A panic attack can happen when a person has high levels of anxiety. Anyone can have a panic attack. Sometimes, these attacks are a symptom of panic disorder.
During a panic attack, a person may experience overwhelming emotions, including helplessness and fear. Physical symptoms can include a fast heartbeat, rapid breathing, sweating, and shaking.
Panic attacks often happen in specific situations that trigger heightened stress. But some people experience them repeatedly, with no clear triggers. In this case, the person may have panic disorder.
A doctor will use criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) to diagnose panic disorder.
Around 1 in 75 people have panic disorder, according to the American Psychological Association (APA). It can severely effect the quality of life.
However, panic attacks and panic disorder are both mental health issues that treatments can help manage.
A panic attack may be an isolated issue or a reoccurring symptom of panic disorder.
Regardless, an attack can be frightening, upsetting, and uncomfortable. The feelings are more intense than those of stress that people usually experience.
Panic attacks typically last 5–20 minutes, but the symptoms can linger for up to 1 hour.
According to the Anxiety and Depression Association of America, a panic attack involves at least four of the following symptoms:
- chest pain and discomfort
- chills or feeling hot
- dizziness and lightheadedness
- a fear of dying
- a fear of losing control or “going crazy”
- heart palpitations, an irregular heartbeat, or a rapid heart rate
- numbness or tingling
- shaking, sweating, or trembling
- trouble breathing, which may feel like choking
- feeling detached from reality
- nausea and an upset stomach
The symptoms of a panic attack can resemble those of other medical conditions, including lung disorders, heart conditions, or thyroid problems.
Sometimes, a person having a panic attack seeks emergency medical care because they feel as if they are having a heart attack. Here, learn to tell the difference.
What is panic disorder?
Panic disorder is a mental health condition, and panic attacks are a symptom.
Many people experience at least one panic attack at some point, but people with panic disorder experience recurrent attacks.
Genetic and biological factors may increase the likelihood of having panic disorder, but scientists have yet to identify a link with any specific gene or chemical.
The disorder may develop when a person with certain genetic features faces environmental stresses. These include major life changes, such as having a first baby or leaving home. A history of physical or sexual abuse may also increase the risk.
Panic disorder may develop when a person who has experienced several panic attacks becomes afraid of having another one. This fear can cause them to withdraw from friends and family and refrain from going outside or visiting places where a panic attack may occur.
Panic disorder can severely limit a person’s quality of life, but effective treatments are available.
Anxiety is a natural response to stress, but if anxiety levels become too high, this can lead to panic.
When the brain receives warnings of danger, it alerts the adrenal gland to release adrenaline, which is sometimes called epinephrine or the “fight or flight” hormone.
A rush of adrenaline can quicken the heartbeat and raise blood pressure and the rate of breathing. These are all characteristics of a panic attack.
A number of issues can increase the likelihood of having panic attacks and panic disorder. These include:
- genetic factors
- major stress or life changes
- caffeine, tobacco, alcohol, recreational drugs, and sugary foods and drinks
Also, panic attacks can be a symptom of other conditions, such as:
Using the guidelines in the DSM-5, a doctor may diagnose panic disorder if the person has:
- frequent, unexpected panic attacks
- had an ongoing fear of having a panic attack for at least 1 month
- significantly changed their behavior due to this fear
- no other condition, such as social phobia, and no use of medications or drugs that could account for the symptoms
The most common treatments for panic disorder are medications and psychotherapy.
According to the APA, many people feel better when they understand what panic disorder is — and how common it is.
A person may benefit from cognitive behavioral therapy, sometimes shortened to CBT. It can help them identify triggers and new ways of facing difficult situations.
Another option is interoceptive exposure, which teaches a person to grow accustomed to the symptoms of a panic attack a safe environment. The aim is to reduce the fear of an attack and to break the symptoms down into manageable stages.
Meanwhile, relaxation techniques such as slow breathing and visualization can also help.
For some people, a doctor may also prescribe one or more of the following medications:
- Benzodiazepines: These can treat symptoms of anxiety, and examples include alprazolam (Xanax) and clonazepam (Klonopin).
- Selective serotonin reuptake inhibitors (SSRIs): These are commonly used to treat depression, and some examples include fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft).
- Serotonin and norepinephrine reuptake inhibitors (SNRIs): These are also antidepressants, and one example is venlafaxine hydrochloride (Effexor XR).
- Beta-blockers: These can regulate the heartbeat.
SSRIs and SNRIs are long-term treatments and can take several weeks to have an effect. Benzodiazepines can reduce symptoms more quickly, but there is a risk of dependence.
Some medications produce adverse effects. It is important that a doctor works with the person to find the best possible treatment.
In 2020, the Food and Drug Administration (FDA) strengthened their warning about benzodiazepines. Using these drugs can lead to physical dependence, and withdrawal can be life-threatening. Combining them with alcohol, opioids, and other substances can result in death. It is essential to follow the doctor’s instructions when using these drugs.
Various tips can help reduce the frequency and impact of panic attacks.
When a panic attack starts:
- Try not to fight it.
- Stay where you are.
- Practice slow, deep breathing.
- Try to visualize positive images.
- Remember that it will soon pass and that is not life threatening.
To reduce the risk of further attacks:
- Learn about panic attacks and talk to others about the experience.
- Avoid substances that can contribute to the issue, including caffeine, tobacco, alcohol, recreational drugs, and sugary foods and drinks.
- Get regular sleep and exercise to reduce stress.
- Practice yoga, deep breathing, positive visualization, and other techniques for relaxation.
Without treatment, panic disorder can harm many aspects of a person’s life. It may, for example, lead to:
- an unhealthy use of alcohol, tobacco, or other substances
- phobias, such as agoraphobia
- problems at school or work
- social withdrawal
- other health concerns, which require frequent medical care
- financial difficulties
- suicidal thoughts or behaviors
If you know someone at immediate risk of self-harm, suicide, or hurting another person:
- Ask the tough question: “Are you considering suicide?”
- Listen to the person without judgment.
- Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
- Stay with the person until professional help arrives.
- Try to remove any weapons, medications, or other potentially harmful objects.
If you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24 hours per day at 800-273-8255. During a crisis, people who are hard of hearing can call 800-799-4889.
Panic attacks and panic disorder affect many people. The attacks can be frightening, but there are effective treatments.
Anyone with concerns about panic attacks or panic disorder should receive medical care. Receiving this care early on can keep the symptoms from worsening and prevent complications.