If you’ve ever had a panic attack, you’ll know it can be both a terrifying experience and exhausting experience. Panic disorder is a diagnosis given to people who experience recurrent unexpected panic attacks—that is, the attack appears to occur from out of the blue. Panic attack symptoms include sweating, shaking, shortness of breath, feelings of choking, chest pain, and a fear of dying.

What is a Panic Attack?

A panic attack is an abrupt surge of intense fear or discomfort that reaches a peak within minutes, and during which time a variety of psychological and physical symptoms occur. These symptoms include rapid heart rate, sweating, shaking, shortness of breath, hot flashes, and lightheadedness—as well as a sense of impending doom, chills, nausea, abdominal pain, chest pain, headache, and numbness or tingling.

What is Panic Disorder?

Panic disorder is a diagnosis given to people who experience recurrent unexpected panic attacks— that is, the attack appears to occur from out of the blue. The term recurrent refers to the fact that the individual has had more than one unexpected panic attack. In contrast, expected panic attacks occur when there is an obvious cue or trigger, such as a specific phobia or generalized anxiety disorder. In the U.S., roughly 50% of people with panic disorder experience both unexpected and expected panic attacks.

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What Does a Panic Attack Feel Like?

Panic attacks cause a variety of distressing symptoms that can be terrifying for the individual experiencing the attack. Some people mistake panic attacks for heart attacks and many believe that they are dying. Others feel a mixture of self-doubt or impending doom. Some can also find the episodes extremely embarrassing and refrain from telling their friends, family, or a mental health professional.

Panic Attack Symptoms

Based on panic disorder DSM-5 criteria, the symptoms of panic attacks are:

Physical

  • Palpitations, pounding heart, or accelerated heart rate
  • Sweating
  • Trembling or shaking
  • Shortness of breath
  • Feelings of choking
  • Chest pain or discomfort
  • Feeling dizzy, unsteady, light-headed, or faint
  • Chills or heat sensations
  • Numbing or tingling sensations (commonly referred to as “pins and needles”)

Psychological

  • Fear or losing control or “going crazy”
  • Fear of dying
  • A sense of being detached from yourself or your surroundings, or observing yourself from outside your body

To receive a diagnosis of panic disorder, the panic attacks must be unexpected and during the attack four or more of the above symptoms must occur. For panic attacks that are expected, meaning they might not be expected by the individual but are expected in relation to any phobia, anxiety or other mental health disorder, four or more symptoms must also occur.

How Long Does a Panic Attack Last?

Although duration varies between individuals, typically, panic attacks reach their peak within 10 minutes or less and then symptoms begin to subside. Panic attacks rarely last for more than an hour, with most lasting for around 20 to 30 minutes.

Are Panic Attacks Bad for Your Heart?

According to a study published in Psychology Medicine1, people who suffer from panic attacks and panic disorder may be at higher risk of heart attack and heart disease later in life. While the link between panic disorder and heart disease remains controversial, the study found that compared to individuals without panic disorder, sufferers were found to have up to a 36% higher risk of heart attack and up to 47% higher risk of heart disease. If you suffer from panic attacks, seek attention for any chest pain symptoms in order to rule out any issues with heart health.

Can You Die from a Panic Attack?

While panic attacks cause a variety of physical issues and many people reporting feeling like they are about to die when experiencing one, you cannot die from a panic attack.

Panic Disorder and Panic Attack Causes

If you are prone to experiencing negative emotions and are sensitive to anxiety you may be at risk for the onset of panic attacks and panic disorder. Childhood experience of sexual or physical abuse, smoking, and interpersonal stressors in the months before the first panic are also risk factors.

Furthermore, it is believed that genetics play a role in susceptibility to panic disorder, although the exact genes, gene products, or functions that are implicated are not known. Individuals with a parent or parents diagnosed with anxiety, depression, or bipolar disorder are also thought to be at a higher risk of developing panic disorder.

How to Stop a Panic Attack

As symptoms begin to peak during a panic attack it can feel like the experience will never end. While you might think there’s nothing you can do except wait it out, there are some techniques you can practice to reduce the severity of your symptoms and distract your mind.

  1. Have a Plan in Place

No matter what your plan is, having one in place is the most important thing. You can think of your plan as your go-to set of instructions for yourself when you feel a panic attack coming on. One plan might be to take yourself out of your current environment, sit down, and call a friend or family member that can help distract you from your symptoms and help you to calm down. Then you can incorporate the following techniques.

  1. Practice Deep Breathing

Shortness of breath is a common symptom of panic attacks that can make you feel frantic and out of control. Acknowledge that your shortness of breath is a symptom of a panic attack and that this is only temporary. Then begin by taking a deep breath in for a total of four seconds, hold for a second, and release it for a total of four seconds. Keep repeating this pattern until your breathing becomes controlled and steady. Focusing on the count of four not only will prevent you from hyperventilating, but it can also help to stop other symptoms in their tracks.

