What is a Panic Attack? Symptoms, Causes, and Treatment Methods

Panic Attack

A panic attack is a state of intense fear and anxiety that occurs within minutes when there is no real danger. In this situation, the person may feel like they are having a heart attack or losing control. During this attack, which usually reaches its peak intensity within a few minutes, the heart rate increases, and physical symptoms such as shortness of breath and sweating appear. Most panic attacks are not life-threatening, but they can be very frightening. Although rare, they can lead to sudden awakening while sleeping at night or falling asleep. Individuals who experience a panic attack while falling asleep may have difficulty sleeping due to the fear of losing control of their bodies. A nocturnal panic attack occurs with a state of intense fear that starts during sleep without any warning. Having a panic attack in a dream can occur when fears suppressed in the subconscious come to the surface during sleep. If a person experiences a panic attack crisis 1-2 times in their life and this situation resolves on its own, it is not a cause for concern. If recurrent unexpected panic attacks occur and there is anxiety about having another attack, this is called panic disorder. The differences between anxiety and panic attack are distinguished by anxiety being longer-lasting and generalized, whereas panic attacks start suddenly. Panic attack treatment is carried out with psychotherapy and, if necessary, medication support.

What is a Panic Attack?

A panic attack is different from a general state of anxiety based on continuous worry; unlike anxiety, a panic attack starts very suddenly and is short-lived with intense physical symptoms. It usually begins in late adolescence or early adulthood and is more common in women than in men. Although similar fear episodes can be experienced in young children, they are not as common as in adults.

What Are the Symptoms of a Panic Attack?

Panic attack symptoms usually develop suddenly and reach their peak within a few minutes. Panic attack crisis symptoms generally increase intensely within a few minutes and can create a fear of death in the person. Common panic attack symptoms include:

Palpitations or rapid heart rate: The sensation of palpitations is when the pulse beats very fast. During a panic attack, the body secretes adrenaline, which raises the heart rate.

Shortness of breath and choking sensation: Chest tightness, the feeling of not being able to take a deep breath. This is one of the most distressing symptoms frequently seen during panic. When panic attack palpitations and panic attack shortness of breath occur together, the person may feel as if they are suffocating.

Sweating and trembling: Sudden sweating, chills, or trembling episodes. Trembling may increase as muscles tense. Panic attack symptoms in children may include sudden crying episodes, trembling, and breathing difficulty.

Chest pain and pain radiating to the left arm: A panic attack can be confused with a heart attack because the symptoms can be similar. A feeling of tightness, stabbing, or burning in the chest, sometimes radiating toward the left arm or jaw, can be observed. This can create a perception resembling a heart attack during panic. Panic attack left arm numbness can be one of the physical effects of the crisis and can create suspicion of a heart attack.

Dizziness and fainting sensation: Dizziness, darkening of vision, feeling as if one is going to faint. These symptoms may be related to a sudden change in blood pressure and pulse.

Tingling or numbness: A prickling, numbness sensation can occur in a part of the body, primarily the hands, feet, or left arm.

Restlessness and a sense of loss of control: In the middle of the attack, many people feel as though they are losing control; they may experience a fear of going out of control or of dying.

These physical symptoms are sometimes confused with a heart attack or another serious health issue. Furthermore, a panic attack can occur at any time of the day; sometimes it causes sudden awakening while falling asleep in bed at night or during sleep. Similar symptoms can be seen in children and adolescents, but young children may find it difficult to explain these conditions. Symptoms appearing at night can include sudden awakening, inability to breathe, and a rapid heartbeat. In general, blood pressure rises in the body during a panic attack. Nighttime panic attack symptoms can manifest with sudden awakening from sleep, a choking sensation, and intense fear.

How Does a Panic Attack Happen?

