Understanding Panic Attacks

Understanding Panic Attacks

A panic attack is sudden sensation of heavy and difficult breathing along with a pattern of other sensations that can last for several minutes. Panic attacks may occur independently, as a part of Panic disorder, or as a part of other disorders. The DSM criteria for panic disorder are as follows:

  • Recurrent and unexpected (panic attacks)
  • There is a pattern (expected Panic attacks)
  • Many PA within minutes
  • Four of the following should happen for it to be called a panic attack:
  • Palpitations/heart pounding
  • Increased heart rate
  • Sweating
  • Trembling/shaking
  • Shortness of breath
  • Choking sensation
  • Chest pain/discomfort
  • Nausea/abdominal distress
  • Sometimes can this can also be accompanied by:
  • An abrupt surge of intense fear/discomfort that peaks
  • Dizziness, light headedness
  • Chills/hot flushes
  • Numbness/tingling sensation
  • Depersonalization/derealization (losing one’s sense of self and feeling cut off from reality)
  • Fear of losing control
  • Fear of dying
  • At least 1 attack should be followed by 1 month of –
  • Persistent worry about having another Panic attack and its’ consequences
  • Maladaptive changes in behavior to avoid having a panic attack: Patients Often worry that they will have to lose control, will be judged by others for having a Panic Disorder. Therefore, they exhibit avoiding behaviours to tackle this.

Nocturnal PAs or panic attacks during the night are quite common. PA’s usually occur in rare episodes but the symptoms often resurface and very few people have full remission. The first time it happens is usually around the 20s. Inquiring about the childhood can help understand the trigger, it could be a cardiac arrest, exposure to emotional and sexual abuse, or a mental health issue.

There is almost always a trigger, a stressful event that put the person into an exertion-like state. However, there are also some personality types that seem to go with this: mainly fearful, anxious and controlling personality types.

People with these personality types are more likely to worry about controlling one’s body and its reactions. This makes them worry too much when they are not able to control it. Therefore, each time the body’s responses are slightly elevated also, the person misinterprets it as a cardiac arrest or a panic attack and this makes them actually have a panic attack.

However, the good news is that panic attacks are highly manageable. There are definite cues within the body that seem to make people think they are having a panic attack, and that actually leads to a panic attack. In psychotherapy, sensitivity to these cues can be reduced with training and relaxation. Alongside, the therapist also starts to work on thoughts and feelings related to Panic attacks and how they affect work and relationships. With time, the trigger may be identified and worked through. Medications (anti-anxiety or/and anti-depression) can help to curb some of the symptoms.

Therefore, help is available if you or someone else you know has panic attacks. Never hesitate to take help.

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