A Basic Guide to Panic Attacks

A panic attack is a sudden wave of overwhelming anxiety and fear that triggers a host of severe psychosomatic responses. From a clinical perspective, panic attacks typically refer to an experience of intense fear or discomfort where four or more of the following symptoms are felt:

• Pounding heart or increased heart rate
• Sweating
• Trembling/shaking
• Feeling as though you are being smothered or having difficulty breathing
• Choking
• Chest pain/discomfort
• Nausea or abdominal pains and/or discomfort
• Feeling dizzy, lightheaded, or faint
• Feeling as though things around you are unreal or feeling detached from yourself
• Feeling as though you are going to lose control or go crazy
• Fear of dying
• Numbness or tingling in extremities
• Chills or hot flashes

Although the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) says that four or more of the above symptoms must be felt, sometimes a person can have a panic attack that is accompanied by three or less of the above symptoms. This is sometimes referred to as a limited symptom panic attack.

Panic attacks are actually quite common. In fact, as many as 12 percent of people may experience a panic attack at some point in their lifetime.

Cued and Uncued Panic Attacks

Panic attacks can be cued or uncued. Cued panic attacks are those that occur following exposure to some kind of triggers such as a very frightening experience or thought. For example, someone who is scared of public speaking may have a panic attack when placed in front of an audience.

An uncued panic attack (or a spontaneous or unexpected panic attack) is one that occurs “out of the blue” and is the defining feature of panic disorders.

Risk Factors for Panic Attack

Factors that may increase the risk of developing panic attacks include:

• Family history of panic attacks or panic disorder
• Major life stress, such as the death or serious illness of a loved one
• A traumatic event, such as sexual assault or a serious accident
• Major changes in your life, such as a divorce or the addition of a baby
• Smoking or excessive caffeine intake
• History of childhood physical or sexual abuse

Treating Panic Attacks

The main treatment options are psychotherapy and medications. Which route to take depends in part on your preference, your history, the severity of your panic attacks and whether you have access to therapists trained in treating panic attacks.

Psychotherapy is also called talk therapy and is often the first choice of treatment for panic attacks. It can help you learn more about panic attacks and learn how to cope with them. 

A form of psychotherapy called cognitive behavioral therapy can help you learn that panic symptoms are not dangerous. Medications can also help reduce symptoms associated with panic attacks. Several types of medication have been shown to be effective in managing symptoms including selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), and benzodiazepines. It can take several weeks after first starting a medication for your symptoms to improve.