Panic attacks are sudden periods of intense fear and discomfort that may include palpitations, otherwise defined as a fluttering, rapid, irregular heartbeat, sweating, chest pain or chest discomfort, shortness of breath, trembling, dizziness, numbness, confusion, or a sense of impending doom or loss of control. Typically, these symptoms peak within ten minutes of onset and can last for roughly 30 minutes, though their duration can vary anywhere from seconds to even hours. While they can be extremely frightening and distressing, panic attacks themselves are not physically dangerous.
The essential features of panic attacks are consistent, though terminology can be used to better describe them. The DSM-IV, originally published in 1994 (and is no longer used), classified them into three types- situationally bound/cued, situationally predisposed, and unexpected/uncued. However, these are often simplified into two categories: unexpected panic attacks versus expected panic attacks.
Panic attacks function as a marker and determining factor for severity of diagnosis, course, and comorbidity across an array of disorders, including but not limited to anxiety disorders. Hence, panic attacks can be listed as a specifier that is applicable to all DSM-5 disorders.
Panic attacks can be triggered by a identifiable source, or they may happen without any warning and without a specific, recognizable situation.
Some known causes that increase the risk of having a panic attack include medical and psychiatric conditions (i.e. panic disorder, social anxiety disorder, post-traumatic stress disorder, substance use disorder, depression), substances (Nicotine, caffeine), and psychological stress.
Before diagnosis, conditions that produce similar symptoms should be ruled out, such as hyperthyroidism, hyperparathyroidism, heart disease, lung disease, drug use, and dysautonomia, disease of the autonomic nervous system, which is responsible for regulating the body's involuntary physical processes.
Treatment of panic attacks should be directed at the underlying cause. In those with frequent attacks, counseling or medications may be used, as both preventative and abortive measures. Breathing training and muscle relaxation techniques may also be useful in stopping the panic attack from occurring or shortening its duration. Those affected by panic attacks are at a higher risk of suicide.
In Europe, about 3% of the population has a panic attack in a given year while in the United States they affect about 11%. They are more common in females than in males. They often begin during puberty or early adulthood. Children and older people are less commonly affected.
