Understanding Panic Disorder and Panic Attacks
By Lauren Krouse
There’s anxiety that you may experience leading up to or during tough situations: getting into a disagreement with a friend, applying to college, or starting a new job. There’s generalized anxiety disorder, which can cause such intense worry you need treatment to cope. And then there are panic attacks and panic disorder, which is another type of anxiety disorder.
Panic attacks cause an overwhelming flood of anxiety and physical symptoms that can make it hard to function. Panic disorder is an anxiety disorder that involves frequent panic attacks.
Here’s everything you need to know about panic attacks and panic disorder, including symptoms, treatment, and how to deal with a panic attack.
What Is a Panic Attack?
A panic attack is an episode of sudden, intense fear that reaches a peak within minutes. You may feel like you’re losing control, having a heart attack, or, in some cases, fear you are dying. There’s no immediate threat or danger, but you may feel like you can’t escape the panic for minutes at a time.
Symptoms of a panic attack include:
- A sense of doom or dread
- Feeling out of control or like you are losing your cognitive abilities
- Pounding, racing heart
- Sweating
- Trembling or shaking
- Difficulty breathing
- Weakness or dizziness
- Chills
- Hot flashes
- Nausea or stomach pain
- Chest pain
- Headache
- Numbness or tingling
- Feeling detached from reality
Anyone can have a panic attack. You may have a few panic attacks — or just one — during a high-stress period in your life, only to never experience them again. In some cases, panic attacks can become a recurring experience that disrupts your life.
What Is the Difference Between a Panic Attack and Anxiety Attack?
An anxiety attack is a period of overwhelming anxiety that may include persistent worry, dread, restlessness, or edginess. Anxiety can slowly build into something that feels unmanageable, with constant loops of negative thoughts and feelings.
Panic attacks, on the other hand, happen suddenly, are so intense you feel like you cannot function or think clearly, and generally last about five to 20 minutes.
The term “anxiety attack” is subjective, which means each person’s experience and definition of an anxiety attack is different. Many people use the terms “anxiety attack” and “panic attack” interchangeably, but anxiety attacks are not included in the Diagnostic and Statistical Manual of Mental Illnesses, or DSM-5, a professional guide used to diagnose mental health conditions. In many cases, an anxiety attack is actually a panic attack.
What Causes Panic Attacks?
Panic attacks can be brought on by chronic stress, ongoing trauma, or a traumatic event, such as a natural disaster. They can also be part of mental health conditions, such as anxiety disorders, mood disorders, phobias, or post-traumatic stress disorder (PTSD), as well as some medical conditions, such as hyperthyroidism and cardiovascular disease. More research is needed to fully understand the root causes of panic attacks, but it is believed genetics and environmental factors can also contribute to them.
What Is Panic Disorder?
Panic disorder is a type of anxiety disorder in which you have frequent panic attacks that impact your quality of life. With panic disorder, you may avoid certain situations in the hopes of not having another panic attack, but they keep coming.
Many people experience panic disorder during their lifetime. The condition often emerges in your teens or early adulthood when you’re dealing with a lot of stress.
Symptoms of panic disorder include:
- Sudden and repeated panic attacks
- Intense worry about having more panic attacks
- Fear or avoidance of places where you’ve had panic attacks
Panic disorder can be associated with intense fears of being in open spaces or being outside of your home alone (known as agoraphobia). It can also present at the same time as other anxiety disorders or depression, and it can lead to self-medicating with alcohol or drugs.
Can You Have Panic Attacks and Not Have Panic Disorder?
Having a panic attack does not automatically mean you have panic disorder. To be diagnosed with panic disorder, you must have recurring panic attacks and meet the criteria in the DSM-5.
How Is Panic Disorder Diagnosed and Treated?
Panic disorder can be diagnosed by a primary-care physician, therapist, or psychiatrist. A good first step is to meet with a primary-care physician so they can rule out other medical conditions and refer you to a therapist or psychiatrist for additional support.
Your doctor or therapist will ask about the frequency and intensity of attacks to determine whether your symptoms indicate panic disorder or another condition, since panic attacks can also occur with other mental health conditions.
If you fit the criteria for panic disorder, it’s highly treatable. Treatment plans often include therapy and medication.
Therapy
Working with a therapist can help address panic attacks and panic disorder. Cognitive behavioral therapy (CBT) and exposure therapy are especially useful in treating panic disorder.
- CBT starts with education about panic attacks and understanding the relationship between your panic attacks and your thoughts, feelings, and reactions. As you identify thoughts, feelings, and behaviors associated with your panic attacks, you will learn strategies to adjust your response to them, and you may begin to have fewer panic attacks or get to a point where they stop completely.
- Exposure therapy involves gradually introducing yourself to what triggers your panic attacks to increase your tolerance for uncomfortable situations. You’ll progress from thinking and talking about these situations to slowly and safely encountering them in real life.
Medication
Medication can also be an effective treatment option for panic attacks and panic disorder.
- Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) can help ease anxiety and reduce panic attacks.
- Benzodiazepines can be taken occasionally for fast-acting relief. They are often referred to as “rescue medications.” There is a risk of dependency, so it’s important to take them only as prescribed.
Learn more about mental health medications.
How to Deal With a Panic Attack
In-the-moment strategies can help you get through panic attacks. Try these:
- Label your experience. Tell yourself, “I’m having a panic attack.” Simply naming what you’re going through can help you reground yourself and start to feel better.
- Try a deep-breathing exercise. One helpful exercise is box breathing. Do each of the following for a count of four: exhale, hold, inhale, hold, repeat. With each count of four, imagine that you are forming the side of a box.
- Use the 5-4-3-2-1 grounding method. Name five things you can see, four things you can hear, three things you can feel, two things you can smell, and one thing you can taste.
Name Panic, Find Peace
Panic attacks can feel overwhelming, but they often fade out of your life with time and treatment. Even if you have a panic attack again, there are plenty of ways to get through them — and they always end. If you’re struggling with intense anxiety or panic attacks, don’t hesitate to reach out for help. With support, you can find peace again.
Learn More About Coping With Anxiety and Anxiety Disorders
Can I Be Anxious Without Having an Anxiety Disorder?
How Can I Talk to Someone About My Anxiety?
How to Relieve Stress: Breathing Exercises You Can Do Anywhere
How to Handle Anxiety Around Mass Shootings and Going Back to School
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