  1. Use Muscle Relaxation Techniques

In the midst of a panic attack, it’s inevitable that you’ll feel like you’ve lost control of your body, but muscle relaxation techniques allow you to gain back some of that control. Progressive muscle relaxation (PMR) is a simple but effective technique for panic and anxiety disorders. Start by clenching your fist and holding this clench until the count of 10. Once you get to 10, release the clench and let your hand relax completely. Next, try the same technique in your feet and then gradually work your way up your body clenching and relaxing each muscle group: legs, glutes, abdomen, back, hands, arms, shoulders, neck, and face.

  1. Repeat a Mantra

You may feel a little awkward doing this at first but repeating an encouraging, positive mantra to yourself during a panic attack can serve as a coping mechanism. Try repeating something as simple as “This is temporary. I will be okay,” or “I’m not going to die. I just need to breathe.”

  1. Find an Object and Focus on It

Pick an object that you can see somewhere in front of you and note everything you notice about that object—from its color and size to any patterns it may have, where you might have seen others like it, or what something completely opposite to the object would look like. You can do this in your head or speak your observational aloud to yourself or a friend.

Panic Attack Treatment

Both psychotherapy and medication has been found to be effective in helping to reduce the frequency and intensity of panic attacks. Your specific treatment path will depend on personal preference, medical history, and the severity of your attacks.

A form of psychotherapy called cognitive behavioural therapy (CBT) has been found by several studies to be the most effective treatment for panic attacks and panic disorder. During CBT, you will work with a therapist on relaxation training, restructuring your thoughts and behaviors, mindfulness, exposure treatment, and stress reduction. Many people that suffer from panic attacks start to notice a reduction within weeks, and symptoms often decrease significantly or go away completely within several months.

Your doctor might also suggest that you try some form of medication as part of your treatment path. These medications can be extremely helpful in managing panic attack symptoms, as well as anxiety and depression. Examples of medications your doctor might prescribe are:

  • Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac), paroxetine (Paxil, Pexeva) and sertraline (Zoloft). SSRI depressants are usually the first choice for treating panic attacks and panic disorder due to their effectiveness and the low risk of any serious side effects.
  • Serotonin and norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine (Effexor) are FDA approved for the treatment of panic disorder.
  • Benzodiazepines such as alprazolam (Xanax) and clonazepam (Klonopin) may also be prescribed.

Anxiety Attack vs. Panic Attack

Many people use the terms anxiety attack and panic attack interchangeable, but in reality, they represent two different experiences. The DSM-5 uses the term panic attack to describe the hallmark features of panic disorder or panic attacks that occur as a result of another mental disorder. To be considered a panic attack, four or more of the symptoms outlined in the DSM-5 must be present.

In contrast, the term anxiety attack is not a specifier outlined in the DSM-5. Rather, anxiety is used to describe a core feature of multiple different anxiety disorders. The culmination of symptoms that result from being in a state of anxiety—such as restlessness, shortness of breath, increased heart rate, and difficulty concentrating—may feel like an “attack,” but are generally less intense than those experienced at the height of a panic attack.

Given that anxiety attacks aren’t specifically outlined as a diagnosis in the DSM-5, the usage of the word is open to interpretation and different individuals may use it in varying ways and circumstances. For one person, an anxiety attack might be overthinking about a specific worry to the extent that they are unable to concentrate on anything else; for another, anxiety attack might refer to sweating and shortness of breath when faced with a certain situation.

How to Help Someone Having a Panic Attack

Seeing a friend or a loved one experience a panic attack can be a frightening experience. It can also be challenging to feel powerless to help that person and to watch them suffer. While you’re unlikely to be able to stop your loved one’s panic attack in its tracks, there are things you can do and say to help them through the experience.

Primarily, it is important to stay calm, patient, and understanding. Help your friend wait out the panic attack by encouraging them to take deep breaths in for four seconds and out for four seconds. Stay with them and assure them that this attack is only temporary and they will get through it. You can also remind them that they can leave the environment they are in if they would feel more comfortable elsewhere and try to engage them in light-hearted conversation.

Once the panic attack is over and the person has returned to a calm state, encourage them to seek help from a mental health professional at their earliest convenience, if they haven’t already. You can help them further by assisting with the search for a licensed professional, researching coping techniques online, and looking for self-help books that might be useful.

Panic Attack Help and Support

If you’ve been experiencing panic attacks or think you may have panic disorder, we encourage you to seek diagnosis and treatment from your doctor and a mental health professional. Although panic attacks can feel like a debilitating and embarrassing condition, it is important to remember that you aren’t alone and your mental health is nothing to be embarrassed about. There are a variety of resources available to you for advice and support, both online and in the form of support groups. For more information, ask your healthcare provider about what is available in your area and check out the links below:

Support Group Directory from the ADAA

MD Junction Anxiety and Panic Support

Facebook Anxiety and Panic Attack Support Group

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Last Updated: Jul 20, 2018