Panic Attacks

Panic attacks are overwhelming waves of intense fear that can strike anywhere - during a drive, at the mall, in business meetings, or even while you are sound asleep. The good news is that most people experience just one or two panic attacks without any lasting effects. However, some develop panic disorder, which brings recurring attacks and a constant fear of future episodes. Women are twice as likely as men to face this challenge. The attacks usually last 5 to 20 minutes, though some people's episodes can stretch up to an hour.

People typically first experience panic disorder in their late teens or early adulthood. The condition can affect anyone, whatever their circumstances or environment. These attacks are frightening, but knowledge about symptoms, causes, and panic disorder treatment can help you manage the condition effectively. This article covers everything about panic attacks - from early warning signs to various treatment options that provide relief.

What is a Panic Attack?

A panic attack hits you with a sudden wave of intense fear that reaches its peak within minutes. Your body reacts strongly even when there is no real danger around. These episodes can make you feel completely overwhelmed. Many people think they are losing control or dying when it happens. These attacks can strike anywhere - while you are driving, shopping, sleeping, or sitting in meetings.

Symptoms of Panic Attacks

Your body reacts in powerful ways during an attack. Physical symptoms show up as:

• Heart racing or palpitations
• Trouble breathing or feeling like you're choking
• Pain or discomfort in your chest
• Sweating, chills, or hot flashes
• Body trembling or shaking
• Feeling dizzy or lightheaded
• Upset stomach or nausea
• Numbness or tingling feelings

The psychological symptoms show up as:

• Feelings of doom
• Disconnection from reality
• Fear of losing control
• Extreme terror

Most attacks reach their peak within 10 minutes. They usually last between 5 and 20 minutes, though some might go on for an hour.

Panic Attack Causes

Doctors haven't found one single cause for panic attacks. Several factors seem to play a part:

• The biological side includes your genes (panic disorder often runs in families), changes in brain chemistry, and an overactive fight-or-flight response.
• Life changes, too much caffeine, drug use, and poor sleep can trigger these attacks.

Risk of Panic Attack

Some people face a higher chance of getting panic attacks:

• Women get panic disorder twice as often as men. 
• The problem usually starts in late teens or early adulthood. 
• Your risk goes up if you have experienced childhood trauma, major stress, or big life changes. 
• Your family history matters too - having relatives with anxiety disorders makes you more likely to develop them.

Complications of Panic Attacks

Panic attacks can affect your quality of life if left untreated. You might develop specific fears, stay away from social events, or have trouble at work. On top of that, the constant fear of another attack often makes people avoid normal activities.

This condition often shows up alongside depression, substance abuse, and other mental health issues. Some people end up with agoraphobia - avoiding places where they might feel trapped if an attack happens.

Diagnosis of Panic Attack

Your doctor will conduct a complete physical exam and blood tests to evaluate your thyroid and heart function. They will then do a psychological evaluation to learn more about your symptoms, worries, and the things you tend to avoid. You may also need to complete a questionnaire to share details about your experiences.

To receive a panic disorder diagnosis, you must have:

• Frequent, unexpected panic attacks
• Ongoing worry about having another attack that lasts at least a month
• Much change in behaviour, like avoiding certain situations

Panic Attack Treatment

The right treatment reduces panic episodes' intensity and frequency. These approaches work best:

• Psychotherapy - Cognitive behavioural therapy (CBT) shows you that panic symptoms aren't dangerous. Your therapist helps you recreate panic sensations in a safe environment so your body learns they're harmless. CBT offers budget-friendly options and better results than medication alone.
• Medication - These options can help:
  • SSRIs - doctors usually prescribe these first
  • SNRIs - alternative antidepressants
  • Benzodiazepines - doctors prescribe these briefly due to dependency risks

The combination of therapy and medication benefits many people.

When to See a Doctor

Reach out to your doctor if panic attacks disrupt your daily life or cause serious distress. Get immediate medical attention for first-time chest pain since these symptoms mirror heart attacks. 

