What Are Panic Attacks?

Panic attacks are brief episodes of sudden, intense fear that pop up without warning or an obvious trigger. The level of fear you feel is out of proportion or unrelated to the situation. During a panic attack, you can also experience a wide range of uncomfortable physical symptoms like chest pain, sweating, and chills.

Fortunately, there are some self-calming tactics to help get yourself through a panic attack, as well as medical treatment options available if needed.

Signs and Symptoms of Panic Attacks

A panic attack is much more intense than a normal stressed-out feeling people may experience in response to a mildly uncomfortable situation.

Panic attacks involve a combination of emotional, mental, and physical symptoms that can lead to a person feeling severely embarrassed, fearful of losing control, or desperately wanting to escape the situation.

Experts use a set of specific criteria to diagnose a panic attack, which involves the typical sudden feelings of fear, anxiety, or dread along with at least four of the following symptoms:

• Chest pain
• Heart palpitations or rapid heart rate
• Sweating, hot flashes, or chills
• Dizziness or lightheadedness
• Nausea or stomach pain
• Feeling like you're going to choke
• Feelings of being disconnected from reality or being detached from yourself
• Fear of dying
• Fear of losing control or "going crazy"
• Numbness or tingling sensations
• Shortness of breath
• Shaking or trembling

What Triggers a Panic Attack?

Most times, panic attacks happen unexpectedly without a clear reason. Panic attacks might even happen when you are relaxed or asleep.

Sometimes, certain situations can trigger a panic attack. Being exposed to the trigger or anticipating exposure to the trigger and having a panic attack in response is known as a situational-induced panic attack.

There is a wide range of factors can trigger a panic attack. Some typical scenarios that may prompt an expected panic attack include situations that can be stressful or intense (but not necessarily dangerous), such as:

• Working
• Driving or flying
• Going to stores or restaurants
• Riding on an elevator
• Using public transportation
• Exercising
• Drinking coffee
• A traumatic event, like a car accident

Regardless of whether there was a trigger, panic attacks can lead to what's known as agoraphobia. Agoraphobia is the fear of places or situations or places where escape is difficult. If you've already had a panic attack, you might then fear situations that can lead to other panic attacks and start to anxiously avoid such situations.

Panic Attacks vs. Panic Disorder

Panic attacks and panic disorder are not the same thing. While a panic attack describes an incident where you experience a sudden surge of overwhelming fear or discomfort, panic disorder is a condition that's characterized by frequent, unexpected panic attacks that happen over and over.

If you think you might be living with panic disorder, it's important to get an accurate diagnosis from a healthcare provider. This office visit could involve:

• A physical exam to better understand any physical symptoms you may be experiencing
• Questions about your symptoms, medical history, behavior patterns, mood, and emotions
• A blood test to rule out a heart or other physical condition, as panic attack symptoms like palpitations can mimic cardiovascular issues

To officially diagnose panic disorder, you may also be referred to another provider who specializes in mental health conditions. They'll use criteria from the Diagnostic and Statistical Manual of Mental Disorders (or DSM-5), which is a set of mental health condition guidelines from the American Psychiatric Association. The provider will assess for specific markers, such as:

• Panic attacks that happen frequently and sometimes unexpectedly
• An ongoing worry that you'll have another panic attack
• A fear that you'll lose control during the attack
• Lack of another possible cause of the panic attacks (like drug use or another health condition)

How To Calm Yourself During an Attack

Calming yourself during a panic attack is easier said than done, but it is possible with relaxation techniques centered around breathing and visualization.

Breathing retraining can help slow your breathing rate. Practice this by inhaling, holding, exhaling, and repeating. This type of breathing can send your body signals of calm.

Positive visualization can help foster peace or calm and reduce feelings of nervousness or anxiety—lowering your fight-or-flight response to stress.

You can also consider looking into other calming self-help strategies, such as sensitization (carefully exposing yourself to a fearful situation to help get past the extreme fear) or progressive muscle relaxation (a body tension-reducing technique that helps counteract the normal fight-or-flight response).

It might also be helpful to remind yourself that there is an end in sight. Most panic attacks last no more than 10 to 20 minutes, which is how long the body can keep up the fight-or-flight response.

How To Prevent a Future Attack

Panic attacks aren't always predictable, but you can take steps to sometimes prevent them. For example, you could:

• Learn your triggers and learn how to cope with them
• Engage in regular physical activity to help reduce stress and relax the mind
• Get enough sleep so you're not groggy and potentially anxiety-prone
• Be mindful when consuming caffeine, alcohol, tobacco, or recreational drugs to avoid triggering an attack

Also keep in mind that there are treatment options available to help cut down on how often you're getting panic attacks—and how severe they are. Your healthcare provider might suggest a treatment plan involving medication, psychotherapy, or a combination of the two. Possible treatments include:

• Antidepressants—usually selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRI), or tricyclics—to help regulate your emotional response
• Benzodiazepines for immediate help calming during an attack
• Talk therapy to help manage stress, rearrange thinking patterns, and cope with panic attacks
  

A Quick Review

Panic attacks are brief episodes of sudden, intense, almost-paralyzing fear around a situation that doesn't actually present a high level of danger. The attacks can come with a broad range of physical symptoms like heart palpitations, sweating, and feeling faint. Panic attacks can happen in response to a trigger or, more commonly, they can pop up out of the blue. If you are experiencing a panic attack, you can try to use calming tactics and relaxation techniques to ease your fear. A healthcare provider may recommend medication or talk therapy to help ease the frequency and severity of attacks.