Panic Attacks & Panic Disorder
Symptoms, Triggers, and Evidence-Based Treatment Options
What is a panic attack?
A panic attack is a sudden surge of overwhelming fear that triggers severe physical reactions when there is no real danger or apparent cause. It can be incredibly frightening and may make you think you’re losing control, having a heart attack, or even dying.
These episodes can occur at any time, even during sleep. While panic attacks are not life-threatening, they can be frightening. Understanding the symptoms of a panic attack and how it manifests can be the first step toward managing and overcoming this anxiety disorder.
- Rapid, pounding heart rate: This is often the first sign of a panic attack. The heart rate can increase dramatically, causing a sensation of a pounding heart or palpitations.
- Sweating: Excessive sweating is a common symptom, even if the person is not overheated.
- Trembling or shaking: This can range from slight trembling to full-body shaking.
- Shortness of breath or tightness in the throat: Some people feel like they can’t breathe or are being choked.
- Chills or hot flashes: These can occur even if the person is not in a hot or cold environment.
- Nausea or abdominal discomfort: This can range from a slight stomachache to severe nausea.
- Feeling dizzy, light-headed, or faint: Some may faint, but most feel like they might.
- Fear of losing control or going crazy: This fear is often due to the intensity of the symptoms and the inability to control them.
- Fear of dying: Because the symptoms can be so severe, many people fear that they are having a heart attack or other life-threatening condition.
- Numbness or tingling sensations: These sensations can occur in any part of the body but are most commonly felt in the hands, feet, arms, or legs.
- Feelings of unreality or being detached from oneself: This can be one of the most disturbing symptoms, as the person feels as if they are observing themselves from an outside perspective.
The exact causes of why people with panic disorder have attacks are not entirely understood, but it’s clear that a combination of factors contributes to their occurrence. These include:
- Genetic Factors: Panic disorder can sometimes run in families, suggesting a genetic predisposition. If a close relative, such as a parent or sibling, has panic disorder, you may be more likely to develop the condition.
- Biological: Certain changes in how parts of your brain function may play a role in panic attacks. Some researchers believe panic attacks are like “false alarms,” where our body’s natural fight-or-flight response to danger is involved too often, too intensely, or some combination of the two.
- Major Stress: Significant life stressors, such as the death of a loved one, a traumatic event, or significant life changes, can trigger panic attacks.
- Temperament: Individuals more sensitive to stress or prone to negative emotions may be more likely to experience panic attacks.
- Environmental Factors: Certain environmental factors, such as significant changes in your life, like a divorce or the addition of a baby, can contribute to the onset of panic attacks.
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- Example 1 – The Unexpected Panic Attack at the Grocery Store:
Imagine you’re at the grocery store, standing in the cereal aisle. Suddenly, your heart starts to race, and you feel a wave of heat rushing over you. Your hands start to shake, and you feel a sense of impending doom. You’re unsure why this is happening – you were trying to decide between cornflakes and oatmeal. This is a classic example of a panic attack occurring unexpectedly in a mundane situation.
- Example 2 – The Panic Attack Triggered by Public Speaking:
You’re about to present at work. As you approach the podium, your palms sweat, your throat feels tight, and your mind goes blank. You feel dizzy and fear that you might faint. Despite your extensive preparation, the fear of public speaking has triggered a panic attack.
- Example 3 – The Panic Attack During a Plane Ride:
You’re on a plane, and as it starts to take off, you feel an intense fear gripping you. Your breath becomes shallow, your chest tightens, and you feel like you’re choking. The idea of being unable to escape or get off the plane has triggered a panic attack.
How to Handle a Panic Attack
When a panic attack strikes, it can feel overwhelming. However, there are strategies you can use to help manage the various symptoms of panic and regain control. Here are some techniques to consider:
- Deep Breathing: During a panic attack, your breathing can become quick and shallow, which may increase feelings of fear and anxiety. Deep breathing can help to reduce these symptoms. Try to inhale slowly through your nose, hold your breath for a few seconds, and then exhale slowly through your mouth.v
- Don’t Distract Yourself: While it might seem helpful to distract yourself during a panic attack, this can reinforce the idea that the panic attack is something to be feared.
- Grounding Techniques: Grounding techniques can help you stay connected to the present moment, alleviating panic attack symptoms. This could involve focusing on the physical sensations of your feet touching the ground or describing what you can see, hear, and feel.
- Mindfulness and Meditation: Mindfulness involves focusing on the present moment without judgment. During a panic attack, try to focus on the physical sensations you’re experiencing and remind yourself that these are temporary and will pass.
- Seek Professional Help: If panic attacks impact your quality of life, it may be beneficial to seek professional help. Therapists and counsellors can provide you with practical strategies and techniques to manage panic attacks.
