29Jul

Panic Attacks: Symptoms, Causes, and Treatment

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A panic attack is a wave of overwhelming fear, triggered by an unexpected situation. Physical symptoms include fast heartbeat, difficulty in breathing or a choking sensation. Your mind stops functioning and you feel like you are going to die. In certain cases, an episode of panic attack may occur even without a trigger when you are relaxed or asleep. It may occur once or you may experience repeated episodes. If you undergo panic attacks quite often without a trigger or warning, it is known as a panic disorder. The situation that triggers panic makes you feel threatened you and you feel that you will not be able to escape it. One of the major traits of this condition is that you panic out of the fear of getting another attack. A panic attack may have a negative impact on your functional life. It is often associated with social phobia, depression, alcoholism, or drug abuse. Regardless of severity and cause, panic attacks are treatable. Developing well-planned coping strategies will enable you to lead a normal life.

Table of Contents

Types

There are no types for panic attacks.

Causes And Risk Factors

Causes

Doctors believe there is robust evidence to support the role of neurotransmitters such as serotonin and norepinephrine in panic attacks. However, it has been found to run in families sometimes. Life events such as job stress, marriage, pregnancy, separation and loss of a loved one could be potential triggers behind a panic attack. However, certain health and psychological conditions along with behavioural issues can up your risk of this disorder.

  • Mitral valve prolapse (a condition when your heart valves do not correctly close)

  • Hyperthyroidism (overactive thyroid gland)

  • Hypoglycemia (low blood sugar)

  • Stimulant use (amphetamines, cocaine, and caffeine)

  • Medication withdrawal

  • Claustrophobia (fear of enclosed spaces)

  • Acrophobia (fear of heights)

  • Social phobia

  • Depression

  • Post-traumatic stress disorder

  • Obsessive compulsive disorder

  • Schizophrenia

Risk Factors

Anyone can experience a panic attack. Panic attacks occur in ~11% of Americans. Factors that are a risk factor for developing panic attacks are listed below:

  1. Age - Panic attacks are widespread in teenage and adult years but have a probability of occurring in all age groups.

  2. Gender - Women are more prone to having panic disorders than men.

Prevention

After a trigger for the occurrence of a panic attack is identified, you can identify strategies to prevent another one. You can avoid panic attacks by :

  1. Avoiding drinking too much caffeine.

  2. Keep exercising regularly.

  3. Try to eat a healthy, nutritious diet.

  4. Ensuring appropriate stress management.

  5. Not taking any herbal supplements or over the counter medication without consulting a doctor.

Diagnosis

The symptoms of a panic attack are the accurate indicator for a panic attack. Symptoms of a panic attack can be mistaken for heart attack, stroke, or breathing problems, and therefore ensure to get a proper diagnosis performed by a medical professional.

Alcohol, amphetamine, marijuana, and other substance abuse drug use can trigger symptoms of panic attacks.

A detailed history interview that includes family history, personal history, and medical history is usually asked by the doctor. The doctor may ask about stress in contemporary life. The general physician might refer you to a mental health physician that evaluates your mental status, including :

  1. Thoughts, feelings and symptoms during a panic attack

  2. Thoughts, feelings and symptoms after a panic attack

  3. Checking for the presence of other psychiatric illnesses

Treatment

To treat a panic attack, your psychiatrist may resort to a combination of therapies. They may require additional therapies such as relaxation techniques like the Jacobson progressive muscle relaxation (JPMR) or breathing and positive visualisation. Here is a low-down on a few common treatments for a panic attack.

  • Psychotherapy: In this method, a trained psychological therapist helps a person suffering from panic attack by talking to him or her. The aim of the conversation helps the people with an improved understanding of the self and the problem. A psychotherapist may use methods such as questionnaire for counselling sessions.

  • Cognitive-behavioural therapy: It helps a person modify his thought process and behavioural patterns. This therapy helps you identify the triggers behind a panic attack.

