A panic attack is a sudden and brief episode of intense fear and anxiety which triggers a host of unpleasant physiological and psychological symptoms, including:

• Accelerated heart rate
• Chest pain or discomfort
• Chills or hot flashes
• Shortness of breath
• Derealization and/or depersonalization
• 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
• Nausea or abdominal pain
• Trembling or shaking

Types of Panic Attacks

Though all panic attacks involve a sudden surge of anxiety, they differ in significant ways that can impact diagnosis, treatment, and prognosis. According to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM V), there are two types of panic attacks: unexcepted and expected.

Unexpected Panic Attacks

Some individuals experience a panic attack out of the blue without a clear cause. Seemingly out of nowhere, their anxiety will rise dramatically, despite knowing they are not in a dangerous situation.  

These types of panic attacks can be particularly stressful for the people who experience them, especially the first few times they happen. Not knowing why you are feeling intense fear can make the feeling of panic even worse. Once one learns they experience unexpected panic attacks, they may spend lots of time worrying about when the next one will happen since they can’t identify causes or triggers.

Expected Panic Attacks

Some panic attacks have a clear and identifiable cause. One of the more common triggers is being exposed to something you are extremely fearful of. For example, someone who has a phobia of spiders may experience a panic attack upon finding a spider in their house. Likewise, someone who fears flying may have a panic attack when thinking about an upcoming flight. 

Expected panic attacks can also be brought on by your environment, even when you know there is nothing dangerous about it. For example, in one case study, an individual tended to experience panic attacks while driving, traveling alone, in enclosed spaces, and in crowds, even though they had no specific fears associated with those circumstances. 

These panic attacks are importantly different from unexpected panic attacks because they are predictable. Since they have an identifiable source, those who experience them may have an easier time avoiding them. 

Panic Attacks and Mental Health Conditions

While panic attacks are intensely stressful events regardless of their type, they are not always a sign that one suffers from a mental health condition. One reason for this is that some events are simply very scary and warrant a lot of fear and anxiety. If you only experience panic attacks in these situations, you may not receive any mental health diagnosis.

Panic Attacks and Phobias

Some situations don’t warrant intense fear. For example, there is little reason to be scared when enjoying your favorite ice cream while sitting at home and watching tv. If you consistently have panic attacks in response to a situation, idea, or object that is not a direct and immediate threat, you may be diagnosed with a specific phobia disorder.

Panic Attacks and Panic Disorders

Some people experience one panic attack and never have another. However, others experience them repeatedly. If this happens to you and your panic attacks are of the unexpected variety, you may have what is known as a panic disorder.

Panic Attacks and Other Mental Health Conditions

Panic attacks may also occur as a symptom of several other mental health conditions, including:

• Generalized Anxiety Disorder (GAD)
• Major Depressive Disorder
• Bipolar Disorder
• Obsessive-Compulsive Disorder (OCD)
• Social Anxiety Disorder
• Post-Traumatic Stress Disorder (PTSD)

Treatments

Treatments for panic attacks vary depending on the type of panic attack you experience and the condition it is a symptom of.

Exposure Therapy

If you experience panic attacks resulting from phobias, you may undergo what is known as exposure therapy. For this treatment, individuals are gradually exposed to what they are afraid of until their fear response goes away or no longer interferes with their daily lives.

Recently, this form of therapy has been combined with virtual reality (VR). By offering immersive virtual environments, VR allows patients to get one step closer to their fears without encountering the real thing. Studies have found that this modified version of exposure therapy is a promising alternative to the standard approach.  

Medications

Exposure therapy doesn’t work for the unexpected panic attacks common in panic disorders. Physicians typically treat panic disorders with medications (e.g., selective serotonin reuptake inhibitors and benzodiazepines). Some studies have found that ketamine can resolve panic disorders, though more experiments are needed to confirm this result.  

If you feel you may suffer from panic attacks or have additional questions about them, please give us a call at 512-777-2591 and we would be happy to assist you.