An Overview of Panic Attack Types and Symptoms

Panic attacks are characterized by feelings of fear, dread, and uncomfortable physical symptoms. Attacks are not classified as a mental health disorder in and of themselves, rather they are classified as a set of symptoms that occur in the context of other mental disorders. Panic attacks are classified into two types: expected and unexpected. Here's what you need to know about each one.

Symptoms

The Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) is the handbook used by mental health providers in making accurate diagnoses.

The four or more other symptoms may include:

• Chest pain or discomfort
• Chills or hot flashes
• Derealization and/or depersonalization
• Excessive sweating
• Fear of dying
• Fear of losing control or going crazy
• Feeling of choking
• Feeling dizzy, unsteady, lightheaded, or faint
• Feelings of numbness or tingling sensations (paresthesias)
• Heart palpitations or accelerated heart rate
• Nausea or abdominal pain
• Shortness of breath or smothering sensations
• Trembling or shaking

The symptoms of panic attacks typically come on rapidly and peak within minutes. Once a panic attack has subsided, the symptoms can taper off completely or the person can remain in an anxious state, possibly repeating the panic cycle again.

Limited-symptom panic attacks occur when the person experiences less than four of the listed symptoms.

Types of Panic Attacks

Not only can panic attacks vary in intensity and duration, but they can also differ according to what prompted the attack.

Expected Panic Attacks

Expected attacks are anticipated when a person is subjected to specific cues or panic triggers. For instance, someone who has a fear of enclosed spaces (claustrophobia) may expect to have panic attacks when in an elevator or other cramped areas.

A person who has a fear of flying (aerophobia) may predictably have a panic attack when boarding a plane, at the time of take-off, or at some time during the flight.

Unexpected Panic Attacks

Unexpected panic attacks occur suddenly without any obvious cause or indication. When an unexpected panic attack occurs, a person can be completely relaxed before symptoms develop.

This type of panic attack doesn't accompany any conscious internal cues, such as having fearful thoughts, feelings of intense dread and anxiety, or uncomfortable physical sensations. Unexpected attacks also don't occur with external cues, such as specific phobias or being exposed to a frightening event or situation.

Diagnosis

Panic attacks are most often associated with a diagnosis of panic disorder but can be associated with other mental health disorders. Panic attacks are often related to mood and anxiety disorders, such as:

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

These attacks can also occur in conjunction with a variety of mental health disorders, including personality disorders, eating disorders, and substance-related disorders.

Your practitioner can provide you with an accurate diagnosis and a proper treatment plan. The earlier you get treated for your panic symptoms, the sooner you can expect to manage your panic attacks.

Panic Attacks in Panic Disorder

Panic disorder is a complex mental health condition that involves feelings of anxiety and apprehension. As outlined in the DSM-5, panic disorder is classified as an anxiety disorder with its own distinct set of diagnostic criteria.

People diagnosed with panic disorder may also be subject to having nocturnal panic attacks, a type of unexpected panic attack that occurs when a person is sound asleep and wakes them up with panic symptoms.

Panic disorder typically develops in late adolescence or early adulthood, but can occasionally begin in childhood or late adulthood. It is also almost twice as prevalent in women as men. Because of this, experts recommend that women and girls over the age of 13 be screened for anxiety disorders during routine preventative care exams.

The causes of panic disorder aren't currently known, but research has found strong familial links, suggesting that having a close biological family member with panic disorder puts someone at greater risk for developing this condition.

Different theories examine the influence of environmental, biological, and psychological influences. Most experts agree that panic disorder is the result of a combination of these factors.

Treatment for Panic Disorder

A person with panic disorder may experience great limitations due to panic attacks. For example, they may spend a significant amount of time worrying about future panic attacks and may even avoid certain places and situations that they believe will contribute to the possibility of having a panic attack.

Additionally, many people with panic disorder deal with loneliness and isolation, feeling ashamed of their symptoms and fearing that others would negatively judge them for their panic symptoms.

Even though there isn't a cure for a panic disorder, there are numerous treatment options available to help people manage their symptoms. The most common options include prescribed medication and/or psychotherapy. Most people with panic disorder will try both of these options along with practicing self-help techniques.

Medications for panic disorder, such as antidepressants and benzodiazepines, can reduce the intensity of panic attacks and other anxiety-related symptoms. Psychotherapy can assist in helping you deal with difficult emotions and develop healthy coping techniques.

A Word From Verywell

Regardless of the options someone chooses, it's important to get help for panic and anxiety. The sooner a diagnosis has been made and treatment begins, the quicker a person can expect to cope with symptoms and manage life with panic disorder.