Recurring Panic Attacks Can Lead to Panic Disorder

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By Meera Balasubramaniam, MD

Many people experience anxiety from time to time and can easily move on from those feelings.

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But for some, the feelings associated with anxiety are so overwhelming that they can cause a panic attack. And while not life threatening, panic attacks can be frightening and debilitating, and in some cases can lead to panic disorder.

The good news is that with help from a mental health professional you can learn to manage the symptoms of a panic attack and even lessen their severity.

Understanding Panic Attacks

A panic attack happens when the mind and body work together to trigger a chemical reaction — essentially a rush of hormones, such as adrenaline — that tells your body to activate your fight or flight response to keep you safe from harm.

As your body tries to take in more oxygen, your breathing quickens, hormones are released, your heart beats faster, and muscles tense.

For most people, a panic attack lasts from five to 30 minutes. They typically start without warning and can happen any time, even when you are sound asleep.

Panic attacks are more common in women than men, likely because of differences in brain
chemistry and hormone fluctuations.

Like other anxiety disorders, panic attacks typically have their onset in late childhood or early adulthood, peak in middle age, and then the frequency decreases.

The exact cause of panic attacks is unknown, but stress, emotional trauma, and genetics can all play a part.

Symptoms

Symptoms of a panic attack include:

  • Rapid, pounding heart rate.
  • Shaking or trembling.
  • Sweating.
  • Shortness of breath or tightness in the throat or chest.
  • Nausea, dizziness, or fainting.
  • Sense of impending doom or fear.
  • Feeling out of touch with reality.

It is not unusual for a person to experience one or two panic attacks in their lifetime during periods of intense stress.

However, when panic attacks occur once or twice a month or even several times a week and cause constant worry about having another attack, it is likely panic disorder.

Panic disorder can lead to complications ranging from mild social impairments to a total inability to face the outside world.

An estimated 4.7% of U.S. adults experience panic disorder at some time in their lives, according to the National Institute of Mental Health.

In addition, regularly experiencing panic attacks can also lead to phobias, such as fear of social situations, driving, or even leaving home. The anticipatory anxiety associated with panic attacks can also lead to other problems such as depression and substance abuse.

Treatment

Panic attack symptoms can resemble other serious health problems, including a heart attack.

So, if you’re experiencing a panic attack for the first time and aren’t sure if the symptoms are related to an underlying medical problem, you should call 9-1-1 or have someone take you to the local emergency room. Do not attempt to drive yourself.

A physical exam, blood tests, and other tests such as an EKG can help rule out heart problems and determine if a medical condition is causing your symptoms. The sooner you identify the cause of your symptoms, the sooner you can address them.

If a physical exam and diagnostic testing don’t suggest an underlying medical condition, you most likely experienced a panic attack.

You should also seek immediate medical help if during a panic attack you are worried that you might hurt yourself or someone else. If this is the case, and if your panic attacks happen regularly, consider seeing a mental health professional who can help you better manage your anxiety.

Treatment often involves a combination of medication and psychotherapy. Certain antidepressants that increase levels of serotonin in the brain can help reduce anxiety, and anti-anxiety medications, such as benzodiazepines, can be used to manage severe symptoms.

Individual or group therapy can also help. At Penn Medicine Princeton House Behavioral Health, cognitive behavioral therapy (CBT) is commonly used to treat panic disorder. CBT teaches you new ways of thinking and problem solving as well as relaxation techniques that enable you to respond to the feelings that happen before or during a panic attack.

Tips

With practice, you can learn to manage the symptoms of a panic attack and lessen their severity. Here are two tips that can help:

  • Focus on your breath. If you breathe quickly during an attack, there are specific breathing exercises that can ease your symptoms. A popular technique is 4-7-8 breathing, which involves breathing in for 4 seconds, holding the breath for 7 seconds, and exhaling for 8 seconds. By focusing on your breath, you can regulate your body’s reaction in moments of anxiety, often interrupting the fight or flight cycle and keeping the panic attacks from escalating.
  • Relax your muscles. Those who experience muscle tension during a panic attack often benefit from a technique called progressive muscle relaxation, which involves tensing and releasing the major muscle groups. It may seem counterintuitive to increase tension in already tense muscles, but tightening the muscles a bit more, enables them to release into a calmer, looser state.

If you don’t suffer from panic attacks but know someone who does, you can guide them through these techniques to help them manage the moment and feel safe. A panic attack isn’t dangerous, but it can be scary, largely because it makes you feel out of control.

Fortunately, with the help of a mental health professional, you can learn what’s triggering your anxiety and identify techniques that can help you manage overwhelming feelings, so you can focus on the things you enjoy.

For more information about Penn Medicine Princeton House Behavioral Health, call (888) 437-1610 or visit www.princetonhouse.org.

Meera Balasubramaniam, MD, is associate medical director at Penn Medicine Princeton House Behavioral Health’s Hamilton site.

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