Panic Attacks

Experiencing recurrent panic attacks and fear of having them, even if you haven’t had one in a while or both, are signs that you may have panic disorder. Panic disorder is an anxiety disorder. People with panic disorder may experience frequent panic attacks or have only a few but live with the fear of these happening. However, not everyone who experiences panic attacks has panic disorder.

Understanding Panic Attacks

Emotional and environmental stressors can trigger panic attacks. However, it is not always possible to identify an evident cause. Panic attacks and anxiety attacks are not the same, even though anxiety is a major ingredient of panic disorder. Anxiety “attacks” can manifest as an intense worry or uncomfortable bodily sensation that builds up. A high level of anxiety can trigger a panic attack. However, an anxiety attack is not a recognised clinical term used by professionals, and there are no set criteria for an anxiety attack. In contrast, panic attacks have specific sets of criteria to be identified as such. Further panic attacks usually last between 5 minutes and an hour, whereas high anxiety levels can last much longer.

Panic attacks can be pretty debilitating. Although they are not life-threatening, a shared experience when having a panic attack is feeling like you are dying, given the intensity of the physiological symptoms and emotional distress, for example, believing you have a heart attack. This might result in avoiding situations which are likely to trigger the physiological feelings experienced during a panic attack like, for example, exercise or other intense physical activities, and having difficulties in leaving the house and going on with your daily activities for fear of experiencing a panic attack, for example, avoid/being afraid of going alone to places and always locate the nearest exit or bathroom in case you have another panic attack. Because the experience of a panic attack is characterised by very intense physiological and psychological symptoms, having a panic attack can leave the person feeling exhausted and on edge afterwards. 

What Is a Panic Attack?

A panic attack is an intense and immediate episode of anxiety and fear characterised by overwhelming and severe physical and psychological symptoms. The experience of panic attacks is unique to everyone.

Types of panic attacks

- Unexpected Panic Attacks

The panic attack comes with no apparent trigger cause. For example, it might happen when you are relaxing or enjoying yourself entirely out of the blue. However, this type of panic attack, despite not having an apparent trigger, is still caused by something in the environment or your psyche, but it might be very hard to identify. For example, it can be that subconsciously you had picked up on cues in the situation in which you are before your conscious mind did, or that you are unconsciously associating your present situation with a time that was very scary for you in the past. 

- Expected Panic Attacks 

The panic attack comes as a result of a specific trigger. These can be situationally predisposed or cued. 

Situationally predisposed panic attacks might not happen when you are exposed to the trigger. They might happen before, during or after you are exposed to the triggering situation or event. For instance, if you are anxious about a presentation at work that triggers high levels of anxiety, even though the trigger is the presentation, the onset of the panic can differ. For example, you may experience a panic attack the day before the presentation, once you have finished the presentation or during.

Whereas situationally cued panic attacks are different as they can occur immediately after exposure to a situation, environment or circumstance that had triggered your anxiety or fear in the past or where you had a traumatic event. For example, being inside a car after a traumatic car accent can immediately trigger a panic attack as soon as you sit in the car. These types of panic attacks are generally more common in people who suffer from social anxiety, generalised anxiety disorder and agoraphobia. 

Triggers (whether you are aware of them or not) can be anything from smells, sensations, places, noises, people, and objects. The “fear of the fear” of having another attack can also become a trigger.

What Are The Main Symptoms Of Panic Attacks?

- Physiological symptoms:

• Heart palpitations

• Shaking or trembling

• Feeling tight chest/ chest pain

• Sweating

• Shortness of breath

• Feeling faint, Light-headed or dizzy 

• Feeling of choking

• Abdominal distress 

• Nausea

• Hot flushes or chills sensations

• Depersonalisation (feeling out of your body)

• Feeling numb or tingly sensation in your body

• Dry mouth 

- Psychological symptoms: 

 • Fear of losing control 

 • Fear of dying

 • Fear of having a heart attack

 • Fear of having further panic attacks in the future

Moreover, if someone experiences frequent panic attacks or has developed a “fear of the fear” of having further attacks, there might be behavioural changes, such as:

• Avoid activities likely to trigger the physiological feelings experienced during a panic attack.

• Avoid situations that might likely trigger a panic attack.

• Difficulties in leaving the house alone or going places alone for fear of experiencing a panic attack.

• Always locate and place yourself near an exit or a bathroom in each situation.

What Causes Panic Attacks?

As in most mental health conditions, we are not entirely sure of the causes of panic attacks and panic disorders. However, research shows that these factors play a role in the development of the condition:

• Genetics

• Major stress event/trauma

Research suggests that a genetic predisposition might make an individual more likely to develop panic attacks or panic disorder if another family member has the condition. 

Research shows that panic disorder or panic attacks can develop due to significant stress or trauma, such as losing a loved one.

Therapy For Panic attacks

Psychotherapy is highly effective in the treatment of panic attacks or panic disorders.

Different therapies have proven to be effective in the treatment of panic attacks, such as:

• Cognitive Behavioural Therapy (CBT)

• Acceptance and Commitment Therapy (ACT)

• Psychodynamic Therapy

• Dialectical Behavioural Therapy (DBT)

Please get in touch with us to learn more about therapy for panic attacks or schedule an appointment for a free initial consultation.