Panic attacks come on suddenly and often without any obvious triggers. The intense anxiety mounts for a period, usually ranging from a few brief moments to as much as 10 (or even 30 in extreme cases) minutes, and then subsides. Sometimes panic or anxiety attacks form a cyclic loop of episodes — starting then stopping — that can continue for hours.

Fortunately, unless the sufferer is predisposed to a medical condition such as heart disease, the attacks are physically harmless. They are actually the body’s “fight or flight” response taken out of context. The body reacts to a nonexistent danger by flooding the system with adrenaline in order to either defend itself (fight) or run (flight) from the perceived danger.

A panic attack may be one of the most frightening experiences you will ever have. The attack may bring on feelings as simple as lightheadedness and dizziness or as extreme as the fear that you’re having a heart attack or even the fear of death. Other symptoms can be any of the following: headaches, hyperventilation, intense fear, intense stress, numbness in the face, numbness in the fingers, trouble breathing, faintness, fatigue, heart palpitations or a racing heartbeat, nausea or abdominal pains, chest pains or tightening in the chest. Your body may tremble and you may have trouble swallowing and tunnel vision is sometimes experienced.

The panic attack may bring on feelings that you are unable to escape a threatening situation or feelings that you are deficient in some way. You may feel that you are being judged, or criticized or that you are being watched by others. You may have feelings that you are out of control or trapped; feelings that your surroundings are surreal. Muscle tension and body aches are common during and after panic attacks.

Panic attacks can cause a person to completely alter their lifestyle. It can bring on a fear of driving, a fear of eating in restaurants, a fear of flying and a general fear of people. Our working environment can become a minefield with the fear of authority figures and public speaking and low self-confidence.

The effects of a panic attack vary with the individual. Because they come on suddenly and without any apparent cause, first-time sufferers often call for emergency services. First-time sufferers often fear that they are having a heart attack or a nervous breakdown.

Panic attacks are distinguished from other forms of anxiety by their suddenness and intensity.

Agoraphobia

Because of the loss of control a panic attack sufferer experiences, he or she may develop a fear of experiencing an attack in a public place. They feel that the attack may create an embarrassing situation for them that they could not easily escape from. As a result they avoid public places. With this irrational fear, or phobia, the person is said to have panic disorder with agoraphobia.

Agoraphobia is usually thought of as a fear of public places however it is actually the fear of having a panic attack in a public place and being unable to escape, thereby being embarrassed.

Nocturnal (nighttime) Panic Attacks

 Although less common than daytime panic attacks an episode can occur at any time of day or night. The sufferer may bolt from sleep, drenched in sweat, in a state of panic with no apparent cause. As with a daytime episode, it can be accompanied by accelerated heart rate, trembling, erratic breathing and a sense of impending doom.

Although researchers have so far been unable to discover the cause of nocturnal attacks, they have pretty much ruled out dreams as a cause. Sleep researchers have noted the majority of panic attacks occur during the early sleep cycle rather than the later REM (rapid eye movement) or dream cycle.

It is estimated that at least half of people that suffer from daytime panic attacks also experience at least one episode of a nocturnal panic attack.

Whether it occurs daytime or nocturnally, it’s important to undergo a complete physical examination to rule out any serious medical condition.

 

Symptoms

Did you experience a distinct period of intense fear or discomfort that:

Occurred suddenly

Reached a peak within 10 minutes

Did you experience 4 or more of the following symptoms:

Palpitations, pounding heart, or accelerated heart rate

Sweating

Trembling or shaking

Sensations of shortness of breath or smothering

hyperventilation (deep, rapid breathing that may bring on dizziness)

Feeling of choking

Chest pain or discomfort

Nausea or abdominal distress

Feeling dizzy, unsteady, lightheaded, or faint

Feelings of unreality (dreamlike) or of being detached from oneself

Fear of losing control, doing something embarrassing or going crazy

Terror: a sense that something terrible is about to happen and you are powerless to prevent it

Numbness or tingling sensations (especially in the face or fingertips)

Chills or hot flashes

A need to escape

Fear of dying

Causes and Triggers

 

Hereditary

An overly cautious view of the world expressed by parents

Cumulative stress over time

Exposure to a feared entity (insects, snakes, etc.) or feared situation (public speaking, crowded public areas, etc.)

Suffering a personal loss (spouse or lover)

Major life changes (getting married, divorced, buying a home, moving, etc.)

Stimulants (caffeine, nicotine, etc.)

Illicit drugs (marijuana, hallucinogens, etc.)

Prescription drugs (amphetamines, Ritalin, certain antibiotics, etc.)

Rigid avoidance of places and situations that have caused past attacks

Cycle of fear inducing self-talk (“I know I’m going to have another attack”)

Withholding feelings

Mistaken beliefs (that your symptoms are harmful or dangerous)

Lack of assertiveness (i.e. a passive style of communication)

Withdrawal from drugs, alcohol or certain medications

Hyperventilation (can be a cause or a symptom)

Assuming a feared place or entity of a previous attack will bring on a repeated occurrence