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Panic Attack

Panic Attack

Definition

Description

Resources

Definition

Panic attacks, the hallmark of panic disorder, are discrete episodes of intense anxiety. Panic attacks can also be experienced by people with anxiety disorders, mood disorders, substance-related disorders (e.g., cocaine addiction), or general medical conditions (e.g., hyperthyroidism).

Description

Panic attacks are intense anxiety experiences that occur suddenly over discrete periods of time, and are characterized by intense apprehension or fearfulness in situations where there is no actual danger. Physical symptoms of a panic attack may include palpitations, difficulty breathing, chest pain or discomfort, choking or smothering sensations, excessive perspiration, or dizziness. Panic attacks often include the fear of going crazy, losing control, or dying. Panic attacks triggered by a specific experience are called situational panic attacks, since a certain situation (e.g., public speaking, driving, shopping in a crowded store) initiates the intense anxiety.

Persons affected with panic attacks usually exhibit a broad range of clinical signs and symptoms that include:

  • heart palpitations (accelerated heart rate)
  • shaking or trembling
  • sweating
  • shortness of breath or sensation of feeling smothered or choked
  • feeling of tingling
  • chest discomfort or pain
  • nausea or abdominal distress
  • feeling dizzy, light headed, unsteady or faint
  • perceptions of being detached from oneself (deper-sonalization), or a feeling out of touch with reality (derealization)
  • chills or hot flashes
  • fear of dying
  • fear of going crazy or losing control

A person meets the criteria for a panic attack if the symptoms start abruptly, reach a quick peak (usually within 10 minutes), and if the affected individual has at least four symptoms as listed above. In persons who have less than four symptoms during an attack, the disorder is called a limited symptom attack.

It is typical that affected persons who seek treatment usually have one to two attacks a week and in worse periods may have one daily attacks or several within a week.

As stated, panic attacks can be experienced as a result of stimulant chemical usage, such as cocaine usage. There is evidence to suggest that persons with panic attacks are sensitive to certain chemicals such as caffeine, carbon dioxide, antihistamines, and, in women, progesterone replacement. Exposure to these substances may precipitate an attack.

Resources

BOOKS

Rakel, Robert E. Conn’s Current Therapy. 54th ed. Philadelphia: W. B. Saunders Company, 2002.

Schmidt, Leonard J., and Brooke Warner, (eds). Panic: Origins, Insight, and Treatment. Berkeley, CA: North Atlantic Books, 2002.

Starcevic, Vladan. Anxiety Disorders in Adults: A Clinical Guide. New York: Oxford University Press, 2005.

VandenBos, Gary R. (ed). APA Dictionary of Psychology. Washington D.C.: American Psychological Association, 2007.

ORGANIZATIONS

Anxiety Disorders Association of America (ADAA). 11900 Parklawn Drive, Suite 100, Rockville, MD 20852-2624. (301) 231-9350. www.adaa.org

Laith Farid Gulli, MD

Jean Suvan, BS, RDH

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