  • Drug therapy: Usually, anti-anxiety medications (such as alprazolam and clonazepam) and antidepressants (such as paroxetine and sertraline) are prescribed to people suffering from severe panic disorders. In certain cases, medications such as beta blockers are used to control heartbeat of people with panic attack.

Lifestyle/management

Yes, you feel powerless during a panic attack. You feel out of control; however, the good news is you can take a few small steps to help yourself and they actually work! Here we inform you how to take charge of your life:

Know more about panic and anxiety: Learning a little more about your condition will give you a better control over the situation. Join a support group to exchange thoughts with people who have similar experiences and read up on anxiety and panic disorder.

Reduce smoking, alcohol, and caffeine: These can all provoke panic attacks in people who are susceptible. Moreover, be careful with medications that come with stimulants such as diet pills.

Learn to control your breathing: Breathing techniques help you control the symptoms of hyperventilation that occur during an episode of panic attack, including light headedness and chest tightness. Breathing techniques can help calm your nervous system.

Practise meditation: This is a relaxation technique that is able to control body’s stress response. Meditation can help you identify an internal equilibrium.

Talk to family and friends: Loneliness or isolation can worsen the symptoms of anxiety, stress, depression and any other mental health challenges. Talking to your friends, family and close ones will strengthen your mind. Friendly support will definitely go a long way in reducing your episodes of panic attack.

Moreover, exercise and sound sleep will improve your condition.

Helping someone having a panic attack:

  1. Stay calm: Being calm and non-judgemental will help your loved one get out of a panic attack sooner.

  2. Focus on breathing: Take your friend to a calm place and inform them to take nice long breaths.

  3. Distract your friend's thoughts: Try to distract them from the attack by talking about something random that will deviate their attention.

  4. Encourage them to take help: After the panic attack, your friend might feel ashamed about the episode but reassure them about your feelings and help them understand what you think.

Prognosis And Complications

People with panic attacks tend to get better with proper treatment and care. Stopping attacks is the ultimate key for leading a good quality of life.

Note that 30%–40% of people are symptom-free while the other 50% experience slight symptoms.

Complications

Untreated panic disorder can result in severe consequences. The primary danger is of developing phobia and avoiding situations of when the attack happened.

People with panic disorder show avoidance, e.g., a driver avoids driving because of an attack he experienced during driving.

In addition to phobias, quality of life can be severely affected. People having panic disorders are more prone to:

  1. Alcohol and drug abuse

  2. Suicidal risk

  3. Spending time in emergency rooms in hospitals

  4. Lack of interest in hobbies, sports and other leisure activities

  5. Financial problems

  6. Poor mental health

  7. Fears of driving or going outside

Panic disorders are associated with economic effects such as losing jobs because of the condition.

You can avoid all of this with a proper treatment plan and care.

References

Cleveland Clinic. Panic Disorder. [Internet] [Updated on: 8 December, 2020] Available at: my.clevelandclinic.org/health/diseases/4451-panic-disorder. Accessed on: 28 March, 2021. (my.clevelandclinic.org/health/diseases/4451-panic-disorder)

Health Harvard. Panic Disorder. [Internet] [Updated on: 28 September, 2020] Available at: www.health.harvard.edu/a_to_z/panic-disorders-a-to-z. Accessed on: 28 March, 2021. (www.health.harvard.edu/a_to_z/panic-disorders-a-to-z)

Help Guide. Panic attacks and Panic Disorder. [Internet] [Updated in September, 2020] Available at: www.helpguide.org/articles/anxiety/panic-attacks-and-panic-disorders.htm. Accessed on: 28 March, 2021. (www.helpguide.org/articles/anxiety/panic-attacks-and-panic-disorders.htm)

APA. Panic Disorder. [Internet] [Updated on: 2019] Available at: www.apa.org/topics/anxiety/panic-disorder. Accessed on: 28 March, 2021 (www.apa.org/topics/anxiety/panic-disorder)

 

 









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