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Panic Attack Symptoms Causes Treatment Preventions & More All you need to know

December 30, 2021

A panic attack is an episode of extreme fear and anxiety without any real danger or frightening stimulus. It is a type of anxiety disorder that triggers many physical reactions in a person without any apparent cause.

It is characterized by catastrophic fear along with cardiorespiratory symptoms, physiological arousal, and sets a flight response.

Panic Attack Symptoms Causes Treatment Preventions

A person gets extremely frightened during a panic attack. He may feel to have a heart attack or loss of control on his nerves. A person may experience panic attacks occasionally in his lifetime.

They are not life-threatening. But if a person frequently gets panic attacks and always fears getting a panic attack, he may have a condition called panic disorder. It affects the quality of life and the patient remains disturbed and anxious.

Panic attack and panic disorder are quite different. A panic attack is a brief period of stress and anxiety with a wave of fear that comes and dies out while panic disorder is a chronic condition of having recurrent panic attacks and fear of getting more.

A patient with panic disorder fears when he thinks about the previous attack and becomes frightened when he sees the place or surroundings of the previous attack and it may set a new attack.

People with panic disorder remain anxious as they can't predict when the new attack will begin.

Panic attacks can occur in teenagers as well as adults. They occur more commonly in women as compared to men.

The risk of panic attacks usually declines with age but the gender gap increases as the older men experience panic attacks rarely as compared to the women of the same age. Women also become feebler in panic attacks as compared to men of the same age.

What are the symptoms of a panic attack?

Panic attacks occur suddenly without any preceding warning. They can occur anytime and anywhere. They don't care whether you are driving a vehicle or giving a presentation on the stage.

They can spoil your business meetings, can arouse you from sleep, or even distract you totally from a class lecture.

People with panic attacks report the following symptoms:

  • Dry mouth
  • Anxiety
  • Annoying thoughts
  • Apathy towards surroundings and the feeling of detachment from the environment
  • Increased heart rate (tachycardia)
  • The feeling of chest congestion
  • Tense muscles
  • Sweating
  • Fear of going mad
  • Fear of losing body control
  • Fear of ending up or death
  • Tingling sensation in arms and hands
  • A strong feeling of some unknown danger lying ahead
  • Nausea
  • Headache
  • Abdominal discomfort with a need to go to the washroom
  • Chills
  • Hot flashes
  • Weakness
  • Ringing sensation in the ears
  • Tightness in your throat
  • Shortness of breath
  • A churning stomach
  • Dizziness or lightheadedness
  • Chest pain
  • Trembling or shaking

The symptoms of a panic attack vary greatly from person to person. The patient becomes extremely annoyed and disturbed during the episode of a panic attack. 

The symptoms of a panic attack usually reach the peak level within 10 to 15 minutes and may last for about 30 minutes but the duration is highly variable ranging from a few seconds to hours.

A person becomes fatigued during a panic attack and the fatigue subsides even after the panic attack.

People having a panic attack once are at a greater risk of having panic attacks later in life as compared to a person who never experienced a panic attack.

These attacks are extremely frightening but they do not cause any physical harm to the body so a person is unlikely to be admitted to hospital for a panic attack.

They are not dangerous but these symptoms may also arise in other medical conditions too that require immediate medical treatment.

What are the types of panic attacks?

Panic attacks are broadly classified into the following three categories:

Un-cued or spontaneous panic attacks:

These panic attacks occur without any warning. They occur spontaneously at any time or any place. They cannot be linked to any specific environmental factors.

They occur without any triggering stimuli from the surroundings. Even these attacks occur during sleep and may arouse a person.

Cued or situation bounded attacks:

These attacks are bound to specific situations. They require specific triggering factors from the environment for onset. They occur always when a person experiences those triggering stimuli.

For example: If a person fears height, he will experience a panicattack when he looks down from the top floor of a building. If a person fears a closed chamber, he will experience a panicattack in an elevator.

Situationally predisposed panic attacks:

They are also linked to a triggering stimulus but don't occur always upon exposure to the stimulus. In this case, a person may or may not experience a panic attack when he is exposed to the triggering stimuli.

For example, a person who fears the crowd or public gathering may not get a panicattack whenever he is walking in the crowd.

What are the causes

The actual causes of a panicattack are not known but it is proposed that panicattacks are caused by misinterpretation of harmless sensations as dangers or threats.

They may run in families showing genetic involvement. Following conditions may be a cause of a panic attack:

  • Genetic predisposition
  • Stress
  • Anxiety
  • Being prone to negative thoughts or emotions
  • A major change in your life such as getting married, having a child, or getting widowed
  • Death of a dear one
  • Depressions
  • History of physical or sexual abuse
  • Alcoholism or drug addiction
  • Smoking marijuana
  • Cigarette smoking
  • Social transitions

"Fight or flight" response:

Panicattacks are due to the ability of the body to cope with an emergency that is termed a "fight or flight" response.

When our body feels some danger, such as a lion coming from the front, or a vehicle is going to hit us, adrenaline hormone is released.

Adrenaline produces physiological changes in the body such as elevation of the blood pressure, inhibition of the digestion of food, increase in respiratory rate, and shifting of blood flow towards muscles. These changes prepare the body either to face the danger or run away.

The same physiological changes occur in a panic attack but the difference is that a panic attack occurs in the absence of danger or harmful stimuli.

What are the risk factors for a panic attack?

Following are the prevalent risk factors of panic attacks.

Obsessive-compulsive disorder:

It is a mental disorder in which a person experiences the same thoughts again and again and performs some tasks repeatedly as a compulsion.

The patient can neither control his thoughts nor the repetitive activities but for a short time only.

