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  • Sam DiFranco

Panic and Panic Attacks

Panic is the most extreme form of anxiety. A person experiencing panic may feel terror, confusion, or behave irrationally, often as a result of a perceived threat, for example, a natural disaster or the possibility of a plane crashing. Panic can sometimes result in panic attacks, and panic disorder is a condition characterized by the fear of experiencing a panic attack, especially in a public place. Those who experience frequent panic attacks or fear the onset of an attack may wish to speak to a therapist.


A panic attacks typically comes on suddenly. While it may be precipitated by overwhelming stress, a panic attack is unpredictable, although the anxiety that climaxes in panic may have been present for a long time. They generally last only a short while (5 to 30 minutes) and may occur only once in a lifetime or as often as several times each day. Attacks often have an obvious trigger (a frightening event, place, person, or memory, for instance), but they may also seem to occur for no reason, although most therapists believe that panic attacks do generally have an explanation that can be discovered and addressed.

What causes panic attacks is not clear, but it is believed that some individuals may have a genetic predisposition to panic, and that certain stressors in life can also contribute by triggering panic attacks. They can also be caused by medical conditions such as mitral valve prolapse, hyperthyroidism, hypoglycemia, or medication withdrawal. The use of stimulants such as amphetamines, cocaine, and caffeine can also lead to the development of panic attacks in some individuals.

Often frightening and upsetting, a panic attack can produce sudden, extreme fear and discomfort and can be otherwise physically intense and overwhelming. Panic attacks usually include some of the following sensations and experiences:

  1. Trembling

  2. Shortness of breath, choking sensations

  3. Racing heart, heart palpitations, chest pain

  4. Nausea, dizziness, fainting

  5. Racing thoughts

  6. Tunnel vision

  7. Numbness in the extremities

  8. Frightening thoughts, especially of death

  9. Extreme restlessness

  10. Pacing

  11. Tension in the muscles

  12. Belief one is losing control or losing a sense of reality

  13. Feeling detached from one’s body

Panic attacks are relatively common, and about 30% of people have had at least one panic attack in their life. Because of the severity of physical symptoms, many people go to the hospital thinking they are having a heart attack when they have their first panic attack.

Although panic attacks seem to come on suddenly, people can sometimes anticipate them. An individual diagnosed with panic disorder, for example, may experience both expected attacks and unexpected attacks, but for the condition to be diagnosed, both unexpected, recurrent attacks and a persistent fear of attacks occurring are necessary. People with other anxiety issues or posttraumatic stress (PTSD) may also regularly experience panic attacks.


In the middle of an attack, focusing on breathing and getting to a safe, private space can help the attack subside. Releasing physical tension and relaxing one’s muscles can help, too. Panic attacks are not dangerous and usually go away on their own, but can pose a danger if the person is driving or engaging in other dangerous activities when the attack hits. It can also be helpful to think realistically, instead of either overestimating the dangers of a panic attack (fainting, dying, experiencing a heart attack) or catastrophizing the dangers (embarrassing oneself in public, not receiving help). To challenge these types of thinking, a person might write out any fears or imagine the worst possible scenario that a panic attack could lead to and then plan a way to cope if it does occur.

Stress management is also vital in combating panic attacks. Many people have panic attacks when they grow so overwhelmed with stress that they simply cannot cope, but talking about stress and getting regular breaks and leisure time can help mitigate the damaging effects of chronic stress. Remembering that a panic attack is not likely to cause one to faint, lose control, “go crazy,” or die may also help some individuals relax and deal with panic attacks more effectively, when they occur.

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