What Is The Definition Of A Panic Attack

What Is A Panic Attack

What is a Panic Attack?

A panic attack is a sudden and intense feeling of terror, fear, or apprehension, without the presence of actual danger. The symptoms of a panic attack usually happen suddenly, peak within 10 minutes, and then subside. However, some attacks may last longer or may occur in succession, making it difficult to determine when one attack ends and another begins.

Anyone can experience a panic attack. An attack can sometimes be triggered by a specific event, but these attacks can also be a symptom of anxiety disorders like panic disorder or agoraphobia.

Mediating Autonomic Mechanisms Of Cardiac Risk During A Panic Attack

Our own extensive clinical experience with the cardiological management of panic disorder sufferers has provided case material encompassing the range of cardiac complications which occur. Those patients with typical, severe anginal chest pain during panic attacks, who are in the minority, appear to be at cardiac risk. During panic attacks in such patients we have documented, variously, triggered cardiac arrhythmias, recurrent emergency room attendances with angina and ECG changes of ischemia, coronary artery spasm during panic attacks occurring at the time of coronary angiography and myocardial infarction associated with coronary spasm and thrombosis. Our research findings suggest that release of epinephrine as a cotransmitter from cardiac sympathetic nerves and activation of the sympathetic nervous system during panic attacks may be mediating mechanisms.

Figure 126.4. Coronary angiogram in a patient with panic disorder, performed because of recurrent angina. During a panic attack occurring during angiography, spasm occurred in the left anterior descending coronary artery . The arterial spasm was reversed by administration of glyceryl trinitrate .

J.E. HassellJr., … C.A. Lowry, in, 2017

Breathing Exercise For Panic Attacks

If youre breathing quickly during a panic attack, doing a breathing exercise can ease your other symptoms. Try this:

breathe in as slowly, deeply and gently as you can, through your nose
breathe out slowly, deeply and gently through your mouth
some people find it helpful to count steadily from one to five on each in-breath and each out-breath
close your eyes and focus on your breathing

You should start to feel better in a few minutes. You may feel tired afterwards.

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Prevalence Of Panic Disorder Among Adults

Based on diagnostic interview data from National Comorbidity Survey Replication , Figure 1 shows past year prevalence of panic disorder among U.S. adults aged 18 or older.1
An estimated 2.7% of U.S. adults had panic disorder in the past year.
Past year prevalence of panic disorder among adults was higher for females than for males .

An estimated 4.7% of U.S. adults experience panic disorder at some time in their lives.2

Figure 1

Past Year Prevalence of Panic Disorder Among U.S Adults

Demographic
0.8

Panic Attack Vs Panic Disorder

Panic disorder always includes panic attacks. But having a panic attack doesnt necessarily mean you have panic disorder.

In making a panic disorder diagnosis, doctors will look at the amount and frequency of any panic attacks. Theyll also take into consideration your feelings surrounding them.

Many people experience a panic attack at some point in their lives. But when you have multiple panic attacks and live in fear of their reoccurrence, this can indicate panic disorder.

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How Long Do Panic Attacks Last

Panic attacks are generally brief, lasting less than 10 minutes, although some of the symptoms may last longer. An isolated panic attack, while extremely unpleasant, is not uncommon or life-threatening.

Panic attacks can be a symptom of other anxiety disorders, and people whoâve had one panic attack are at greater risk for another compared to those whoâve never had one. Panic attacks and panic disorder are not the same thing. When the attacks happen repeatedly and you worry about having more episodes, you may have panic disorder.

How To Get A Diagnosis

If you experience symptoms of a panic attack for the first time, you may want to seek emergency medical care. Many people who have a panic attack for the first time believe theyre having a heart attack. It can be hard to differentiate the symptoms without the help of a medical professional.

While at the emergency care facility, a healthcare professional will perform several tests to see if your symptoms are caused by a heart attack.

These include:

an electrocardiogram to check heart function

If they determine you do not need emergency care, youll likely be referred back to your primary care physician if you have one.

Your primary care physician will likely:

review any earlier lab results
ask about your symptoms
perform a mental health examination

Your primary care doctor or a mental health specialist can diagnose panic attacks and panic disorder.

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Medication For Panic Attacks And Panic Disorder

Medication can be used to temporarily control or reduce some of the symptoms of panic disorder. However, it doesn’t treat or resolve the problem. Medication can be useful in severe cases, but it should not be the only treatment pursued. Medication is most effective when combined with other treatments, such as therapy and lifestyle changes, that address the underlying causes of panic disorder.

Medications used may include:

Antidepressants. It takes several weeks before antidepressants begin to work, so you have to take them continuously, not just during a panic attack.

Benzodiazepines. These are anti-anxiety drugs that act very quickly . Taking them during a panic attack provides rapid relief of symptoms. However, benzodiazepines are highly addictive and have serious withdrawal symptoms, so they should be used with caution.

