What are Panic Attacks?
Understanding panic attacks and panic disorder
If you’re looking for a way to cope with anxiety disorder, you are probably also concerned about panic attacks. You may have experienced this extremely unpleasant phenomenon or you may have just heard about it, and you’re looking to inform yourself on this matter.
To begin with, we should clarify exactly what panic attack is. According to the Diagnostic and Statistics Manual of Mental Disorders, the official definition is
in which certain symptoms develop quite abruptly,
reaching a peak within 10 minutes.”
In order for a Panic Attack diagnostic to be applicable, you must experience at least four of the following symptoms within the brief period of time in which panic surges:
- Palpitations, pounding heart or accelerated heart rate
- Excessive and sudden perspiration
- Sudden trembling or shaking
- Shortness of breath or smothering sensations
- Sensation of choking
- Chest pains or discomforts
- Nausea or abdominal distress
- Dizziness, lightheadedness, unsteadiness or fainting
- Sudden feelings of derealization of depersonalization
- Intense fear of losing control or going crazy
- Overwhelming fear of dying
- Numbness or tingling sensations
- Chills or hot flushes.
Do they sound familiar? If so, there’s a good chance your anxiety disorder has been sourcing these Panic Attacks. It could be that you have a full-blown Panic Disorder, even. In order for this diagnosis to be applicable, four features must be observed:
To qualify for a diagnosis of Panic Disorder:
- You must have recently experienced recurrent and unexpected Panic Attacks
- You have developed intense concerns over having more Panic Attacks
- You have actually changed your behavior significantly, fearing new attacks
- The Panic was not caused by substance abuse or another medical condition
There is no such thing as anxiety attacks
If you spent some time browsing the Internet looking for information on Panic Attacks, you have probably come across articles on “Anxiety Attacks” as well. While this expression is often tossed around as a synonym to panic attacks, it doesn’t really make sense.
Anxiety does not attack: it may persist, lurk, creep, envelop, engulf, overwhelm. But it does not arise suddenly within a period of 10 minutes. Panic attacks do.
Also, Panic Attacks may occur with any of the known types of anxiety disorder, but it’s not a disorder in itself. There are indeed two documented variants of Panic Disorder (with and without Agoraphobia), but you can’t have Panic Disorder and GAD, for example: you either have one or the other, and depending on the diagnostic, treatment will differ.
For more information on the different types of anxiety disorder and their respective anxiety symptoms, you may want to read this article.
The three subtypes of panic attacks
Not all panic attacks are the same, and understanding their subtypes is the key to dealing with them on the long term. There are three subtypes of panic attacks, defined by the relationship between the onset of the attack and what actually triggered it.
Unexpected Panic Attacks: also referred to as “uncued”. In this subtype, panic just seems to come out of the blue, with no apparent reason or causality.
Situationally Bound Panic Attacks: also known as “cued”. The panic is triggered by exposure or anticipation of something scary, for example, if you have extreme fear of heights and for some reason you’re forced near a very high lookout point, it could trigger a panic attack.
Situationally Predisposed Panic Attacks: this is similar to the previous sub-types, except the cue doesn’t always trigger panic, for example, you may feel intense fear of riding a car, but doing so doesn’t always cause a panic attack – only sometimes.
Believe it or not: panic attacks are all bark and no bite
If you feel as though panic is taking hold of your life, you are probably growing more restless and scared each and every day. Please don’t. While experiencing Panic Attacks is undeniably an oppressive and terrifying event, it’s just a moment in time and not nearly as serious as you imagine. In fact, this popular quote would best describe the truth behind panic attacks: “there is nothing to fear, but fear itself”.
It may sound a ludicrous statement, especially if you’ve recently experienced a panic attack, but truth of the matter is that most people overcome this problem by learning how to do… absolutely nothing, in the eminence of Panic.
You simply cannot die from having panic no matter how intense it feels because in the worst scenario (which is actually quite rare) you will merely faint; however, in the best scenario – and provided you can just make yourself wait it out, the panic bubble will burst within a few minutes, and it will simply disappear. Read our article on anxiety and panic coping to learn more details about how this works.
There’s no reason to be alone with your panic attacks
Being able to just hold steady and withstand those feelings of rising panic until they just peak, drop and fade? If you’ve already had panic attacks, this approach must sound like something you can’t possibly do. But remember, it’s not something you have to by yourself.
There has been notable progress in the psychotherapeutic treatment of Panic Attacks and Panic disorder, especially though CBT (cognitive-behavioral) treatments. Your therapist will be able to help you overcome this problem with relative ease, if only you look for help.
If you can’t believe that treating something you perceive as ominously threatening as panic attacks can be so simple, you should read the 2008 peer-reviewed study by Shandley el al on the treatment of Panic Disorder; the researchers have demonstrated that even a regular GP can successfully treat Panic Attacks without need to prescribe medications, provided with the right training.
More impressively even, in this study the researchers have analyzed an Internet-based, Therapist-assisted treatment for Panic Disorder. The conclusions were quite clear:
“Evidence-based Internet interventions represent a potentially valuable resource to reduce the burden of care and the cost of managing mental health disorders within primary care settings and, at the same time, improve patient outcomes(…)This study provides evidence that Internet-based interventions are an effective adjunct to existing mental health care systems.”
Further reading:
Shandley, K. et al. Therapist-Assisted, Internet-Based Treatment for Panic Disorder: Can General Practitioners Achieve Comparable Patient Outcomes to Psychologists? 2008 Journal of Medical Internet Research 2008 Apr–Jun; 10(2): e14.
