Panic attacks refer to episodes or periods of sudden and intense fear or dread, often accompanied by extreme anxiety. Sometimes the immediate cause – like a very distressing situation – is recognised , but at other times a panic attack seems to strike from out of nowhere. Panic attacks may be experienced by anyone, with or without a family history of such episodes.

Symptoms of a Panic Attack

The five most common major symptoms of panic attacks are palpitations, shortness of breath (possibly accompanied by chest pain), nausea, profuse sweating, and dizziness. Palpitations are also known as rapid heartbeats or, in medical terms, tachycardia.  The sensation feels like one’s heart is racing, fluttering, or skipping beats. Shortness of breath feels like one is running short of air, as one would experience underwater or in space with no oxygen reserves.  Nausea is the nasty feeling of needing to vomit, although nothing usually comes out.

Applying a cold wash cloth – even better when it is sprinkled with a few drops of lemon – to the mouth usually helps to temporarily alleviate nausea. Profuse sweating refers to sudden, excessive perspiration that occurs for no apparent reason.

It is uncommon to sweat profusely when one is not exposed to extreme humidity or engaged in an intense physical activity like exercise. This physical reaction to acute anxiety is often mistaken for poor hygiene and tends to carry a social stigma. Dizziness is a lightheaded, reeling, whirling, or spinning sensation combined with a feeling of losing one’s balance.

During a panic attack, it is never a lone symptom.  It is typically accompanied by palpitations, sweating, numbness or tingling in any part of the body, loss of movement in the arms or legs, difficulty speaking, blurred vision, or confusion.

Some other common symptoms of panic attacks are:

  • paranoia
  • hyperventilation
  • a choking feeling
  • shaking
  • chest pain
  • stomach cramps
  • headaches
  • feeling faint
  • insomnia
  • unexplained muscle soreness
  • nervous ticks

Paranoia is the feeling of being constantly watched and under attack. Hyperventilation is abnormally rapid deep breathing that may lead to a loss of carbon dioxide in the blood, which may result in a tingling sensation or even fainting.

According to the Royal Australian and New Zealand College of Psychiatrists, 40% of young people have had at least one spontaneous panic attack, although they do not necessarily meet the criteria for panic disorder.

Not everyone who experiences a panic attack develops panic disorder. If the occurrence is rare, it is a temporary condition that goes away when the situation that triggered the anxiety has been resolved. However, when panic attacks occur frequently – and the timing of the onset is generally unpredictable – it may be time to seek professional help.

Panic attacks are often mistaken for heart attacks due to the similarity in symptoms. In many cases, they are not as immediately life-threatening as heart attacks. However, they should be taken just as seriously because they can severely impair one’s ability to function when the symptoms become overwhelming or recurrent.  Experiencing repeated episodes of panic attacks is a symptom of panic disorder.

Panic Disorder

Panic disorder is an anxiety disorder characterised by recurrent panic attacks that may or may not be triggered or provoked by a specific or immediate cause.

Anxiety disorders are the most common mental disorders, accounting for one-quarter of the incidence of mental disorders.  The Australian National Mental Health Survey showed that 0.7% of the Australian population suffered from panic disorder, which occurred twice as often in women as in men.

Although the age of onset varies considerably throughout the developed world, early onset occurs in the age range of 15-24 while the later mode is 45-54. The prevalence is greatest in individuals aged 15-24 years old, although it typically occurs from the early to mid-twenties.

A small number of cases begin during the childhood years.  In about 15% of patients, the onset begins after age 40.  For women, the peak range of panic attacks and panic disorder is between 35-44 years; for men, the highest rate of prevalence is in the lower age group.

When a person lives in fear of another attack – and of losing control as a consequence – the condition is called an anticipatory attack.

A panic attack can occur at the most inconvenient, and perhaps dangerous, moment such as when one is driving.  Leaving a panic disorder undiagnosed and untreated can prove to be very risky.

One study found that men who had panic disorder were twice as likely to die from heart-related illness as those who did not have the condition.

Causes of Panic Attacks

Although inheritance plays a role – panic disorder has been found to run in families – there is no single cause for the condition. It has been found to co-exist with other hereditary disorders such as bipolar disorder and a genetic predisposition to alcoholism.

Life transitions and other stressful life events, environment, exaggerated thinking patterns and other psychological factors also contribute to the incidence of panic disorder. People who are inclined to take on excessive responsibilities may develop a tendency to suffer from panic attacks.

Post-traumatic stress disorder (PTSD) patients also show a high rate of panic disorder.  Evidence suggests that some medical conditions such as hypoglycemia, hypothyroidism, and respiratory disorders may cause or aggravate panic disorder.

A growing body of evidence shows a link between panic disorder and substance abuse.  Stimulants such as caffeine, nicotine, and recreational drugs like cocaine are a common cause of panic attacks.

Excess intake of caffeine leads to palpitations and nervousness.  Stimulant drugs such as cocaine increase the heart rate. Smoking has been found to increase the risk of panic attacks and panic disorder in young people. Nicotine withdrawal contributes to panic attacks as well because of the significant anxiety experienced during this phase.

Although alcohol intake initially eases panic attack symptoms, medium- or long-term alcohol abuse can cause or worsen panic disorder, particularly during the alcohol withdrawal stage.

Panic disorder can lead to irrational fears known as phobias. These phobias can make sufferers desperately avoid situations, no matter how ordinary and harmless such as grocery shopping or riding an elevator, in which the panic attacks occurred because of the high level of anxiety they associate with the circumstances.  This can have a very limiting and debilitating effect on one’s lifestyle and social relationships.

Not only adults but also children can suffer from the disabling effects of panic disorder.  Boys and girls tend to experience panic attacks with equal frequency.  This can lead to declining grades, avoidance of school, separation anxiety, substance abuse, and depression as well as suicidal thoughts, plans, or actions.

Panic disorders are generally believed to be caused by an abnormality of the brain that inappropriately activates the body’s hormonal system to trigger the “fight” or “flight” response.

People with panic disorder have been found to have reduced levels of a type of serotonin receptor called 5-HT1A in three areas of the brain. These findings support the concept that brain abnormality due to serotonin dysfunction is a major factor in panic disorder.  Medication that regularises or normalises the occurrence of serotonin is used to treat this condition.

Treatment for Panic Attacks

Treatment that combines both medication and psychotherapy has a significantly higher rate of success. Treating panic disorder isn’t as easy as simply popping pills. The psychological roots of the individual’s anxiety must be addressed in order to obtain long-lasting results.

Psychoanalytic and cognitive behavioural therapies teach a client to understand the origins of the anxiety and gradually but permanently modify his/her thoughts and behaviour.

Life is full of potential for anxiety-ridden situations.  Helping clients develop the understanding and skills to accept these situations calmly and respond to them positively is the essential role of psychotherapists and mental health counsellors.

Australia Counselling has counsellors and psychologists in Perth, Adelaide, Sydney, Melbourne, Canberra, Brisbane and regional areas of Australia. If you’re wanting to get treatment for anxiety and/or panic attacks, visit our anxiety and/or panic attacks page, to find a counsellor, therapist or psychologist in your local area.