Panic attacks are frightening but fortunately physically harmless episodes. They can occur at random or after a person is exposed to various events that may "trigger" a panic attack. They peak in intensity very rapidly and go away with or without medical help.
- People experiencing panic attacks may fear they are dying or that they are suffocating. They may have chest pain or believe that they are having other symptoms of a heart attack. They may voice fears that they are "going crazy" and seek to remove themselves from whatever situation they may be in.
Some people may experience other associated physical symptoms. For example, they may begin breathing very rapidly and complain that they havepalpitations, in that their "hearts are jumping around in their chest". Then, within about an hour, the symptoms fade away.
- About 5% of the population will experience panic attacks during their lifetimes. People who have repeated attacks require further evaluation from a mental-health professional. Panic attacks can indicate the presence of panic disorder, depression, or other forms of anxiety-based illnesses.
- Panic attacks may be symptoms of an anxiety disorder and affect at least 20% of adult Americans, or about 60 million people. Other facts about panic include that about 3 million people in the United States will have full-blown panic disorder at some time in their lives, usually beginning between 15-19 years of age. Panic attacks occur suddenly and often unexpectedly, are unprovoked, and can be disabling.
- Once someone has had a panic attack, he or she may develop irrational fears, called phobias, about the situations they are in during the attacks and begin to avoid them. That, in turn, may reach the point where the mere idea of doing things that preceded the first panic attack triggers terror or dread of future panic attacks, resulting in the individual with panic disorder being unable to drive or even step out of the house. If this occurs, the person is considered to have panic disorder with agoraphobia.
- Panic disorder in adolescents tends to show similar symptoms as in adults. Teens tend to feel like they are not real, as if they are operating in a dreamlike state (derealization), or be frightened of going crazy or of dying.
- The disorder in younger children is less likely to have the symptoms that involve ways of thinking (cognitive symptoms). For example, panic attacks in children may result in the child's grades declining, decreased school attendance, and avoiding that and other separations from their parents. Both children and teens with panic disorder are further at risk for developingsubstance abuse and depression as well as suicidal thoughts, plans, and/or actions.
The American Psychiatric Association's official Diagnostic and Statistical Manual of Mental Disorders IV, Treatment Revision (DSM-IV-TR) defines a panic attack as a discrete period of intense fear, distress, nervousness or discomfort, in which four (or more) of the following symptoms develop abruptly and reach a peak within 10 minutes:
- Palpitations, pounding heart, or fast heart rate.
- Trembling and shaking.
- Sensations of shortness of breath or smothering.
- Feelings of choking.
- Chest pain or discomfort.
- Nausea or abdominal distress.
- Feeling dizzy, unsteady, lightheaded, or faint.
- Derealization (feelings of unreality) or depersonalization (being detached from oneself).
- Fear of losing control or going crazy.
- Fear of dying.
- Paresthesias (numbness or tingling sensations).
- Chills or hot flashes.
Some of these symptoms will most likely be present in a panic attack. The attacks can be so disabling that the person is unable to express to others what is happening to them. A doctor might also note various signs of panic: The person may appear to be very afraid or shaky or be hyperventilating (deep, rapid breathing that causes dizziness).
Anxiety attacks that take place while sleeping, also called nocturnal panic attacks, occur less often than do panic attacks during the daytime, but affect about 40%-70% of people who suffer from daytime panic attacks. Individuals with nocturnal panic attacks tend to have more respiratory symptoms associated with panic and have more symptoms of depression and of other psychiatric disorders compared to people who do not have panic attacks at night.
Nocturnal panic attacks tend to result in sufferers waking suddenly from sleep in a state of sudden fright or dread for no known reason. As opposed to people with sleep apnea and other sleep disorders, sufferers of nocturnal panic can have all the other symptoms of a panic attack. Although nocturnal panic attacks usually last no more than 10 minutes, it can take much longer for the person to fully recover from the episode.
Recent literature suggests that men and women may experience different symptoms during an attack. Women tend to experience a predominance of respiratory symptoms compared to men.
As with most behavioral illnesses, the causes of panic attacks are many. Certainly there is evidence that the tendency to have panic attacks can sometimes be inherited. However, there is also evidence that panic may be a learned response and that the attacks can be initiated in otherwise healthy people simply given the right set of circumstances. Research into the causes of panic attacks is ongoing.
Panic disorder is a separate but related diagnosis to panic attacks. People experiencing repeated panic attacks and who meet other diagnostic criteria may be diagnosed with this illness. Panic disorder is thought to have more of an inherited component than panic attacks that are not a part of panic disorder.
Certain medical conditions, likeasthma and heart disease, as well as certain medications, like steroids and some asthma medications, can have attacks of anxiety as a symptom or side effect. As individuals with panic disorder are at higher risk of having a heart-valve abnormality called mitral valve prolapse (MVP), that should be evaluated by a doctor since MVP may indicate that specific precautions be taken when the person is treated for a dental problem.
Research is inconsistent as to whether nutritional deficiencies (for example, zinc or magnesium deficiency) may be risk factors for panic disorder. While food additives like aspartame, alone or in combination with food dyes, are suspected to play a role in the development of panic attacks in some people, more research is needed to understand their role in this disorder.
Taking care of panic attacks at home is possible, but be careful not to mistake another serious illness (such as a heart attack) for a panic attack. In fact, this is the dilemma that doctors face when people experiencing panic are brought to a hospital's emergency department or the clinic.
- There are things that people with panic disorder can do to assist with their own recovery. Since substances like caffeine, alcohol, and illicit drugs can worsen panic attacks, those things should be avoided. Other tips for managing panic attacks include engaging in aerobic exercise and stress-management techniques like deep breathing and yoga on a regular basis, since these activities have also been found to help decrease panic attacks.
- Although many people breathe into a paper bag in an attempt to alleviate the hyperventilation that can be associated with panic, the benefit received may be the result of the individual thinking it will help (a placebo effect). Unfortunately, breathing into a paper bag while having trouble breathing can worsen symptoms when the hyperventilation is caused by a condition associated with oxygen deprivation, like an asthma attack or a heart attack.
- If a person has been diagnosed with panic attacks in the past and is familiar with the signs and symptoms, the following techniques may help the person stop the attack. You may also try these tips for overcoming the symptoms of a panic attack.
- First, relax your shoulders and become conscious of any tension that you may be feeling in your muscles.
- Then, with gentle reassurance, progressively tense and relax all the large muscle groups. Tighten your left leg while taking a deep breath in, for example, hold it, then release the leg muscles and the breath. Move on to the other leg. Move up the body, one muscle group at a time.
- Slow down your breathing. This may best be done by blowing out every breath through pursed lips as if blowing out a candle. Also, place your hands on your stomach to feel the rapidity of your breathing. This may allow you to further control your symptoms.
- Tell yourself (or someone else if you are trying this technique with someone) that you are not "going crazy". If you are concerned about not being able to breathe, remember that if you are able to talk, you are able to breathe.
- If a person is diagnosed with any medical illness, especially heart disease, home treatment is not appropriate. Even if the person has a history of panic attacks, home care is not appropriate if there is any new or otherwise worrisome symptom.