What causes panic attacks? 7 possible conditions

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What Is a Panic Attack?

Panic attacks are intense and frightening episodes in which a person may perceive a threat, even though no actual threat exists. Severe panic attacks can cause a person to believe they are experiencing a heart attack. Untreated panic attacks can lead a person to avoid others or avoid going outdoors for fear of experiencing another panic attack.

A panic attack is the chief symptom for people suffering from a panic disorder.

What Causes Panic Attacks?

The exact cause of a panic attack is often unknown. A variety of factors can influence the likelihood a person will be prone to panic attacks. These include having a family history of panic attacks and experiencing a significant amount of stress.

Who Is at Risk for Panic Attacks?

People with a family history of panic attacks are at increased risk for having panic attacks.

Additional risk factors for panic attacks include:

  • a history of childhood abuse
  • experiencing a traumatic event, such as a serious car accident
  • undergoing a major life change, such as having a baby
  • losing a loved one
  • working or living in a high-stress situation

What Are the Symptoms of Panic Attacks?

Panic attacks can occur suddenly and without warning. Symptoms may come on gradually then peak at about ten minutes. Panic attacks trigger the sympathetic nervous system, leading to the “fight or flight” response that people have when faced with danger.

Panic attack symptoms are similar to reactions a person has when perceiving danger. Symptoms include:

  • chest pain
  • chills
  • choking
  • difficulty swallowing
  • feeling that death is imminent
  • feeling faint
  • hot flashes
  • hyperventilating
  • nausea
  • rapid heartbeat
  • shaking
  • shortness of breath
  • stomach pain
  • sweating
  • tingling or numbness

Patients may be overcome with the fear that a panic attack will reoccur. A person may feel unsafe for fear of having another panic attack.

How Are Panic Attacks Diagnosed?

Panic attack symptoms can be similar to symptoms of serious health condition, such as a heart attack. Patients should seek medical attention after a panic attack to rule out an emergency health condition.

To diagnose a panic attack, a doctor will conduct a physical exam by evaluating symptoms.

To rule out a heart attack, a doctor will likely use an electrocardiogram (EKG) to measure the electric function of the heart. A doctor may also recommend blood tests to check thyroid hormones. A thyroid hormone imbalance can affect the body’s ability to regulate heart rhythms.

Having a single panic attack does not mean that a person has panic disorder. Criteria for diagnosing a panic disorder include:

  • frequent, unexpected panic attacks
  • a change of lifestyle or behavior due to an ongoing fear of a panic attack
  • a panic attack that is unrelated to another condition, such as substance abuse, social phobia, depression, or obsessive-compulsive disorder

Panic attacks can worsen if a patient does not seek treatment.

How Are Panic Attacks Treated?

Doctors often treat panic disorders with a combination of medication and psychotherapy. Some patients may experience one panic attack and never experience another, so they may not need treatment. Patients with recurring panic attacks may need treatment.

Medications

  • Benzodiazepines: These medications include alprazolam (Niravam, Xanax), clonazepam (Klonopin), and lorazepam (Ativan). They depress the central nervous system and have a mild sedative effect. These medications can be habit-forming.
  • Beta Blockers: These medications include carvedilol, propranolol, and timolol. They may reduce the symptoms associated with a panic attack, including sweating, dizziness, and a pounding heartbeat. These medications are not as commonly prescribed as others to reduce panic attacks.
  • Selective Serotonin Reuptake Inhibitors (SSRIs): These medications include fluoxetine (Prozac), paroxetine (Paxil and Pexeva), and sertraline (Zoloft). SSRIs are usually the first-line treatment for panic attacks because they have lesser side effects than other medications. However, side effects can include difficulty sleeping, nausea, and headache.
  • Selective and Norepinephrine Reuptake Inhibitors (SNRIs): Venlafaxine hydrochloride (Effexor XR) is an FDA-approved SNRI that treats panic disorder.

Psychotherapy

A psychotherapy approach known as cognitive behavioral therapy can help to reduce panic attacks. Therapy aims to address a patient’s thinking, behavior, and reactions associated with a panic attack to reduce fears and anxieties. Psychotherapy may aim to help a patient “re-train” his or her brain to differentiate between real and perceived threats.

Therapy can help patients overcome fears related to experiencing a panic attack. When symptoms start to improve, patients can often discontinue therapy.

At-Home Therapies

Taking steps to reduce stress and improve health can reduce the incidence of panic attacks. For example, getting plenty of sleep and staying physically active can lower stress levels. Alcohol, caffeine, and illegal drugs can trigger a panic attack and are best avoided.

Stress management techniques such as deep breathing or progressive muscle relaxation can reduce panic attack triggers. Also, attending a support group can help patients identify positive coping mechanisms for reducing fear and anxiety.

What Is the Outlook for Panic Attacks?

Patients with chronic panic attacks are at increased risk to develop what the American Psychiatric Association calls a “Triple A” threat. This threat includes:

  • Anticipatory anxiety: This is triggered by simply thinking about a future possible panic attack and may cause a person to be reclusive.
  • Avoidance: A panic attack sufferer may start to avoid going to public places for fear that he or she will experience a panic attack.
  • Agoraphobia: Avoidance can lead to agoraphobia, or the intense fear of being in public places. A person may become fearful of leaving home.

Seeking treatment for panic attacks can help a patient experience a life free from fear and anxiety. By addressing underlying conditions and stress that can lead to a panic attack, patients can likely find relief.

Preventing Panic Attacks

Most panic attacks that people have are unpredictable, and preventing them is difficult. However, patients can take steps to enhance their overall well-being. This will reduce the likelihood they will have a panic attack. Seeking a physician’s care and following treatment recommendations can help a patient prevent a panic attack.

Taking steps to minimize stress can also help a patient prevent panic attacks. This includes engaging in regular physical activity and getting enough rest on a regular basis.

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See a list of possible causes in order from the most common to the least.

1

Panic Disorder

Panic disorder occurs when you live in fear of having a panic attack. You are having a panic attack when you feel sudden, overwhelming terror that has no obvious cause. You may experience physical symptoms such as ...

Read more »

2

Phobias

A phobia is an excessive and irrational fear reaction. If you have a phobia you will experience a deep sense of dread, and sometimes panic, upon encountering the source of your fear. The fear can be of a certain place...

Read more »

3

Obsessive-Compulsive Disorder (OCD)

Obsessive-compulsive disorder is an anxiety disorder. People who develop this disorder have uncontrollable thoughts and fears (obsessions). These obsessions cause repetitive behaviors (compulsions) that the person use...

Read more »

4

Acute Stress Disorder

In the weeks after a traumatic event, you may develop an anxiety disorder called acute stress disorder (ASD). ASD typically occurs within one month of a traumatic event. It lasts at least two days and up to one month...

Read more »

5

Agoraphobia

Agoraphobia is an anxiety disorder that causes people to avoid situations that might cause them to feel trapped, helpless, embarrassed, or scared. It's more common in women than it is in men.

Read more »

6

Post Traumatic Stress Disorder (PTSD)

Post-traumatic stress disorder (PTSD) is an anxiety disorder that occurs after experiencing or witnessing a traumatic event. PTSD can cause disruptive symptoms of panic, increased arousal, and mental/emotional problems.

Read more »

7

Generalized Anxiety Disorder

People who suffer from generalized anxiety disorder, or GAD, worry uncontrollably about common occurrences and situations. The condition may also be called chronic anxiety neurosis.GAD is different than normal feeling...

Read more »

This feature is for informational purposes only and should not be used to diagnose.
Please consult a healthcare professional if you have health concerns.
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