It affects the normal routine activities. The patient feels that his activities are ridiculous but still unable to control them. It causes anxiety, stress as well as panicattacks and increases the risk of attempting suicide.

Postural orthostatic tachycardia syndrome:

It is a condition in which posture change such as standing from lying position causes an abnormal increase in heart rate.

Other symptoms may include blurred vision, lightheadedness, the feeling of weakness, and the troubled thinking that initiate a panic attack.

Post-traumatic stress disorder:

Post-traumatic stress disorder is a mental and behavioral condition that develops after suffering from a traumatic event such as a roadside accident, sexual assault, business loss, domestic violence, mental trauma due to the death of a dear one, or child abuse, etc.

It results in disturbing and annoying thoughts related to the traumatic event. It also increases the risk of developing a panicattack.

Hypoglycemia:

A decrease in blood glucose level is called hypoglycemia.

It causes a variety of symptoms such as confusion, weakness, inability to walk, difficulty in talking, seizures, and loss of consciousness.

Similar symptoms arise in the case of a panic attack so it may be linked to a panic attack.

Hyperthyroidism:

Hyperthyroidism is characterized by increased production of thyroid hormone and an increase in basal metabolic rate. It alters the thinking process and is directly linked to panic attacks.

It causes a variety of symptoms such as tachycardia, anxiety, hand tremor, weight loss and enlargement of the thyroid, etc.

Wilson disease:

Wilson disease is due to the accumulation of copper in the body. It affects the brain and liver mainly.

It increases the risk of panicattacks. The most common symptoms are tremors, muscle weakness, anxiety, troubled thinking, yellowish skin, and build-up of fluid in the abdomen, etc.

Mitral valve prolapse:

It is a disorder of the mitral valve in which an abnormally thickened valve moves back into the left atrium at the onset of systole. It can lead to mental anxiety along with panic attacks.

Pheochromocytoma:

Pheochromocytoma is a condition characterized by the tumor of the adrenal medulla. These tumors increase the production of adrenaline that produces the symptoms such as tachycardia, sweating, hypertension. Increased adrenaline can also lead to a panicattack.

Labyrinthitis:

Labyrinthitis is the inflammation of the inner ear. It causes nausea, vomiting, ringing in the ears, difficulty in hearing, and hearing loss. It makes a patient extremely uncomfortable and can lead to a panic attack.

Hyperventilation:

Hyperventilation causes respiratory alkalosis due to disturbance of acid-base balance in the body. It causes lightheadedness, tachycardia, dizziness, which can initiate a panicattack.

What are the complications

 A panicattack that occurs rarely doesn't cause any of the serious complications but if a person gets panic syndrome with frequent panicattacks then it's detrimental to his health and will cause several psychiatric problems.

It will affect his daily routine as well as the sleep-wake cycle. He will be in a constant state of fear and anxiety that can lead to other medical issues. The patient experiences a poor quality of life along with social isolation.

Common complications associated with frequent panic attacks are:

  • Development of unnecessary phobias such as fear of moving outside, fear of moving to crowd or fear of driving, etc.
  • Depression
  • Psychiatric disorders
  • Irritative behavior
  • Alcohol misuse
  • Drug addiction
  • Suicidal thoughts increasing the risk of attempting suicide

When to see a doctor?

If you experience panic attacks, consult a physician as soon as possible. Panic attacks are highly uncomfortable and their symptoms resemble other medical anomalies too such as myocardial infarction.

So if you experience the symptoms like increased heart rate, sweating, troubled breathing, nausea and confusion seek medical assistance as soon as possible.

Diagnoses of a panic attack:

It is not difficult to diagnose a panic attack. It can be diagnosed easily on observing the symptoms like:

  • Increased heart rate
  • Fear
  • Nausea
  • Headache
  • Hot flashes
  • Weakness
  • Ringing sensation in the ears
  • Tightness in your throat
  • Shortness of breath etc.

What is the treatment

The physician first examines and rules out the possibility of unrelated medical problems that may cause a panicattack. Then he may refer you to a psychologist or psychiatrist for further evaluation and treatment.

Treatment of frequent panic attacks may involve psychotherapy as well as medication.

Psychotherapy:

To treat the problems like panic disorders, cognitive behavioral therapy (CBT) is useful. During this therapy, a patient learns new ways of thinking and responding to different stimuli that cause a panicattack.

Once a patient learns to respond properly to the anxiety, the risk of getting panicattacks is greatly reduced.

Medication:

The frequent panicattacks can be treated by the use of antidepressants and anti-anxiety drugs such as:

  • Beta-blockers
  • Benzodiazepines
  • Selective serotonin reuptake inhibitors
  • Serotonin-norepinephrine reuptake inhibitors

What are the home remedies for a panic attack?

A panicattack is an uncomfortable condition. You can cope with a panicattack by:

  • Distracting yourself from the symptoms and try to focus on something else such as recall some kind of joke or count back from 100 etc.
  • Remind yourself that it will not cause any harm.
  • Assure yourself that you have experienced this before and you are safe and sound.
  • Don't try to fight it and focus on positive and pacifying images
  • Breathe deeply and slowly

What are the preventions

The risk of panic attacks can be reduced by:

  • Adopting the habit of regular exercise
  • Spending time in the company of nature
  • Avoiding caffeine and alcohol
  • Avoiding cigarette smoking
  • Seeking medical assistance if you experience anxiety or depression
Abdur Rashid
Medically Reviewed By Abdur Rashid
MSC Public Health, MCSP, MHCPC
BSC (Hon) Physiotherapy
Consultant Neuro-spinal & Musculoskeletal Physiotherapist

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