You’re going about your daily routine, just like any other day when all of a sudden, it hits you: A wave of dread envelops your body. A sense of impending doom that you can’t escape or pinpoint. You can’t breathe. Your chest hurts. Your heart feels like it’s beating out of your chest. You break into a sweat. You feel numb and dizzy, like you’re just about to faint. And the worst part is you have no idea why, or what is making you feel this way.
Are you having a heart attack? Are you dying? And then, just as quickly as it came on, the feeling dissipates. The world hasn’t ended. Things come back into focus. So what the hell just happened?
Odds are, you had a panic attack.
Panic attacks can come on at any time, very often for no discernible reason and without warning. And while they affect people of both genders, women are more prone to panic attacks than men.
Suffering from panic attacks can become an isolating experience, while the causes of attacks can be confusing to pinpoint. Because of this, panic attacks are often mistaken for other anxiety disorders, but it’s important to note there are distinct differences between the two and that, if left untreated, panic attacks can lead to panic disorder, a more serious and debilitating condition.
So what is a panic attack exactly?
While having a panic attack may feel like you’re dying (with symptoms including, but not limited to, difficulty breathing, pounding heartbeat, chest pains, and dizziness), it is something else entirely. It’s actually a chemical reaction caused when the bloodstream is flooded by adrenaline. This signals to the body that a threat is imminent and triggers a fight or flight response. The result is an overwhelming feeling of discomfort and often terror.
According to Gerard Lawson, President of the American Counseling Association, what primarily distinguishes panic attacks from generalized anxiety disorder and phobias is that “Anxiety disorders do not typically have the profound experience of panic with them and present more as worry and preoccupation. Specific phobias will have a have an identifiable trigger, which is not the case with panic attacks.”
He adds that it’s also important to distinguish panic attacks from PTSD. “Post-traumatic stress disorder will have similar features, but a professional counselor will be certain to assess for a trauma history, which may better explain the symptoms of PTSD and not panic.”
It should be noted, however, that PTSD, panic attacks, and panic disorder aren’t mutually exclusive. Those who suffer from PTSD have much higher rates of panic attacks than the general public, which is just one of the reasons why it’s important to reach out to a healthcare professional to help determine the root cause of any recurrent panic or anxiety you’re experiencing.
The Difference Between Panic Attacks and Panic Disorder
Panic attacks and panic disorder are two closely linked conditions, but their relationship is often misunderstood. The easiest way to explain the difference between the two is that those who suffer from isolated panic attacks don’t have panic disorder, but those who have panic disorder suffer from repeat panic attacks.
Repeat panic attacks can cause a snowball effect, and if left unchecked, the sufferer can experience a vicious cycle of constantly worrying about the onset of the next attack. This constantly anxious and exhausting mental state can eventually give way to panic disorder.
When panic attacks lead to panic disorder, it causes many chronic sufferers to withdrawal from normal activities. Lawson says panic disorder can best be described as “a vicious cycle of feeling panic, and then crippling anxiety over whether and when the next one will occur… The very experience of the panic attack causes people to begin to think about not engaging in the activity that caused the panic.”
Lawson adds that early prevention is the key to prevent isolated attacks from developing into panic disorder. “Even if you do not have a panic disorder, if you have had more than one panic attack, it is important to reach out to a professional counselor for assistance. Counseling can help, [but] without treatment, the isolated attacks can begin to develop into a full-blown disorder.”
What are the symptoms of a panic attack?
According to psychologist Anna Prudovski, clinical director of Turning Point Psychological Services, the primary symptoms of a panic attack include “racing heart, shaking, shortness of breathing, sweating, chest pain, dizziness, nausea, and feelings of unreality. Often there’s a fear of dying or a fear of going crazy or losing control.”
The Anxiety and Depression Center of America says other reported symptoms include “feelings of choking, chills or heat sensations, and numbness or tingling.”
Contributing to a U.S. News and World Report piece on panic attacks, Todd Farchione, research assistant professor at the Boston University Center for Anxiety & Related Disorders, said that all these symptoms “are tied to an evolutionarily sound response to protect the individual. It’s really designed to get that person to either fight or flight; it’s primarily to escape.”
So approximately how long does a panic attack last? Normally about 20 to 30 minutes, but it can feel like a lifetime for the sufferer, so it’s no wonder that these symptoms can be extremely alarming and disconcerting to the person who’s experiencing them—necessitating both professional help and personal support.
What triggers a panic attack?
One of the most frustrating aspects of panic attacks is that determining an exact cause is often difficult. But there are a variety of causes and conditions that may contribute to occurrences.
While anyone can experience panic attacks (and panic disorder), certain groups may have a higher risk factor than others, including those who suffer from agoraphobia, alcoholism, and bipolar disorder. Experiences of childhood trauma and abuse—particularly emotional abuse—are also linked to an increased likelihood of an individual developing various anxiety and panic disorders in adulthood.
