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Panic Attacks and Panic Disorder

Panic attacks are intense feelings of fear and anxiety that can be accompanied by uncomfortable physical sensations. These episodes can occur at any time; during stressful situations, while sleeping, or at random and unexpected times throughout the day. Though the physical sensations that accompany a panic attack are uncomfortable, they are not harmful. Common panic attack symptoms include:

- Racing heart
- Chest pains
- Shortness of breath
-Numbness or tingling in extremities
-Feeling sweaty
- Feeling of loss of control
- Stomach discomfort
- Feeling detached from reality
- Tired or feeling exhausted once panic attack is over

A comparison can be made between panic attacks and an individual's fight or flight response system. During a panic attack, your brain communicates to the rest of your body that there is a threat. This message activates the same biological response as occurs when faced with a true threatening situation. However, for those suffering from panic disorder, this biological fight or flight response is repeatedly activated despite no real threat or danger.

It is common for individuals to experience 1 or 2 panic attacks in their lifetime, typically in response to stressful situations. The panic experience will disappear once the stressful situation has concluded. Panic attacks last anywhere between a few minutes to half an hour, on average. However, if you are experiencing panic attacks regularly, without an obvious reason, and are beginning to change your behavior as a result, then you might have something called a panic disorder. Individuals who suffer from a panic disorder have a deep fear of when the next panic attack may occur, and they may avoid places where past attacks have occurred or where they fear attacks might occur.

It is unclear what causes panic attacks and panic disorder, but evidence suggests that genetics can play a role. For people who have a biological vulnerability to panic attacks, they are at greater risk for experiencing a panic attack in response to stress, caffeine intake, trauma, and general depression or anxiety. Also, some medical conditions, such as thyroid issues, can contribute to the onset of panic attacks. If you are suffering from panic attacks, it is important to undergo a comprehensive medical exam to rule out other underlying causes.

Panic disorder is treatable. Typical treatment includes psychotherapy, medication, or a combination of both medication and therapy. Cognitive behavioral therapy is the psychotherapy treatment of choice for panic attacks/panic disorder. This form of treatment provides education about panic attacks and panic disorder, and teaches tools for coping with symptoms. Therapy helps one learn that the panic attacks, though they feel terrible and threatening, are not dangerous. Therapy may include a safe and gradual exposure to the physical sensations that accompany panic attacks, until those sensations no longer feel threatening. With cognitive behavioral treatment, most will begin to experience some relief within a few weeks.

For some, medication can be a useful adjunct to psychotherapy. Medications that are typically prescribed for panic attacks and panic disorder include SSRIs (selective serotonin reuptake inhibitors), SNRIs (Serotonin and norepinephrine reuptake inhibitors) and Benzodiazepines. Benzodiazepines are sedatives and are best for short term use only, as they are habit forming. They should not be used if there is any history of alcohol or other substance use issues.

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