G., & Smits, J.A. (2008). Cognitive-behavioral therapy for adult anxiety disorders: A meta-analysis of randomized placebo-controlled trials. Journal of Clinical Psychiatry, 69(4), 621-632.
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