Panic Disorder And Agoraphobia Diagnosis And Phenomenology

What Do You Do When You Have a Panic Attack

Table 1. DSM-5 criteria for panic disorder

1.: Repeated, unexpected panic attacks that came from out of the blue or no apparent reason . A panic attack is a sudden surge of intense fear or discomfort that comes to a peak quickly, and during which time four of symptoms occur:; Note: The attack can occur from a calm or anxious state.
1.

The fear, anxiety, and/or avoidance is persistent, typically lasting for 6 months or more.
7.: The fear, anxiety, and/or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
8.: If another medical condition is present, the fear, anxiety, and/or avoidance is excessive.
9.: The fear, anxiety, and/or avoidance is not better explained by another disorderfor example, symptoms are not only related to: specific phobia include solely social situations and exclusive to obsessions physical appearance , reminders of trauma , or separation .; Note: Agoraphobia is diagnosed irrespective of the diagnosis of panic disorder. If the presentation meets criteria both for panic disorder and for agoraphobia, both diagnoses should be given.

Table 4. ICD-11 criteria for agoraphobia

Douglas Vanderburg, in, 2003

When To Get Help

See a GP if you’ve been experiencing symptoms of panic disorder.

They’ll ask you to describe your symptoms, how often you get them, and how long you have had them.

They may also carry out a physical examination to rule out other conditions that could be causing your symptoms.

It can sometimes be difficult to talk about your feelings, emotions and personal life, but try not to feel anxious or embarrassed.

You may be diagnosed with panic disorder if you have regular and unexpected panic attacks followed by at least a month of continuous worry or concern about having further attacks.

What’s Happening In A Panic Attack

A panic attack is the sudden response to the feeling of imminent danger. And the body brings all its forces to bear to protect you from what your system has signaled is a dire threat. The body response, sudden and exaggeratedpounding heart, rapid breathing, shakinessis itself interpreted as a threat, and the entire experience is compounded by a perception of no escape. But panic attacks are false alarms, and no threatfrom within or without actually exists.

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Causes Of Panic Attacks And Panic Disorder

Although the exact causes of panic attacks and panic disorder are unclear, the tendency to have panic attacks runs in families. There also appears to be a connection with major life transitions such as graduating from college and entering the workplace, getting married, or having a baby. Severe stress, such as the death of a loved one, divorce, or job loss can also trigger panic attacks.

Panic attacks can also be caused by medical conditions and other physical causes. If you’re suffering from symptoms of panic, it’s important to see a doctor to rule out the following possibilities:

Mitral valve prolapse, a minor cardiac problem that occurs when one of the heart’s valves doesn’t close correctly

Hyperthyroidism

Medication withdrawal

When Should I Call The Doctor

Common Panic Attack Symptoms of Disorder Stock Vector

Some panic attacks have signs that can be confused with a physical problem like a heart attack. If you have chest pain or trouble breathing or lose consciousness, seek emergency medical care.

You should call your healthcare provider if you have panic attacks and experience:

Chronic anxiety that interferes with daily life.
Difficulty concentrating.

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What Causes Panic Disorder

Panic disorder is a common mental health problem. It often starts in the teens or early adulthood, but may also begin in childhood. Women are twice as likely as men to have it. There may be a genetic link. It tends to run in families.

Panic disorder may be an overreaction of the body’s normal survival instincts and behaviors. In people with panic disorder, the body may be more sensitive to hormones that trigger excited feelings in the body.

What Causes Panic Attacks

Experts dont know why some people experience panic attacks or develop panic disorder. The brain and nervous system play key roles in how you perceive and handle fear and anxiety. Your risk of having panic attacks increases if you have:

Family history:Anxiety disorders, including panic disorders, often run in families. Experts arent sure why.
Mental health issues: People who have anxiety disorders, depression or other mental illness are more prone to panic attacks.
Substance abuse problems:Alcoholism and drug addiction can increase the risk of panic attacks.

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Panic Disorder With Agoraphobia

Agoraphobia was traditionally thought to involve a fear of public places and open spaces. However, it is now believed that agoraphobia develops as a complication of panic attacks and panic disorder. Although it can develop at any point, agoraphobia usually appears within a year of your first recurrent panic attacks.

If you’re agoraphobic, you’re afraid of having a panic attack in a situation where escape would be difficult or embarrassing. You may also be afraid of having a panic attack where you wouldn’t be able to get help. Because of these fears, you start avoiding more and more situations.

For example, you may begin to avoid:

Crowded places such as shopping malls or sports arenas.
Cars, airplanes, subways, and other forms of travel.
Social gatherings, restaurants, or other situations where it would be embarrassing to have a panic attack.
Physical exercise in case it triggers panic.
Certain food or drinks that could provoke panic, such as alcohol, caffeine, sugar, or specific medications.
Going anywhere without the company of someone who makes you feel safe. In more severe cases, you might only feel safe at home.

