What to know about panic attacks and panic disorder

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.

However, panic attacks and panic disorder are both mental health issues that treatments can help manage.

Symptoms

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

People with panic attacks sometimes develop agoraphobia, which involves a fear of situations where help or an escape may be difficult to access.

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.

The symptoms typically arise in early adulthood, around the ages of 18–25 years, but panic disorder can develop in children. It is twice as likely to occur in females as males.

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.

Causes

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.

Risk factors

A number of issues can increase the likelihood of having panic attacks and panic disorder. These include:

• genetic factorsTrusted Source
• major stress or life changes
• caffeine, tobacco, alcohol, recreational drugs, and sugary foods and drinks

Also, panic attacks can be a symptomTrusted Source of other conditions, such as:

• generalized anxiety disorder
• obsessive-compulsive disorder
• post-traumatic stress disorder

Diagnosis

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

Treatment

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 medicationsTrusted Source:

• 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 heartbeatTrusted Source.

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.