Research suggests that panic attacks can also be hereditary. According to a 2011 study from The Journal of Korean Medical Science, “Linkage studies have implicated several chromosomal regions. …In addition, an anxious temperament and anxiety-related personality traits may represent intermediate phenotypes that predispose to panic disorder.”
Many people who experience panic attacks recall encountering them early in adolescence. And, as mentioned before, women tend to experience them more than men.
In fact, according to “Gender Differences in Panic Disorder,” a 2004 study published in Psychiatric Times, panic disorder is actually more than twice as prevalent among women as it is in men. Younger participants (those ages 15 to 24) had more occurrences than those ages 35 to 44, which suggests that age may also be a factor in the severity of panic attack symptoms.
Major life transitions are another potential trigger for panic attacks, including milestones like college graduation, getting married, or having a baby. Panic attacks are also associated with divorce or loss of a loved one and can even occur as a result of being overwhelmed by overcommitting or taking on too many responsibilities.
Those with sensitivities to certain medications or oversensitivity to external stimuli also may be at greater risk. Self-care is of utmost importance for panic attack sufferers since smoking, drug use, lack of sleep, and caffeine intake can all contribute to an increase in incidents.
Treatment and Prevention
The first step in treating panic attacks and preventing recurrence, according to Prudovski, is getting properly diagnosed by a healthcare professional. Once you’ve been properly diagnosed, the next step is seeking care from a psychologist or mental health professional. She says, “In many instances, panic attacks are related to another anxiety disorder, such as social anxiety, phobia, OCD, etc. In those cases, you may be diagnosed either with one of the anxiety disorders, or a panic disorder, or both. Correct differential diagnosis is crucial for treatment.”
While not every instance of a panic attack can be avoided, therapy (either cognitive behavioral therapy, exposure therapy, or both) can prove beneficial. Certain medications (including antidepressants and anxiety medications) can also be helpful, but as noted by Lawson “because the onset is unpredictable, they are usually after the fact, trying to manage the physical symptoms.”
Prudovski says that in addition to breathing, relaxation, and grounding techniques, exposure therapy can also be helpful, and when used in concert with cognitive behavioral therapy “is very effective and has a high rate of success.”
One reason so many mental health professionals are fond of exposure therapy for panic attacks and panic disorder is that it helps to lessen the power panic attacks hold over the sufferer. So how does it work? By inducing the symptoms of an attack in the confines of a safe environment, the shock and hold they have can be addressed and lessened.
For example, by inducing one of the most common panic attack symptoms, hyperventilation (through rigorous exercise), a therapist can then show the patient breathing techniques that can help slow and control their oxygen intake so the patient can be better prepared at the onset of another attack.
According to Jill Howell, Board Certified Art Therapist, Licensed Professional Counselor, and author of Color, Draw. Collage: Create Your Way to a Less Stressful Life, “One of the best tips that I tell my patients to use when they are feeling panicked is a mindfulness trick to bring them back to the here and now. I ask them to name everything that is around them out loud. To describe in detail everything that is on the wall, the floor, the counters. Naming colors, textures. Describing everything helps them to become more centered and focused which in turn distracts them from the feeling of panic.”
Potential Health Risks for Panic Attack Sufferers
There’s another very important reason to go visit your doctor if you believe you’re suffering from panic attack symptoms—you could be mistaking them for other potentially life-threatening conditions.
According to Lawson, “Some medical disorders, particularly cardiac or respiratory issues, can masquerade as panic disorders because the physical sensation is similar.”
Other illnesses that might be confused with panic attacks include mitral valve prolapse, hyperthyroidism, hypoglycemia, and even medication withdrawal. This makes it all the more important to check with your doctor if these symptoms keep recurring, as all the aforementioned conditions require proper medical diagnosis and supervision, and can even be fatal if left untreated.
And while many people think panic attacks are benign, research suggests the symptoms might not only feel like a heart attack—they could actually be linked to heart disease. In a piece for Harvard Health Publishing, psychiatrist Christopher Celano, MD, says that instances of panic and anxiety disorders are higher among those who have coronary heart disease and heart failure. Additionally, panic and anxiety disorders are also linked to other health issues including irritable bowel syndrome, chronic obstructive pulmonary disease or COPD, and asthma.
When it comes to panic attacks, knowledge is power.
While those who experience panic attacks may feel that relief is unachievable, sufferers should know that there is hope that their condition can improve or even be eliminated. Proper diagnosis and treatment can help an individual suffering from panic attacks manage their symptoms or even stop experiencing them entirely.
If you suffer from panic attacks or are a caregiver for someone who does, seek advice from a doctor or mental health professional to learn techniques and tools that can help those who suffer from panic attacks and disorders live a healthier, happier life.