You’ve likely seen someone acting out a panic attack in a movie. They might fall to their knees or clutch at their chest. They might exclaim they can’t breathe or that they’re dying. For a theatrical representation of a panic attack, this isn’t too far off from the reality of a real-life panic attack. 

What is a panic attack?

A panic attack is a sudden and unforeseen surge of fear and extreme anxiety. It comes out of nowhere, perhaps even during sleep. It causes psychological symptoms such as:

  • fear of dying
  • sudden detachment from reality
  • the feeling of a loss of control

It also causes physical symptoms such as:

  • rapid heartrate
  • shortness of breath
  • sweating
  • dizziness
  • shaking
  • chest pain
  • hot flashes or chills
  • knotted stomach/nausea
  • disorientation
  • numbness/tingling in limbs
  • feeling of choking

According to the Diagnostic and Statistical Manual, 5th Edition (DSM-5), at least four of these symptoms need to be present in order to be considered a panic attack.  

Is it a panic attack or an anxiety attack?

Panic attacks can be confused with anxiety attacks because both have similar physical symptoms. Typically, anxiety attacks are a response to a frightening scenario, a threat or certain triggers. In essence, this makes them somewhat predictable, as the attack will not happen without exposure to the anxiety-inducing situation. Panic attacks, on the other hand, may occur as a response to a trigger, or they may happen seemingly out of the blue. Another difference is that panic attacks are usually more intense, but typically peak and subside within a short time frame (within a few minutes to a half hour), while anxiety attacks tend to build gradually and may last much longer.

Panic attacks generally occur in people with panic disorders, while anxiety attacks generally affect those who have anxiety disorders, obsessive compulsive disorders, trauma and other mental health issues. However, this isn’t a hard and fast rule. These types of attacks can overlap in who they affect, or sometimes affect someone who doesn’t fit this general guideline.

What causes a panic attack?

Despite their general differences, the reasons behind either a panic attack or an anxiety attack can be shared. A person may experience anxiety or panic attacks due to:

  • stressful situations
  • withdrawal from drugs and/or alcohol
  • chronic pain or chronic health issues (like breathing disorders)
  • side effects of certain medications
  • stimulated fears or phobias
  • experiencing reminders/triggers of trauma
  • use of stimulants (caffeine, amphetamines)

But keep in mind that panic attacks, unlike anxiety attacks, might also occur without any trigger or stimulation at all.

How to handle a panic attack

The first thing to know is that a panic attack, though it may feel scary and uncomfortable is not life-threatening or dangerous. To manage the sense of panic you feel, you must remind yourself that the overwhelming feeling of anxiety and fear is temporary, and won’t harm you.

Paul Salkovskis, Professor of Clinical Psychology and Applied Science at the University of Bath, advises in an NHS Inform article, that you shouldn’t try to distract yourself from the symptoms of a panic attack. His advice is to ride out the symptoms and try to face your fear of the symptoms and/or the frightening situation you might be in. The idea behind this is that once your symptoms subside, you will see that the situation was survivable. The attacks should hold less power over you if you know you can overcome them on your own.

Breathing exercises can also be helpful to get through a panic attack.  One simple exercise is to take a deep breath but focus on lengthening the exhale.  A longer exhale sends a signal to your brain and helps to activate the parasympathetic nervous system (system responsible for relaxation, rest and digestion) this then eases the sympathetic nervous system (system that is responsible for fight, flight, or freeze response) which helps your body calm down.   

If you often suffer from panic attacks, you can take some preventative measures to try to mitigate your symptoms before they occur. Doing breathing exercises daily, maintaining a regular exercise schedule, seeing a therapist/counselor, avoiding caffeine, drugs and alcohol, and being aware of potential triggers can all help minimize your symptoms when a panic attack does occur.

You might also consult with your physician to discuss treatment options. According to an article in American Family Physician, written by Peter Ham, M.D., David B. Waters, PH.D., & M. Norman Oliver, M.D., anti-depressants (e.g., Prozac or Zoloft) can be beneficial for treating panic attacks, as well as Cognitive Behavior Therapy (CBT) which can be done with a trained therapist or clinician.

“Cognitive behavior therapy (CBT) includes many techniques, such as applied relaxation, exposure in vivo, exposure through imagery, panic management, breathing retraining, and cognitive restructuring,” states Ham, Waters and Oliver. “It is unclear which component of CBT is more important: cognitive therapy (e.g., identifying misinterpreted feelings, educating patients about panic attacks) or behavior therapy (e.g., breathing exercises, relaxation, exposure). However, the efficacy of exposure techniques alone, in which the patient repeatedly confronts the anxiety-provoking stimulus through imagery or in vivo, is well established in patients with panic disorder, particularly in patients with agoraphobia. When possible, referral to a therapist experienced in exposure techniques is preferred.”

If you would like to talk with someone about panic attacks or discuss various treatments options (e.g., cognitive behavior therapy), please contact us at Family & Child Development.