What are panic attacks?
“I’m freaking out.” “I’m having anxiety.” “I feel panicky.”
These are just some of the ways people describe panic symptoms. A panic attack is a sudden period of intense fear or discomfort that reaches a peak within a few minutes, and then subsides. Some common symptoms that can occur during a panic attack, include the following:
- Increased heart rate or palpitations
- Trembling or shaking
- Feeling short of breath or smothering
- Feeling of choking
- Chest pain or tightness
- Nausea or abdominal discomfort
- Feeling dizzy or lightheaded
- Cold or hot flashes
- Numbness or tingling
- Feeling that things are not real (derealization) or feeling detached from oneself (depersonalization)
- Fear of losing control or “going crazy”
- Fear of dying
Panic attacks are also common. About 11% of adults in the United States experience one in any given year. Attacks can start at moments when you’re already feeling anxious, but can also occur when you’re feeling calm. Some are predictable, and happen in response to a noticeable trigger, while others occur “out of the blue.”
Panic attacks can be associated with a variety of psychiatric diagnoses, including generalized anxiety disorder, social anxiety disorder, phobias, depression, posttraumatic stress disorder, and substance use disorders. Panic disorder is a mental health condition which involves recurrent unexpected panic attacks as well as either persistent worry about having additional panic attacks, or avoidance behavior (avoiding exercising, enclosed spaces, unfamiliar situations, etc.). So, while individuals with panic disorder certainly experience panic attacks, not everyone who has a panic attack has panic disorder.
Panic attacks are frightening. In fact, many individuals suffering a panic attack mistakenly believe they are experiencing a serious medical problem (such as a heart attack) and visit the emergency room. However, panic attacks are not actually dangerous. In fact, having a panic attack is only possible because of helpful reactions our bodies have developed to respond to threats. When we are faced with danger, the “fight-or-flight” system is automatically activated. This system has evolved to help us survive when facing threats in the environment. This response leads to a number of physiological changes in the body. While these changes are helpful for escaping a threat, they can also produce the uncomfortable sensations described above. Take a look at the chart below:
|Physiological Change||Benefit for Escaping Threat||Associated Panic Symptoms|
|Faster breathing||Take in more oxygen to meet energy demands||Feeling dizzy or lightheaded
Shortness of breath/discomfort
Chest pain or tightness
|Increase heart rate||Increase blood flow to muscles for energy||Palpitations or pounding heart|
|Increase muscle tension||Provide body with extra speed and strength||Trembling or shaking|
|Dilate blood vessels to muscles/
Constrict other blood vessels
|Maximize blood flow to muscles and core organs||Numbness and tingling
Cold or hot flashes
|Slow digestion||Conserve energy/direct blood flow toward muscles||Nausea or abdominal discomfort|
|Hyperfocus/tunnel vision||Assess and track threat/danger||Derealization or depersonalization
As you can see from this chart, the same physiological processes that are helpful for survival when faced with a threat are also responsible for panic attacks. A panic attack is best thought of a helpful reaction occurring in response to the wrong triggers. These triggers can be stressful or shocking thoughts or emotions (as in the case of predictable panic attacks), or even small physiological changes outside conscious awareness that activate the fight-or-flight response.
CBT and other treatments for panic attacks
Thankfully, there are effective treatments for panic symptoms and the suffering they can cause. Cognitive-behavioral therapy (CBT) has been proven highly effective in the treatment of panic attacks and panic disorder. CBT for panic entails learning and practicing various skills that impart long-lasting benefit and symptom relief. Medications, such as benzodiazepines, can also be effective are often prescribed to help manage panic attacks. However, unlike psychological treatment, the benefits of these medications are lost when the medication is discontinued. Consider consulting with a CBT therapist if panic attacks are interfering with your wellbeing and overall functioning.
Panic attacks do not have to be a part of your life.