Panic Attacks I Turned My Mental Health Crisis Into A Mental Health Triumph

The Facts About Panic Attacks

Although it’s taken me a long time I have learned I am a strong person who has the potential to help others.

You might find that you become scared of going out alone or to public places because you’re worried about having another panic attack. If this fear becomes very intense, it may be called agoraphobia. See our pages on for more information.

I felt like I couldn’t breathe, I just wanted to get out, to go somewhere else, but I couldn’t because I was on a train.

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What Are The Symptoms Of A Panic Attack

Panic attacks trigger your sympathetic nervous system. This leads to the fight or flight response that you experience when faced with danger.

A panic attack can occur suddenly and without warning. Its symptoms may come on gradually and peak after about ten minutes. They may include one or more of the following:

tingling or numbness
feeling that death is imminent

In some cases, you may develop an overwhelming fear of experiencing another panic attack. This may be a sign that youve developed a panic disorder.

Panic attacks arent life threatening. But their symptoms can be similar to those of other life-threatening health conditions, such as heart attack. If you experience symptoms of a panic attack, seek medical attention right away. Its important to rule out the possibility that youre actually having a heart attack.

The exact cause of panic attacks is often unknown. In some cases, panic attacks are linked to an underlying mental health condition, such as:

a major life change, such as having a baby
losing a loved one

Living with a mental health condition, such as a phobia or PTSD, can also raise your risk of panic attacks.

When Might I Have Panic Attacks

Panic attacks happen at different times for everyone. Some people have one panic attack then don’t ever experience another, or you might find that you have them regularly, or several in a short space of time. You might notice that particular places, situations or activities seem to trigger panic attacks. For example, they might happen before a stressful appointment.

Most panic attacks last between 5 to 20 minutes. They can come on very quickly. Your symptoms will usually be at their worst within 10 minutes. You might also experience symptoms of a panic attack over a longer period of time. This could be because you’re having a second panic attack, or you’re experiencing other .

“My panic attacks seem to come out of the blue now. But in fact, they seem to be triggered mainly at night when I want to go to sleep but cannot stop my mind racing, experiencing worry and panic about anything that may be on my mind.”

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Preventing A Further Attack

It may help to:

read a self-help book for anxiety based on the principles of cognitive behavioural therapy ask your GP to recommend one
try complementary therapies such as massage and aromatherapy, or activities like yoga and pilates, to help you relax
learn breathing techniques to help ease symptoms
do regular physical exercise to reduce stress and tension
avoid sugary food and drinks, caffeine and alcohol, and stop smoking, as all they can all make attacks worse

For more help, read how to deal with panic attacks.

Complications Of Panic Disorder

Panic disorder is treatable and you can make a full recovery. But it’s best to get medical help as soon as you can.

If you do not get medical help, panic disorder can escalate and become very difficult to cope with.

You’re more at risk of developing other mental health conditions, such as agoraphobia or other phobias, or an alcohol or drug problem.

Having panic disorder may affect your ability to drive. The law requires you to inform the Driver and Vehicle Licensing Agency about a medical condition that could impact your driving ability.

Visit GOV.UK for further information about driving with a disability or health condition.

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What Are The Complications Of Panic Disorder

As the panic gets worse and an attacks last longer, you may find it very tough to cope with everyday life, keep a job, or function in social settings. You may fear going into places where it may be hard to escape or you feel trapped. Some people can’t leave their home for fear that help is not available or that he or she will be forced into a situation that will trigger an attack.

People with this condition may also abuse alcohol or drugs to relieve stress.

Statistical Methods And Measurement Caveats

National Comorbidity Survey Replication

Diagnostic Assessment and Population:

The NCS-R is a nationally representative, face-to-face, household survey conducted between February 2001 and April 2003 with a response rate of 70.9%. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition mental disorders were assessed using a modified version of the fully structured World Health Organization Composite International Diagnostic Interview , a fully structured lay-administered diagnostic interview that generates both International Classification of Diseases, 10th Revision, and DSM-IV diagnoses. The DSM-IV criteria were used here. The Sheehan Disability Scale assessed disability in work role performance, household maintenance, social life, and intimate relationships on a 010 scale. Participants for the main interview totaled 9,282 English-speaking, non-institutionalized, civilian respondents. Any anxiety disorder was assessed in a subsample of 5,692 adults. The NCS-R was led by Harvard University.
Unlike the DSM-IV criteria used in the NCS-R and NCS-A, the current DSM-5 no longer places post-traumatic stress disorder or obsessive compulsive disorder in the anxiety disorder category. They are listed in new DSM5 categories.

Survey Non-response:

National Comorbidity Survey Adolescent Supplement