A panic attack begins as a result of the body giving an excessive fight-or-flight response. The sympathetic nervous system (hormones such as adrenaline), which is normally activated in times of danger, can be triggered unnecessarily during a panic attack. For example, the heart rate accelerates, blood pressure rises, muscles tense, and breathing speeds up. The brain, on the other hand, may mistake these physiological changes for real danger and react. In some people, attacks may be related to high stress, intense life changes, traumatic events, or anxiety disorders. Excessive consumption of caffeine, alcohol, or certain medications is also counted among panic attack triggers.

How is a Panic Attack Diagnosed?

A panic attack is usually diagnosed through evaluation by a physician. Your doctor may first request a physical examination, blood tests, and an ECG to rule out other conditions that can lead to attack-like symptoms, such as heart disease or thyroid disorders. Afterward, they conduct a psychological evaluation by asking detailed questions about the symptoms you experience, attack frequency, triggering situations, and your medical history. Your symptoms can be recorded using various anxiety scales or questionnaires. According to DSM-5 criteria, diagnosing panic disorder requires recurrent, unexpected panic attacks and fear of having another attack or behavioral changes persisting for at least one month after the attack. There is no definitive laboratory test; diagnosis relies on expert opinion and symptom history. During this process, the panic attack test or questionnaires prepared by your doctor can guide you in determining your symptoms.

How is Panic Attack Treatment Performed?

The main goal in panic attack treatment is to reduce the severity and frequency of symptoms. The most effective methods are psychotherapy and drug treatment. Cognitive Behavioral Therapy (CBT) is recommended as a first-line treatment for panic disorder. This therapy helps you cope with fears by teaching you that what you feel during an attack is harmless. In addition, exposure therapies can help you confront the fearful situations that lead to panic attacks in a controlled manner. The most commonly chosen medications in treatment are selective serotonin reuptake inhibitor (SSRI) or serotonin-norepinephrine reuptake inhibitor (SNRI) antidepressants. Short-term sedatives from the benzodiazepine group and, on a case-by-case basis, beta-blockers can also alleviate symptoms. Medications usually take effect within a few weeks, and the dosage is adjusted under medical supervision. In addition, simple breathing exercises (such as slow and deep breathing) help lower the intensity of a panic attack. Relaxation techniques, relaxation methods like yoga, and regular exercise can also be part of the treatment plan. Importantly, individuals undergoing treatment are advised to avoid caffeine, alcohol, cigarettes, and stimulant drugs; these substances can trigger or worsen panic attacks.

