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Symptoms and Signs of Panic Attacks

Doctor's Notes on Panic Attacks

Panic attacks are a symptom of an anxiety disorder, which include a discrete period of intense fear, distress, nervousness, or discomfort. Panic attacks can be frightening but are fortunately not physically harmful. They can occur suddenly, unexpectedly, unprovoked, and can be disabling. Panic attacks may occur for no known reason or after a person is exposed "trigger". They can intensity to a peak rapidly and also go away with or without medical intervention.

Symptoms of panic attacks may include palpitations, pounding heart, fast heart rate, sweating, trembling and shaking, sensations of shortness of breath or smothering, feelings of choking, chest pain or discomfort, nausea, upset stomach, dizziness, unsteadiness, lightheadedness, fainting, feelings of unreality or being detached from oneself, fear of losing control or going crazy, fear of dying, numbness or tingling sensations, chills, or hot flashes.

Medical Author: John P. Cunha, DO, FACOEP
Medically Reviewed on 3/11/2019

Panic Attacks Symptoms

The American Psychiatric Association's official Diagnostic and Statistical Manual of Mental Disorders IV, Treatment Revision (DSM-IV-TR) defines a panic attack as a discrete period of intense fear, distress, nervousness or discomfort, in which four (or more) of the following symptoms develop abruptly and reach a peak within 10 minutes:

  • Palpitations, pounding heart, or fast heart rate
  • Sweating
  • Trembling and shaking
  • Sensations of shortness of breath or smothering
  • Feelings of choking
  • Chest pain or discomfort
  • Nausea or abdominal distress
  • Feeling dizzy, unsteady, lightheaded, or faint
  • Derealization (feelings of unreality) or depersonalization (being detached from oneself)
  • Fear of losing control or going crazy
  • Fear of dying
  • Paresthesias (numbness or tingling sensations)
  • Chills or hot flashes
  • Some of these symptoms will most likely be present in a panic attack. The attacks can be so disabling that the person is unable to express to others what is happening to them. A doctor might also note various signs of panic: The person may appear to be very afraid or shaky or be hyperventilating (deep, rapid breathing that causes dizziness). Anxiety attacks that take place while sleeping, also called nocturnal panic attacks, occur less often than do panic attacks during the daytime, but affect a large percentage of people who suffer from daytime panic attacks. Individuals with nocturnal panic attacks tend to have more respiratory symptoms associated with panic and have more symptoms of depression and of other psychiatric disorders compared to people who do not have panic attacks at night. Nocturnal panic attacks tend to result in sufferers waking suddenly from sleep in a state of sudden fright or dread for no known reason. As opposed to people with sleep apnea and other sleep disorders, sufferers of nocturnal panic can have all the other symptoms of a panic attack. Although nocturnal panic attacks usually last no more than 10 minutes, it can take much longer for the person to fully recover from the episode.
  • Recent literature suggests that men and women may experience different symptoms during an attack. Women tend to experience a predominance of respiratory symptoms compared to men.

Panic Attacks Causes

As with most behavioral illnesses, the causes of panic attacks are many. Certainly there is evidence that the tendency to have panic attacks can sometimes be inherited. However, there is also evidence that panic may be a learned response and that the attacks can be initiated in otherwise healthy people simply given the right set of circumstances. Research into the causes of panic attacks is ongoing.

Panic disorder is a separate but related diagnosis to panic attacks. People experiencing repeated panic attacks and who meet other diagnostic criteria may be diagnosed with this illness. Panic disorder is thought to have more of an inherited component than panic attacks that are not a part of panic disorder. Certain medical conditions, like asthma and heart disease, as well as certain medications, like steroids and some asthma medications, can cause anxiety attacks as a symptom or side effect. As individuals with panic disorder are at higher risk of having a heart-valve abnormality called mitral valve prolapse (MVP), that should be evaluated by a doctor since MVP may indicate that specific precautions be taken when the person is treated for a dental problem.

Research is inconsistent as to whether nutritional deficiencies (for example, zinc or magnesium deficiency) may be risk factors for panic disorder. While food additives like aspartame, alone or in combination with food dyes, are suspected to play a role in the development of panic attacks in some people, it has not been confirmed by research so far.

Anxiety Disorder Pictures Symptoms, Panic Attacks, and More with Pictures Slideshow

Anxiety Disorder Pictures Symptoms, Panic Attacks, and More with Pictures Slideshow

It's natural to worry during stressful times. But some people feel tense and anxious day after day, even with little to worry about. When this lasts for 6 months or longer, it may be generalized anxiety disorder. Many people don't know they have it. So they may miss out on treatments that lead to a better, happier life.

REFERENCE:

Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.

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