Mental health problems can be complicated to understand and manage, particularly when they occur unexpectedly as a sudden attack. Panic attacks often catch individuals and those around them off guard. These episodes of intense fear peak within minutes and subside quickly, leaving individuals trembling, breathless, and shaken. Even though panic attacks are difficult to predict, they are manageable. To combat panic attacks with confidence, identification of their causes and risk factors is essential. In this blog, we explain the symptoms and causes of panic attacks and share information on treatment options and practical self-care strategies for individuals to improve their quality of life.
What is a Panic Attack?
A panic attack is a sudden and intense physical reaction or fear response to usually non-threatening or ordinary situations. In a panic attack, individuals often experience physical symptoms such as shortness of breath, excessive sweating, and heart palpitations.
An episode comes without warning, lasting anywhere from 5 to 30 minutes or longer, and then disappears suddenly. The frequency of panic attacks varies, with some individuals experiencing multiple episodes per week while others may have them only once or twice a month. However, the frightening attack leaves the individuals physically and emotionally distressed for much longer. When multiple panic attacks occur without warning or a known trigger, it is classified as a panic disorder.
Even though panic attacks are not dangerous or life-threatening, they adversely impact the quality of life of individuals. They may be a symptom of an anxiety disorder. This is why seeking therapy and treatment is crucial.
Difference Between Panic Attacks, Anxiety, and Depression
Panic attacks, anxiety, and depression are distinct mental health conditions that collectively affect millions of individuals worldwide. However, they are very different in terms of symptoms, duration, and triggers.
Characteristics and Duration: Panic attacks are characterised by sudden and intense feelings of fear or terror that peak within minutes, whereas anxiety involves a general feeling of worry, dread, and fear that come in waves and last for long periods. Depression, on the other hand, is a mood disorder that causes persistent feelings of sadness and detachment from daily activities for long durations of time, sometimes lasting even years.
Triggers: Panic attacks often occur without specific triggers, whereas anxiety and depression are typically associated with identifiable stressors or events.
Panic attacks can be a symptom of generalised anxiety disorder. When panic attacks become chronic, severe, and frequent, it is known as panic disorder. Anxiety and panic disorder may coexist and can potentially lead to depression. Treatments for depression, anxiety, and panic attacks include psychotherapy, prescribed medications, support groups, and lifestyle modifications tailored to individual needs.
Signs and Symptoms of Panic Attacks
Panic attacks manifest with physical and psychological symptoms. Many individuals report symptoms similar to a heart attack. It is crucial to consult a medical professional for an accurate diagnosis to differentiate between panic attacks and other health conditions.
Physical Signs and Symptoms of Panic Attacks
Psychological Signs and Symptoms of Panic Attack
A sudden and overwhelming sense of terror
A pervasive fear of losing control or "going crazy"
Feeling like one is going to die
A feeling of detachment from the self
Consult a medical professional if you or someone near you experiences panic attacks along with sleep problems, difficulty concentrating, extreme irritability, or chronic anxiety.
Causes of Panic Attacks
Researchers believe that panic attacks are caused by impaired brain and nervous system function, particularly in the amygdala, which helps individuals perceive and process fears and emotions experienced in daily life events or major stressors. An overactive or dysregulated amygdala can result in exaggerated fear responses, triggering panic attacks.
Another potential cause of panic attacks is an imbalance of neurotransmitters, including:
Gamma-aminobutyric acid (GABA): GABA is a neurotransmitter that inhibits neural activity and helps calm the nervous system. Low levels of GABA can lead to an overstimulated nervous system, which increases the likelihood of panic attacks.
Serotonin: It plays a crucial role in regulating mood and stress responses, and imbalances in serotonin levels are often associated with anxiety and panic disorders.
Cortisol: It is the body’s primary stress hormone that is released during stress responses, and prolonged elevated cortisol levels can exacerbate anxiety and panic attacks.
Although the exact cause of panic attacks remains unknown, understanding risk factors can help individuals proactively manage their condition. Some of the risk factors for panic attacks include:
A family history of anxiety disorders, including generalised anxiety disorder, panic disorder, or depression.
Negative experiences in childhood (typically between the ages of 1 and 17) can increase the likelihood of panic attacks.
Individuals with mental health conditions such as anxiety disorder, OCD, depression, or bipolar disorders are at an increased risk of panic attacks.
Traumatic experiences or significant life events, such as the loss of a loved one, abuse, or divorce, can increase the likelihood of panic attacks.
Substance abuse, especially stimulants such as cocaine, can trigger panic attacks.
Diagnosis of Panic Attacks
To diagnose panic attacks accurately, doctors use a combination of techniques, including a thorough discussion of the patient’s symptoms, medical history, and lifestyle. Additionally, doctors may conduct several tests and evaluations to rule out other potential causes of symptoms and an accurate diagnosis. These tests may include:
Laboratory Evaluations
To rule out underlying health conditions and identify the cause of panic attacks:
Complete Blood Count (CBC): Used to identify infections or conditions like anaemia, which can present with symptoms resembling those of a panic attack.
Thyroid Function Tests: These assess thyroid imbalances, which are known to cause symptoms that mimic those of panic attacks.