Ways to Stop a Panic Attack

These home remedies for panic attacks are beneficial:

• Focus on breathing - Take slow, deep breaths through your nose for four counts, hold briefly, and then exhale through your mouth for four counts. This diaphragmatic breathing activates your body's relaxation response.
• Use grounding techniques - The 5-4-3-2-1 method helps you notice five things you see, four things you can touch, three sounds you hear, two scents you smell, and one taste. Your attention moves away from frightening thoughts naturally.
• Stay where you are - Your brain learns that panic will pass without escape if you remain in your current location.
• Cool down physically - A cool, damp washcloth on your neck can regulate your body's response.
• Repeat a calming mantra - Simple phrases like "This will pass" or "I am safe" help counter catastrophic thoughts.
• Muscle relaxation - Tighten & release each muscle group to ease physical tension.
• Mindfulness - Accept your feelings without judgment and stay present instead of expecting the worst.

Note that most attacks reach their peak within minutes and pass within 30 minutes.

FAQs

1. What's the difference between a panic attack & an anxiety attack?

These two experiences are often mixed up, but they're quite different. Panic attacks hit suddenly with intense fear and peak within 10 minutes. They can happen with or without triggers. Anxiety attacks build up slowly when you're stressed, and their symptoms are nowhere near as intense but last longer. Panic attacks are linked to panic disorder, while anxiety symptoms show up in many conditions like OCD or trauma.

2. What's the typical duration of a panic attack?

Panic attacks generally peak within 10 minutes and last between 5 and 20 minutes. Some people's episodes can go on for up to an hour. The physical symptoms tend to fade first, and then the mental effects follow.

3. Is it possible to fully recover from panic attacks?

You can definitely recover completely. Some people only have one or two panic attacks and never get them again. On top of that, panic disorder responds well to treatment through therapy, medication, or both combined.

4. What are the most common symptoms of a panic attack?

The main symptoms include:

• Racing heartbeat and chest pain
• Shortness of breath or choking sensation
• Sweating, trembling, or shaking
• Dizziness or lightheadedness
• Fear of losing control or dying

5. Can panic attacks happen without an obvious trigger?

Yes, they can. Many panic attacks pop up out of nowhere without any clear cause. Doctors call these "unexpected" panic attacks, and they are one of the main signs they look for when diagnosing panic disorder.

6. Are there natural remedies or lifestyle changes that help prevent panic attacks?

Regular exercise, especially aerobic activities, really helps reduce anxiety symptoms. Cutting back on caffeine makes a difference since it can make anxiety worse and set off attacks. Getting enough sleep, trying deep breathing exercises, and using aromatherapy with essential oils like lavender can all help your recovery.

7. How long can a panic attack last?

Panic attacks typically last between 5 and 20 minutes. In rare cases, they might stretch out to an hour. Some people get several attacks one after another, which can feel like one long episode.

8. How to calm panic attacks?

These proven methods help you regain control when panic strikes:

• Deep breathing - Take slow breaths through your nose for four counts, pause briefly, then exhale for four counts.
• Grounding - Look for five things you see, four things you can touch, three you hear, two you smell, and one you taste.
• Cool down physically - A cool, damp washcloth on your neck's back can regulate your body's response.
• Repeat a calming mantra - Simple phrases like "This will pass" or "I am safe" help counter catastrophic thoughts.

9. Can lack of sleep cause panic attacks?

Sleep and panic are closely connected. Research shows that poor sleep can trigger panic attacks. Your body enters survival mode from sleep loss, which makes your stress response stronger. Small problems feel overwhelming because your brain becomes more reactive to stress without enough rest.

This happens in several ways. Sleep deprivation raises cortisol levels and increases anxiety symptoms. Your brain's fear centre becomes oversensitive and can trigger sudden panic episodes.Good sleep habits are the foundation of managing panic disorder, among other treatments.

Dr. Lalith Agarwal

MBBS, DNB (Internal Medicine), DNB (Cardiology)
CARE Hospitals Outpatient Centre, HITEC City, Hyderabad, CARE Hospitals, HITEC City, Hyderabad

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