Overview
A panic attack is a sudden episode of intense fear that triggers severe physical reactions when there is no real danger or apparent cause. It can cause a range of symptoms such as rapid heart rate, difficulty breathing, chest pain, and feelings of shakiness or numbness. Panic attacks can be very frightening and may lead to avoidance of situations that trigger them. If someone experiences recurrent, unexpected panic attacks and has persistent fear or worry about having another attack, they may have panic disorder.
Understanding the disease
Symptoms
The symptoms of panic attacks typically include: a sense of impending doom or danger, fear of loss of control or death, rapid heart rate, sweating, trembling or shaking, shortness of breath or tightness in the throat, chills, hot flashes, nausea, abdominal cramping, chest pain, headache, dizziness, lightheadedness or faintness, and a feeling of unreality or detachment.
Risk Factors
Risk factors for developing panic attacks include a family history of panic attacks or panic disorder, major life stress, a traumatic event, major changes in life, smoking or excessive caffeine intake, and a history of childhood physical or sexual abuse.
Development
Panic attacks develop when there is a sudden episode of intense fear that triggers severe physical reactions, even though there is no real danger or apparent cause present. Factors that may increase the risk of developing panic attacks or panic disorder include a family history of panic attacks or panic disorder, major life stress, a traumatic event, major changes in your life, smoking, excessive caffeine intake, and a history of childhood physical or sexual abuse. Although panic attacks themselves aren't life-threatening, they can be frightening and significantly impact your quality of life. When left untreated, they can lead to complications such as the development of specific phobias, frequent medical care for health concerns and other medical conditions, and major distress or problems in social situations, work, or other areas of life due to fear, anxiety, or avoidance.
Assessment and Diagnosis
Triage
You should see a doctor if panic attacks are suspected if the symptoms are interfering with your daily life, causing significant distress or problems in social situations, work, or other areas. If you have experienced recurrent, unexpected panic attacks and have been in constant fear of another attack for six months or longer, you may have panic disorder. Additionally, if you have agoraphobia along with panic disorder, it's important to seek medical advice as it can severely limit your ability to perform daily activities.
Diagnosis
A primary care provider will diagnose panic attacks by reviewing your symptoms, conducting a physical exam, and performing various tests, such as blood tests to check for thyroid and other conditions, and a psychological evaluation to assess your mental health. To diagnose panic disorder, the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5) requires frequent, unexpected panic attacks followed by at least one month of ongoing worry or significant changes in behavior. It's important to see a mental health professional if you experience panic attacks or panic disorder to receive appropriate treatment and management strategies.
Management and Treatment
Complications
Potential complications of panic attacks can include the development of specific phobias, frequent medical care for health concerns and other medical conditions, avoidance of social situations, problems at work or school, depression, anxiety disorders, and other psychiatric disorders, increased risk of suicide or suicidal thoughts, alcohol or other substance misuse, and financial problems.
Home Remedies
It is important to note that while some home remedies may help alleviate symptoms, they should not replace professional medical advice and treatment. If you are experiencing panic attacks, it is crucial to seek help from a mental health professional or a healthcare provider.
Treatment
To treat panic attacks, consider the following approaches:
- Professional treatment: Seek help from a mental health professional, such as a therapist or counselor. Psychotherapy, particularly cognitive behavioral therapy (CBT), is an effective treatment for panic attacks and panic disorder.
- Lifestyle and home remedies: Avoid caffeine, alcohol, smoking, and recreational drugs, which can trigger or worsen panic attacks. Practice stress management and relaxation techniques, such as deep breathing exercises, yoga, or progressive muscle relaxation.
- Medications: Consult your doctor about medication options, such as selective serotonin reuptake inhibitors (SSRIs) like fluoxetine (Prozac), paroxetine (Paxil, Pexeva), and sertraline (Zoloft). These medications can help reduce symptoms associated with panic attacks and depression.
- Psychotherapy: Continue to stick to your treatment plan, join a support group, and engage in regular physical activity to help manage panic attacks. Remember that recovery from panic attacks and panic disorder may take time and effort. Be patient and persistent in seeking treatment, and work closely with your healthcare provider to find the most effective approach for you.
Preparing for medical consultation
To prepare for an appointment for panic attacks, you should make a list of the following:
- Your panic attack symptoms, including when they first occurred and how often they happen
- Key personal information, including traumatic events in your past and any stressful major events that occurred before your first panic attack
- Medical information, including other physical or mental health conditions that you have
- Medications, vitamins, herbal products, and other supplements you are taking, including the dosages
- Questions to ask your doctor or mental health professional. Some questions to consider asking include:
- What's the most likely cause of my panic attacks?
- Are there other possible issues or physical health problems that could be causing or worsening my panic attacks?
- Do I need any tests?
- What treatment do you recommend?
- Should I see a psychiatrist, psychologist, or other mental health professional? It's also helpful to ask a trusted family member or friend to join you for the appointment to provide support and help you remember important information. Additionally, avoid alcohol, recreational drugs, and excessive caffeine intake before the appointment, as these can worsen your panic or anxiety symptoms.