Panic Attacks and Panic Disorder - Types, Symptoms, Causes & Treatments

Panic attacks are a common mental health problem that often starts in teenage or early adulthood. Additionally, women are at greater risk of panic attacks compared to men. Although the reason behind this is not lucid, a genetic link might be responsible for it.

Learn all about this disorder, its types, causes, symptoms and treatments in this article.

A panic attack is usually referred to as sudden episodes of fear, triggering a physical reaction without any reason. These episodes can be dangerous, and they might lead to losing control, with a risk of a heart attack. Although most individuals generally witness two panic attacks during their lifetime, they might be brief and usually abate as the stressful situation wards off.

If you are experiencing unexpected or repeated panic attacks, then you might have panic disorder. It creates an overwhelming fear without a specific cause. Also, if you have panic disorder, you might fear the next time you will experience it.

Furthermore, medically, it is a complex mental health condition involving feelings of apprehension and anxiety. Additionally, it is also classified as an anxiety disorder with some specific sets of diagnostic criteria.

The types of panic attacks can be differentiated depending on their duration and intensity. Additionally, they can also be differentiated by the cause behind those attacks.

• Unexpected Panic Attacks: This type of attack happens suddenly without any apparent reason. Most importantly, an individual can be completely relaxed before the symptoms of a panic attack develop. Furthermore, unexpected panic attacks don’t go with internal causes such as feelings of anxiety and intense dread, fearful thoughts, or uncomfortable physical sensations. Also, they don't occur with external cues, such as specific phobias or exposure to frightening situations or events.
• Expected Panic Attacks: In the case of expected panic attacks, specific aspects trigger certain panic attacks. So, if an individual is exposed to such cues, they are most likely to face panic attacks. For instance, if someone has aerophobia, they are most likely to get a panic attack while on a flight.

Panic attacks usually have multiple variations, and their symptoms generally peak within minutes. Nevertheless, a few of the common symptoms of a panic attack include the following –

• Fear of death or loss of control
• Sense of danger or impending doom
• Sweating
• Shortness of tightness or breath in your throat
• Hot flashes
• Feeling faint
• Abdominal cramping
• Trembling or shaking
• A feeling of detachment or unreality 
• Dizziness, faintness, or light-headedness 
• Chest pain
• Tingling sensation or numbness 
• Headache
• Chills
• Rapid heart rate
• Nausea

A panic attack usually abates in 5 to 10 minutes, but in a few instances, it might stay for hours. Additionally, these attacks also depend on the severity of the condition. Hence, some people experience it only once or twice a month, while others might experience it several times a week. So, be aware of these symptoms to detect a panic attack before it hits you.

Although the causes of panic disorder are not straightforward, it is believed that it has something to do with the sensitivity of responding to fear. There is also a link between phobias and panic attacks, so this might be another reason. Another study shows that in adults, CO2 hypersensitivity is also linked with panic attacks, which tricks your brain into believing that you are suffocating.

Apart from this, a few other causes behind it include –

• Family history and genetics
• Changes in brain functions 
• Problem with dealing with negative emotions 
• Frequently feeling negative feelings
• High-stress level

A panic attack might also start after –

• Serious accident or illness 
• The death of loved ones 
• Separation from family
• After giving birth

A few medical experts also believe that there are solid relationship between panic attacks and –

• Alcohol abuse
• Depression
• Suicide risk
• Cigarette smoking
• Seasonal affective disorder

Lastly, if you are above 40 and experiencing panic disorders, you might also be suffering from anxiety. So, to diagnose the actual cause, you should talk to your doctor as soon as you start experiencing the panic disorder.

Panic disorder is severely associated with serious health problems such as thyroid diseases, heart diseases, and other problems. Hence, your health care prescribes several tests for the diagnosis of panic disorder.

Apart from a physical examination, you may also have to go through -

• Blood tests to check thyroid and other conditions 
• Tests for checking your heart, such as ECG or EKG
• Psychological evaluation, including talking about stressful situations, family history, fears and concerns, etc

Panic disorders are also mostly associated with panic attacks and other mental health disorders, and these are also used for diagnosis. Also, they are often related to other mood disorders such as –

• Bipolar disorder
• Agoraphobia
• Major depressive disorder
• Social anxiety disorder (SAD)
• Post-traumatic stress disorder (PTSD)
• Obsessive-compulsive disorder (OCD)
• Generalised anxiety disorder (GAD)
• Specific phobias

In general, medications, psychotherapy or a combination of both is an effective treatment for panic attacks. However, it is essential to remember that the treatment method will depend on the severity of the situation. Regardless, a few treatment options include the following –

1. Antidepressants

A few antidepressants can make panic disorder less severe and less frequent. So, your doctor might prescribe tricyclic antidepressants (TCAs), serotonin-selective reuptake inhibitors (SSRIs), or serotonin-norepinephrine reuptake inhibitors (SNRIs). These SSRIs include paroxetine (Paxil) and fluoxetine (Prozac). On the other hand, SNRIs include venlafaxine (Effexor) and duloxetine (Cymbalta), while the TCAs include doxepin (Sinequan) and amitriptyline (Elavil).

2. Psychotherapy

Another essential treatment method for panic disorder is psychotherapy, and one of the most widely used is Cognitive Behavioural Therapy (CBT). In this type, you will discuss your emotions and thoughts with a mental health professional, licensed psychologist, or counsellor. A medical expert will then try to diagnose your panic attack triggers by diagnosing your behaviour, thinking and reactions.

3. Anti-Anxiety Medications

In the case of anti-anxiety medication, Benzodiazepines are the most commonly prescribed medication. This helps treat anxiety and reduces the risks of addiction or dependence. A few of the medications primarily include alprazolam and lorazepam.

Regardless, before consuming medications, it is advised to take medical advice or consultation.

If you are experiencing panic attacks, seek immediate help. Although panic attacks might be uncomfortable, these are not fatal in most cases. But, it is essential to remember that it is very difficult to manage panic attacks of your own, and the condition might deteriorate if you don’t seek medical help.

Besides this, you should call your doctor if you experience –

• Chronic anxiety
• Sleep problems
• Difficulty in concentrating
• Intense irritability
• Fear of leaving your home
• Symptoms longer than 15 minutes

The most efficient way to manage panic disorder is by seeking medical help. This will help reduce most symptoms and halt the emergence of new symptoms. Apart from this professional medical help, you can also try a few things to prevent panic attacks in future –

• Go through a self-help book for anxiety based on the principles of CBT
• Learn different breathing techniques to abate symptoms
• Try a few complementary therapies, such as aromatherapy
• Avoid drinks and foods with sugar content, caffeine, and alcohol
• Try activities like pilates and yoga to reduce tension, stress and anxiety
• Quit smoking, as it might worsen the symptoms

Besides this, you can also join support groups if these are available within your reach. This will help you meet people with the same condition, and you can put in extra work to recover.

Panic disorder is treatable, and most patients make it to full recovery. But, without medical help, panic disorder can get worse, and you might find performing daily tasks difficult. For instance, you might find yourself uncomfortable in social conditions and experience a false fear of getting trapped, which is hard to escape.

Additionally, you might also develop a risk of developing other mental health conditions such as agoraphobia or a drug or alcohol problem.

Regardless of the symptoms and severity, seeking treatment as soon as possible is essential. This is also true for teenagers, as panic attacks at an early age can hamper their learning and development.