Imagine you are sitting comfortably at home or shopping in a supermarket when your heart suddenly starts racing. You feel breathless, dizzy, and frightened. You may experience chest discomfort and begin to worry that you are having a heart attack or that something terrible is about to happen.
Within minutes, the fear becomes overwhelming. You may feel that you are losing control or even dying.
Then, gradually, the symptoms subside.
This frightening experience may be a panic attack.
For some people, panic attacks happen repeatedly, often without warning. They begin to worry about when the next attack will occur and may start avoiding situations where they fear another attack. When this happens, the person may be experiencing Panic Disorder.
A panic attack is a sudden episode of intense fear or discomfort accompanied by physical and psychological symptoms.
The symptoms usually develop rapidly, reaching their greatest intensity within minutes. Most attacks subside within a relatively short period, although the person may continue to feel exhausted, unsettled, or anxious afterward.
One of the most frightening aspects of a panic attack is that it can occur unexpectedly, even when there is no obvious danger.
Although panic attacks can be extremely distressing, the attacks themselves are generally not dangerous. However, similar symptoms can occur in medical illnesses, so an appropriate medical evaluation is important, particularly when symptoms occur for the first time.
Panic attacks can produce a wide variety of symptoms. Not everyone experiences the same symptoms, and their intensity can vary considerably.
Physical Symptoms
Common physical symptoms of anxiety during a panic attack include:
Psychological Symptoms
A person may also experience:
The combination of these symptoms can be so frightening that some people repeatedly visit emergency departments, believing that they have a serious medical illness.
Having a panic attack does not necessarily mean that you have Panic Disorder.
A person may experience an occasional panic attack during a particularly stressful period without developing a psychiatric disorder.
Panic Disorder is diagnosed when a person experiences recurrent, unexpected panic attacks and develops persistent worry or changes in behavior because of these attacks.
According to the DSM-5-TR diagnostic criteria, at least one panic attack must be followed by a month or more of either:
The attacks must not be better explained by another medical condition, the effects of substances, or another mental health disorder.
Panic attacks are associated with the body’s natural alarm system, sometimes called the fight-or-flight response.
This system prepares us to respond to danger by increasing our heart rate, changing our breathing, and making us more alert.
During a panic attack, this alarm response may become activated even when there is no immediate external threat.
The physical sensations themselves can then become frightening.
For example, a person notices that their heart is beating rapidly and thinks, “Something is wrong with my heart.”
This thought increases their fear, which makes their heart beat even faster. The worsening physical symptoms further reinforce their belief that something dangerous is happening.
A vicious cycle of fear and physical symptoms develops.
Over time, some people become extremely sensitive to ordinary bodily sensations and begin to fear anything that reminds them of a previous panic attack.
Yes. Some people experience nocturnal panic attacks, which wake them suddenly from sleep.
They may awaken with palpitations, breathlessness, sweating, or intense fear.
These episodes can be particularly frightening because they occur without warning.
However, other conditions, including certain sleep disorders, may produce similar symptoms. A medical evaluation may be necessary to identify the cause.
Some people with Panic Disorder begin avoiding situations where they fear experiencing another attack.
For example, they may avoid:
In some individuals, this avoidance becomes severe enough to interfere significantly with their independence and daily activities.
They may develop Agoraphobia, a condition involving marked fear or anxiety about situations where escaping or obtaining help might be difficult if panic-like or other incapacitating symptoms occur.
Agoraphobia and Panic Disorder are separate diagnoses, although they frequently occur together.
Panic Disorder can affect considerably more than the few minutes during which an attack occurs.
Some people spend much of their day worrying about the next episode.
This constant anticipation of another attack is sometimes called anticipatory anxiety.
For example:
Gradually, the fear of another panic attack can become more disabling than the attacks themselves.
Panic Disorder may also occur alongside depression, other anxiety disorders, or substance use problems.
Diagnosis begins with a careful assessment of the person’s symptoms, medical history, and circumstances surrounding the attacks.
A psychiatrist or another qualified healthcare professional will consider:
Certain physical conditions, including heart rhythm disturbances, thyroid disorders, and respiratory illnesses, can produce symptoms resembling panic attacks.
Depending on the clinical findings, a physical examination or investigations may be recommended.
It is important not to assume that every episode of chest pain, palpitations, or breathlessness is caused by anxiety. New or severe chest pain, fainting, or significant breathing difficulty requires urgent medical assessment.
Panic Disorder is a treatable condition. Many people improve substantially with appropriate treatment.
The two main evidence-based treatments are psychological therapy and medication.
Cognitive Behavioral Therapy is one of the most effective psychological treatments for Panic Disorder.
CBT helps individuals understand the connection between their physical sensations, frightening thoughts, and behavioral responses.
Treatment may involve:
A particularly useful component of CBT involves gradually becoming less fearful of harmless bodily sensations that resemble those experienced during panic attacks. This is known as interoceptive exposure and should be undertaken with appropriate professional guidance.
The aim is to help the person recognize that uncomfortable sensations do not automatically indicate danger.
Medication can be effective in reducing the frequency and severity of panic attacks.
Commonly prescribed medicines include antidepressants belonging to the SSRI and SNRI groups.
Although these medications are called antidepressants, they are also effective in treating several anxiety disorders.
Their benefits usually develop gradually over several weeks.
Treatment should be individualized, taking into account the person’s symptoms, medical history, preferences, and possible side effects.
Benzodiazepines may provide rapid relief of anxiety but are generally not recommended for routine or long-term treatment of Panic Disorder because of risks such as dependence and less favorable long-term outcomes.
Certain lifestyle changes may complement professional treatment.
These include regular physical activity, adequate sleep, reducing excessive caffeine intake, avoiding recreational drugs, and practicing appropriate relaxation techniques.
Understanding the nature of panic attacks can itself be helpful, as fear of the symptoms often contributes to their persistence.
If you have previously been medically assessed and recognize the symptoms as a panic attack, the following steps may help:
These strategies can help, but they are not a substitute for a structured treatment program when panic attacks are recurrent.
Many people with Panic Disorder achieve substantial improvement, and some experience complete remission of symptoms.
Others may have occasional recurrences, particularly during periods of stress.
With appropriate treatment, individuals can learn to manage panic attacks, reduce their fear of bodily sensations, and return to activities they previously avoided.
Importantly, successful treatment does not necessarily mean that a person will never feel anxious again. Rather, it means that anxiety and panic no longer dominate their decisions or interfere significantly with everyday life.
Consider consulting a psychiatrist or clinical psychologist if:
Early assessment and appropriate treatment can help prevent the cycle of fear and avoidance from becoming increasingly established.
Panic Disorder can be extremely frightening and, at times, disabling. However, effective treatments are available.
Understanding why panic attacks occur, learning to interpret physical sensations more accurately, and reducing avoidance behavior are important steps towards recovery.
With appropriate psychological treatment, medication when indicated, and consistent practice, many people can regain confidence and lead active, fulfilling lives.
Seeking Professional Help
If you have concerns about your mental health or that of someone you care about, seeking professional guidance can be an important first step. A professional assessment can help clarify the nature of the difficulties and identify appropriate treatment or support.
To enquire about an appointment at Al Soor Specialist Clinic LLC, Sharjah, or to learn more about our services, please contact us at +971 6 551 2913.
Disclaimer: This article is intended for general information and education only. It is not a substitute for professional assessment, diagnosis, or individualized treatment advice.
