Panic Attack

Panic Attack

A panic attack is a sudden occurrence of extreme fear in a person that triggers severe physical reactions without real danger or any apparent cause.
Panic attacks can be frightening, because they trigger a loss of control in the person where they might feel they are having a heart attack or even dying.

Many people might have just one or two panic attacks in their lifetimes, with the problem going away when the responsible stressful situation ends.

Panic disorder is a repeated occurrence of sudden panic attacks or fear.

How do you know it is a panic attack?

There is a rush of intense mental and physical changes in the body that may manifest very quickly for unknown reason. Usually, a panic attack could be scary and distressing for the person experiencing it.

The duration of most panic attacks is between 5 minutes to 20 minutes with some lasting up to 1 hour. Symptoms include:

  • Racing heartbeat
  • Faintish feeling
  • Sweating
  • Nausea
  • Chest pain
  • Shortness of breath
  • Trembling
  • Suddenly feeling hot (hot flushes)
  • A choking sensation
  • Dizziness
  • Feeling numb at the tips of hands and legs
  • Pins and needles feeling
  • Dry mouth
  • Fear of dying
  • A churning stomach

Number of attacks depends on the condition of the person and its severity. Panic attacks might range from either once or twice a month to several times per week. Although frightening, panic attacks are not dangerous. They don’t result in physical harm and hospital admissions owing to panic attack are unlikely.

What are the causes and risk factors of panic attack?

The exact causes of panic attack are not known but few of them maybe as follows:

  • Genetics
  • Extreme stress or stressful event
  • More sensitivity to stress or negative emotions
  • Changes in the brain function

Initially panic attacks may come start suddenly, without warning, but generally they triggered by certain situations. The body’s natural fight-or-flight response to danger is involved in panic attacks, the difference being that this response is triggered even when there is imminent danger.

Certain risk factors for panic disorders are:

  • Presence of panic attacks or panic disorder among family members (family history)
  • A major stressful life event, such as the death or serious illness of a loved one
  • A traumatic event such as a major accident or sexual abuse
  • Milestone changes life such as a a relationship break-up or divorce or having a baby
  • Smoking or excessive caffeine intakes
  • History of childhood physical or sexual abuse

How is panic disorder diagnosed?

The doctor determines if a person’s condition is panic attack or another condition such as heart or thyroid problems that resembles the symptoms of panic attack. The doctor may conduct a physical exam, or blood test and to confirm diagnosis, the doctor may ask the patient to take a self-assessment form. To differentiate between a panic attack or a panic disorder, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association lists the following points for diagnosing a panic disorder:

  • Frequent, unexpected panic attacks.
  • At least one attack is followed by worrying about having the next one, having continued fear of the consequences of an attack, such as loss of control, heart attack or significant behavioural changes of avoiding situations that may trigger panic attack for that person.
  • Panic attacks aren’t caused by drugs or other substance use, a medical condition, or another mental health condition, such as social phobia or obsessive-compulsive disorder.

Untreated panic attacks may lead to panic disorders.

How is a panic disorder treated?

Treatment reduces the intensity and frequency of panic attacks and improves the quality of daily life. The main treatment options are psychotherapy and medications and depending on the preference of the patient, their history and severity of your panic disorder, one or both options may be recommended. Another criteria is the availability of therapists specializing in these disorders.

Psychotherapy: Psychotherapy, also known as talk therapy, an effective first choice for treatment of panic attacks and panic disorder. Consulting the doctor who may suggest a specialist is the best way for psychotherapy.

A form of psychotherapy (cognitive behavioural therapy) helps the patient learn about the harmlessness of panic attack symptoms. The therapist gradually re-creates symptoms in a safe, repetitive manner and helps them to resolve them. After some treatment, sensations of panic no longer feel threatening, and the attacks begin to resolve. This, however, takes time and effort of several weeks. Occasional maintenance visits may be held to ensure that panic attacks remain under control and to prevent recurrence.


There are a variety of class of medications that may help in symptom reduction associated with panic attacks as well as depression if that issue is present. The doctor will suggest a single drug or a combination medication to boost effectiveness.


  1. Panic attacks and panic disorder. December 2023. Mayo Clinic.
  2. Panic attacks. WebMD. December 2023.
  3. Panic disorder. NHS UK. December 2023.

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