Heart Tests: To rule out heart diseases that may be causing symptoms of chest pain and palpitations, which are often associated with panic attacks.
Cortisol Levels: To evaluate stress hormone levels, which are a contributor to panic attacks and anxiety.
Respiratory Test: To check for respiratory conditions such as asthma or hyperventilation, which are known to cause symptoms similar to panic attacks.
Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
This provides a clinical framework to differentiate between panic attacks from other related mental health disorders, including parameters such as:
Frequency: The frequency of panic attacks experienced by an individual over a defined period.
Intensity: The severity of symptoms experienced during an episode.
Impact: The extent to which panic attacks disrupt daily functioning and emotional well-being.
Treatment of Panic Attacks
Panic attacks occur suddenly, but they can be effectively managed with a combination of medical treatments and self-care strategies. Left untreated, panic attacks can cause physical and psychological complications and may even contribute to suicidal ideation.
Therapies for Panic Attacks
Psychotherapies, commonly known as talk therapies, are effective methods for managing panic attacks. The goal of these therapies is to help individuals identify and modify behaviours, patterns, and emotions that may contribute to panic attacks. Come therapies include:
Cognitive Behavioural Therapy (CBT)
In CBT, psychologists or counsellors work with individuals to address and reframe negative thought patterns contributing to panic attacks. They discuss the thoughts, emotions, and concerns of individuals and work with patients to develop healthier ways of thinking and coping strategies, which can significantly reduce the frequency and intensity of panic attacks.
Exposure therapy involves gradually and safely introducing individuals to their perceived triggers, helping them desensitise to stressors and develop effective coping mechanisms.
Medications
When psychotherapy alone is ineffective or when panic attacks are severe, psychiatrists may prescribe medications. These medications help regulate mood, treat physical symptoms, and prevent panic attacks.
Beta-blockers mitigate the effects of adrenaline, effectively managing physical symptoms of panic attacks such as tremors and rapid heart rate.
These medications regulate the brain’s electrical activity, helping stabilise mood and prevent panic attacks.
Drugs such as serotonin-norepinephrine reuptake inhibitors (SNRIs) and serotonin-selective reuptake inhibitors (SSRIs) regulate serotonin levels, thereby helping reduce the severity and frequency of panic attacks.
Drugs such as benzodiazepines help calm the nervous system, thereby providing relief during an acute panic attack. These are also effective in preventing future attacks in some cases.
Self-Care Strategies for Managing Panic Attacks
Panic attacks can be frightening because of their unpredictability. However, there are several strategies you can try to reduce the frequency and intensity of future episodes:
During a Panic Attack:
Stay in your current location: Remaining in a familiar space can prevent the situation from escalating.
Practice deep breathing: Helps regulate the nervous system and reduce panic.
Focus on positive and relaxing images or elements in your space: Effective in distracting the mind and relaxing the body.
Concentrate on relaxing your muscles: Useful for reducing physical tension.
Remind yourself that the panic attack is temporary: Helps reduce fear.
Preventing Future Panic Attacks:
Take prescribed medications as directed: Effective in preventing the recurrence of panic attacks.
Practice breathing exercises: Useful for managing anxiety.
Engage in regular physical exercise: Regulates anxiety levels and improves overall mental well-being.
Avoid smoking and alcohol: Lowers anxiety and likelihood of panic attacks.
Limit intake of sugary foods and caffeine: Controls anxiety and panic.
Engage in calming activities: Practices like yoga, journaling, and mindfulness meditation can effectively relax both the mind and body.
Join a support group: Helps in reducing anxieties and building bonds with like-minded people.
How to Help Someone Having a Panic Attack
When someone around you experiences a panic attack, they may feel intense fear and distress. They may also show physical symptoms, such as sweating, rapid breathing, or trembling. In such situations, you can support them by:
Staying by their side: Offer your presence as a reassurance of safety.
Remaining calm: This may help them relax and feel secure.
Helping them focus on the temporariness of the attack: Gentle reminders may help them come out of the attack sooner.
Asking short, clear questions: Help them relax by asking in short sentences if they need anything.
Guiding them to take slow and deep breaths: Helps them focus on breathing and regulates their nervous system to calm down.
Conclusion
Panic attacks are characterised by episodes of debilitating fear and anxiety. Although the physical symptoms of panic attacks often subside quickly, their emotions and psychological effects can linger, impacting daily life. The good news is that panic attacks are treatable and manageable with the right approach. With psychotherapy, medication, and lifestyle changes, individuals can significantly reduce or eliminate panic attacks from their lives.
Those experiencing symptoms of panic attacks or seeking compassionate care, consider reaching out to a mental health specialist at Artemis Hospitals. Patients trust our hospital in Gurgaon for comprehensive panic disorder and anxiety treatments. Our team of skilled psychiatrists and psychologists can help guide you through treatment options tailored to your needs. For appointments, call our customer care at +91-124-451-1111 or WhatsApp us at +91 959-928-5476. You can also schedule an appointment with our psychiatrist or psychologist through our online patient portal or download and register on the Artemis Personal Health Record mobile app, available for both iOS and Android devices.
Article By Dr. Amit Kumar Chaurasia
Chief Cath Lab & TAVI (Unit I)
Artemis Hospitals