Frequently Asked Questions

Among the causes of panic attacks are genetic predisposition, traumas, and intense stress. During a panic attack, the person generally feels very frightened, helpless, and on the verge of losing control. Their pulse beats rapidly, they sweat, tremble, and their breathing accelerates. Feeling pressure on their chest, they may think they are having a heart attack, which is why they usually try to sit or stay on the ground. Because of dizziness or a fainting sensation, they may want to squat or lie down. It is difficult for them to calm down consciously; sometimes they may ask for help from those very close to them or from medical personnel. In summary, viewed from the outside, a person experiencing a panic attack displays an expression of intense fear and helplessness, and their breathing and heart rhythm appear uncontrollable. The onset of a panic attack can usually develop following a stressful event or spontaneously. Proper breath control and psychological support are of great importance in managing panic attacks. When an attack begins, you should first make sure you are in a safe place and rest by sitting or lying down if possible. Panic attack breathing exercises include techniques of taking deep breaths from the diaphragm and exhaling slowly. Try to remain calm and remember that feelings of panic are temporary. Slow, deep breathing exercises are very effective; breathe in through your nose for 4 seconds and exhale for 4 seconds. The panic attack breathing exercise provides relief by regulating breathing during a crisis. Closing your eyes and thinking of a soothing image or imagining a loved one can be beneficial. A panic attack usually passes on its own within 5–15 minutes; keeping this duration in mind can be comforting. If necessary, notify a loved one or healthcare worker. If it is difficult to cope on your own, immediately ask for support from someone you trust, such as a friend or family members. In summary, focusing on calming down (e.g., doing breathing exercises), remembering that the event is temporary, and asking for help if necessary is the best approach. In silent panic attacks, obvious hand and arm movements are not seen from the outside; although the person may appear calm on the outside, they experience intense panic on the inside. Internal symptoms include: a feeling of heaviness or tightness in the chest, a heartbeat that accelerates suddenly rather than starting slowly, an internal feeling of trembling, dizziness and feeling like fainting, palpitations, and a feeling of inability to breathe. In addition, an intense sense of doom or the feeling that something is about to go wrong is experienced. For example, even if the person does not have involuntary muscle twitching or trembling in their arms or legs, they may have the internal feeling that their hands are tingling or their body is trembling. These symptoms are not noticeable from the outside; the person generally feels like they are experiencing a turbulent storm within. Experts state that findings such as heart palpitations, dizziness, shortness of breath, and intense anxiety can be seen in silent attacks. Although panic attacks generally occur without an obvious prior reason, certain factors can create a risk and act as triggers. Genetic predisposition and differences in brain function can create a tendency toward panic attacks; researchers sometimes define a panic attack as a false alarm. That is, the body mistakes a normal heartbeat for real danger and overreacts. In addition, high stress levels, intense life changes, or traumatic experiences can trigger a panic attack. The use of caffeine, alcohol, certain recreational drugs, or stimulant medications can also initiate an attack. For example, excessive caffeine consumption can accelerate the pulse, causing restlessness and a feeling of panic. A panic attack does not directly harm the heart or other organs. During a panic attack, there is an intense secretion of adrenaline in the body, and as a result, the heart rate increases and blood pressure rises. This can mimic heart attack symptoms, but it does not cause physical damage to the heart muscle. In terms of health, the only temporary effects caused by a panic attack are an elevated heart rate and blood pressure. A panic attack can cause blood pressure to rise, which can lead the person to panic even more. People who have panic attacks generally worry about the moments when they will have an attack. During an attack, they experience a loss of control, fear of death, or a sense of doom. They feel helpless because they had an attack. In addition, they are in a state of constant fear and anxiety about when the next attack will happen. They may tend to avoid environments where they have experienced panic attacks (such as confined spaces, crowds, driving) or refrain from entering these places. When suspecting a panic attack, you can usually start with your family physician or an internal medicine doctor. Tests are performed during the initial examination to rule out physical problems. Afterward, they may refer you to a psychiatry specialist. The primary treatment is provided by a psychiatrist or a clinical psychologist. In some cases, psychologists or psychological counselors who conduct psychological evaluations may also participate in treatment. In short, it is appropriate to apply to a primary care physician as a first step, and then to the psychiatry department. Remember that mental health professionals (in the fields of psychiatry and psychology) play a major role in the treatment of people with panic attacks. A panic attack especially begins in the post-adolescence period and is more common in young adults. Women carry about twice the risk of developing panic disorder compared to men. It is common in people aged 20-30. In addition, the risk increases in those with a family history. Although it can also be seen in children and older ages, the highest incidence has been detected in young adult women. If left untreated, panic attacks can worsen over time and reduce the quality of life. Out of fear of having an attack, the person may begin to avoid social activities and daily chores. Long-term high anxiety can also lead to additional problems such as depression or substance abuse. If treatment is not started in the early period, panic attacks can become frequent and uncontrollable. Therefore, when panic attack symptoms begin, it is important to seek an expert opinion as soon as possible. There is no definitive proof that a direct vitamin deficiency leads to panic attacks, but certain vitamin and mineral deficiencies can increase anxiety symptoms. Vitamin D, magnesium, and zinc deficiencies can also exacerbate anxiety symptoms. Still, vitamin supplementation alone is not sufficient to prevent panic attacks. Eating a balanced health diet and remedying deficiencies upon a doctor's recommendation can improve the general level of anxiety.

If you are experiencing panic attack symptoms or think your anxiety affects your daily life, consult a specialist without delay. Our Hisar Hospital psychiatry specialists can support you in the diagnosis and treatment of panic attacks. Click to Make an Appointment or Review Our Psychiatry Department.