Everyone’s experience with panic attacks and panic disorder is unique, and what works for one person may not work for another. Exploring different techniques and finding what works best for you is important.
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Prevent Panic Attacks
While panic and anxiety attacks often can feel sudden and unpredictable, there are proactive steps you can take to reduce their frequency and intensity. Here are some strategies to consider:
- Educate Yourself: Understanding panic attacks and recognizing the symptoms can help you feel more in control when an attack occurs. It can also help you distinguish between a panic attack and other health issues. Knowledge is power; the more you know about your condition, the better you’ll be to manage it.
- Regular Exercise: Regular physical activity can help reduce anxiety by boosting your mood and acting as a natural stress reliever.
- Healthy Eating: A balanced diet can support your overall mental health. Try to limit caffeine and alcohol, which can trigger or worsen panic attacks in some people.
- Adequate Sleep: Lack of sleep can contribute to anxiety and increase the likelihood of panic attacks. Aim for 7 to 9 hours of quality sleep per night.
- Mindfulness and Relaxation Techniques: Regular mindfulness meditation, yoga, or other relaxation techniques can help reduce anxiety and make you less prone to panic attacks.
- Cognitive Behavioural Therapy (CBT): CBT can teach you different ways of thinking, behaving, and reacting to situations that help you feel less anxious and fearful.
- Support Network: Connecting with others experiencing the same struggles can provide comfort, reduce feelings of isolation, and provide practical advice.
Therapy Modalities That Can Help
Various therapeutic approaches can provide you with the tools and strategies to manage and overcome these intense episodes of fear. Here are some of the most effective therapies for panic attacks:
- Cognitive Behavioral Therapy (CBT): CBT is a highly effective treatment for panic attacks and anxiety disorder. CBT helps you understand and change thought patterns that lead to fear and anxiety. CBT has the strongest research support for treating panic disorder.
- Exposure Therapy: This therapy encourages you to confront your fears and anxieties directly in a safe and controlled environment. Over time, this can help reduce the fear associated with your triggers.
- Mindfulness-Based Stress Reduction (MBSR): This therapy combines mindfulness, meditation, and yoga to help you become more aware of your physical presence and reduce anxiety.
- Dialectical Behavioural Therapy (DBT): DBT can help you learn to manage your emotions, tolerate distress, and improve your relationships, which can be beneficial in controlling panic attacks.
- Eye Movement Desensitization and Reprocessing (EMDR): This therapy is often used for post-traumatic stress disorder (PTSD) but can also effectively treat panic disorder. It can help change how you react to memories of traumatic events that cause your panic disorder symptoms.
Working with a mental health professional to determine the best therapy for your specific needs is essential. With the right help and treatment, you can control your panic attacks.
While panic attacks can be incredibly distressing and disruptive, it’s important to remember that they are treatable and full recovery is possible. With professional help, you can learn to manage and even overcome panic disorder.
Therapy, particularly cognitive-behavioural therapy, is highly effective in treating panic disorder. Our counselling clinic offers in-person and online therapy tailored to your needs and circumstances.
Don’t let panic attacks control your life. Reach out to us and start your journey toward recovery today. Remember, seeking help is a sign of strength, not weakness. You don’t have to face this alone. Search for a therapist near you.
While extremely distressing, panic attacks themselves are not dangerous or life-threatening. However, their physical symptoms may feel intense or resemble other medical emergencies.
The main difference between a panic attack and an anxiety attack is the intensity and duration of symptoms.
A panic attack comes on suddenly, and symptoms peak within minutes. It includes intense physical symptoms like a racing heartbeat, shortness of breath, dizziness, sweating, and trembling. Feelings of fear and impending doom are also common. A panic attack typically lasts around 10 minutes or less.
A panic attack typically lasts about 10 minutes. However, the duration can vary from person to person and even from one attack to another. It's important to note that while the attack itself may be brief, the effects can last for hours or even days.
Yes, panic attacks can occur in younger age groups, especially during the teen years as anxiety increases. It's important to provide therapy and teach coping methods.
No matter what you are struggling with, we are here for you.
No matter what you are struggling with, we are here for you.
- Pompoli, A., Furukawa, T., Efthimiou, O., Imai, H., Tajika, A., & Salanti, G. (2018). Dismantling cognitive-behaviour therapy for panic disorder: A systematic review and component network meta-analysis. Psychological Medicine, 48(12), 1945-1953.
- Telch, M. J., Lucas, J. A., Schmidt, N. B., Hanna, H. H., LaNae Jaimez, T., & Lucas, R. A. (1993). Group cognitive-behavioral treatment of panic disorder. Behaviour research and therapy, 31(3), 279–287. https://doi.org/10.1016/0005-7967(93)90026-q
- Barlow, D. H. (2002), Anxiety and its disorders: The nature and treatment of anxiety and panic, Second Edition. Guildford Press, p. 134.