Panic attacks involve a distinct period of time of intense fear accompanied by a number of physical symptoms. There is usually a particularly sudden onset and the severity of the symptoms typically reaches a peak within approximately 15 minutes.
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Physical Symptoms
Some of the symptoms that people suffering from an acute panic attack experience may include:
- Heart palpitations
- Dizziness
- Trembling
- Shortness of breath
- Feeling of unreality
- Fear of dying or heart attack
- Flashing or tunneled vision
- Faintness
- Nausea
- Numbness
- Heavy breathing or hyperventilation
- Loss of bodily control
- Urge to flee
- Burning sensations in the face and neck
- Lightheadedness
- Hyperventilation
- Difficulty moving
A panic attack is typically recognized as an acute episode with at least four bodily or cognitive symptoms that may last from a few minutes to a few hours.
Psychological Conditions
It is relatively common for people who experience panic attacks to have some psychological themes associated with the condition. This can include fear of death or loss of sanity and depersonalization, such as an abnormal awareness of self.
It is also common for people to experience an overwhelming urge to flee. This is particularly evident if the individual associates the particular situation and place with their feelings of panic and believe that fleeing would free them from this.
Severity
A panic attack can happen to anyone and usually occurs with acute onset with varying severity of symptoms that may debilitate the individual substantially.
Panic attacks are not usually life-threatening in their own right and in most cases do not cause long-term physical harm. However, the immediate effects vary between individuals and many people who have a panic attack for the first time call emergency services for help. This is usually due to fear that they are having a heart attack or nervous breakdown.
If a pattern begins to form and someone experiences panic attacks on a regular basis, they may have a panic disorder, which requires more in-depth management. Screening people that experience panic attacks to detect people that may have a panic disorder is beneficial and can be done using tools like the Panic Disorder Severity Scale to categorize the severity of the condition. If the results suggest a disorder, formal diagnostic testing can then be undertaken.
Pathophysiology
The pathophysiology of the condition can largely explain the reasoning behind the symptoms experienced by people that have panic attacks.
The activation of the sympathetic nervous system leads to a flood of hormones such as epinephrine (adrenaline) in the body. This changes the blood flow within the body and leads to increased flow to important parts of the body in intense situations.
The urge to flee is thought to occur as a consequence of the bodily sympathetic response after the release of hormones.
The symptoms often cause individuals to feel more anxious, forming a positive feedback loop and worsening the panic attack.
Differential Diagnosis
The most distinctive signs of a panic attack are usually shortness of breath and chest pain, which are also characteristic signs of cardiovascular illnesses such as unstable angina and myocardial infarction.
As the outcomes of these conditions are considered serious, it is important that people suspected to be suffering from a panic attack are tested to rule out these conditions, particularly if they have a past history of cardiovascular disease. This is done with the use of an electrocardiogram and an assessment of mental health.
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