What causes panic attacks? (A brief guide)

What causes panic attacks? (A brief guide)

In this guide, we will discuss “What causes panic attacks”, what is considered a panic attack, risk factors associated to panic attacks, symptoms of a panic attack, treatment options for panic disorder, 

What causes panic attacks?

There may be many potential causes or factors that can contribute to increasing the risk of developing a panic attack or panic disorder. For instance, family history of panic attacks, major life stressors or events such as the death of a loved one, getting divorced, serious illness of a loved one or being chronically ill, being sexually assaulted or having a serious accident, etc.

Moreover, according to the Mayo Clinic, It’s not known what causes panic attacks or panic disorder, but these factors may play a role:

  • Genetics
  • Major stress
  • The temperament that is more sensitive to stress or prone to negative emotions
  • Certain changes in the way parts of your brain function

“Panic attacks may come on suddenly and without warning at first, but over time, they’re usually triggered by certain situations”, this is why panic attacks are associated with being unexpected and occurring ‘out of the blue’. 

What is a panic attack?

As indicated by Smith, Robinson, and Segal (2019) from Helpguide.org, “A panic attack is an intense wave of fear characterized by its unexpectedness and debilitating, immobilizing intensity. Your heart pounds, you can’t breathe, and you may feel like you’re dying or going crazy. Panic attacks often strike out of the blue, without any warning, and sometimes with no clear trigger. They may even occur when you’re relaxed or asleep.”

What causes panic attacks? (A brief guide)

Moreover, consider how you could have just one or two panic attacks in your life while other people experience repeated episodes, which is known as panic disorder.

In contrast, you may not know you are experiencing a panic attack the first time but you may think you are having a heart attack due to the symptoms such as chest pain, difficulty breathing, or heart palpitations. However, panic attacks are not dangerous, it is important to visit your doctor so they can rule out any possible medical underlying condition. 

For instance, your doctor could potentially find:

  • Mitral valve prolapse.
  • Hyperthyroidism.
  • Hypoglycemia.
  • Stimulant use such as amphetamines, cocaine, or caffeine.
  • Medication withdrawal. 

Risk factors associated with panic attacks

Some of the risk factors associated with the risk of occurrence of panic attacks are the following, according to the Mayo Clinic: 

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Panic attacks (Know the signs) video

  • Family history of panic attacks or panic disorder
  • Major life stress, such as the death or serious illness of a loved one
  • A traumatic event, such as sexual assault or a serious accident
  • Major changes in your life, such as a divorce or the addition of a baby
  • Smoking or excessive caffeine intake
  • History of childhood physical or sexual abuse

Symptoms of a panic attack

According to the NHS, “A panic attack is when your body experiences a rush of intense mental and physical symptoms. It can come on very quickly and for no apparent reason.”

Symptoms include the following:

  • a racing heartbeat
  • feeling faint
  • sweating
  • nausea
  • chest pain
  • shortness of breath
  • trembling
  • hot flushes
  • chills
  • shaky limbs
  • a choking sensation
  • dizziness
  • numbness or pins and needles
  • dry mouth
  • a need to go to the toilet
  • ringing in your ears
  • a feeling of dread or a fear of dying
  • a churning stomach
  • a tingling in your fingers
  • feeling like you’re not connected to your body

In terms of the duration of the episodes, they have been indicated to last between 5 and 20 minutes. However, some people may have reported their panic attacks to last up to an hour.

What causes panic attacks? (A brief guide)

Moreover, the severity of your condition can determine the frequency of the panic attacks, where some people may experience attacks once or twice a month while others have reported to have them several times during the week.

As the NHS indicates, “Although panic attacks are frightening, they’re not dangerous. An attack won’t cause you any physical harm, and it’s unlikely that you’ll be admitted to hospital if you have one.”

Treatment options for panic disorder

Treatment targets the number of panic attacks you can have and ease your symptoms. This is why you will find mostly psychological therapies, medicine, or a combination of both when talking about how to treat panic attacks.

The most common psychological therapy is based on cognitive behavioral therapy or CBT. The therapist will guide you and discuss with you on how to react and what comes to your mind when you are having a panic attack. Moreover, your therapist can teach you ways or techniques to be used when having a panic attack, such as deep breathing or relaxation techniques.

In contrast, your doctor may consider you need medication so they can prescribe a type of antidepressant called selective serotonin reuptake inhibitor or SSRI, or if they can’t be prescribed to you, they will try with a tricyclic antidepressant which is usually imipramine or clomipramine. The most common SSRIs prescribed are fluoxetine, paroxetine, and sertraline.

What causes panic attacks? (A brief guide)

In addition, they could also prescribe an anti-epilepsy drug such as pregabalin or if your anxiety is severe, they can prescribe clonazepam. Even if antidepressants won’t work immediately, they can take between 2 to 4 weeks before you can see the effects and 8 weeks for you to fully see the benefits so keep taking them even if you consider they are not working and avoid stopping them without consulting with your GP first.

Long term expectation

It is known that panic disorder is a long-term chronic condition that can become difficult to treat since a lot of people do not respond well to the treatment. Some people may have periods where they have no symptoms at all and other periods where the symptoms present themselves severely and with intensity.

It has been reported that most people with panic disorder may experience some symptom relief after starting the treatment, through psychotherapy, medicine or the combination of both.

Can panic disorder be prevented?

As indicated by Darla Burke from healthline.com,  “It may not be possible to prevent panic disorder. However, you can work to reduce your symptoms by avoiding alcohol and stimulants such as caffeine as well as illicit drugs. It is also helpful to notice if you are experiencing symptoms of anxiety following a distressing life event. If you are bothered by something that you experienced or were exposed to, discuss the situation with your primary care provider.”

However, we know there are many useful techniques that can help in the relief of the symptoms associated with panic attacks. Moreover, educate yourself on panic and anxiety, avoid smoking, alcohol and caffeinated beverages (i.e. coffee, energy drinks, tea). In addition, learning how to control your breathing can become quite useful for some. Little tips such as the ones we have mentioned can make quite a difference when experiencing panic attacks, try them out and see which one is better for you.

What causes panic attacks? (A brief guide)

Why is this blog about What causes panic attacks important?

It would be ideal if we could find what causes panic attacks so we could treat the condition better but most of the time there is no obvious trigger we can recognize as the responsible for the panic attack. However, we have mentioned some of the factors, causes and risks someone can be exposed to that could increase the probability of developing panic attacks.

Moreover, we discussed what a panic attack is and the symptoms since many people will believe at first there is something physically wrong with them or how they will die at any moment. Knowing the signs and symptoms can help to address it as soon as possible such as finding ways to cope and manage stress in our lives or major life events that could affect us deeply.

Please feel free to leave any comments or thoughts about the content of this article!

Frequently Asked Questions (FAQs) about What causes panic attacks

What causes panic attacks for no reason?

Panic attacks can be caused for many reasons but sometimes we don’t specifically know the exact reason. However, severe stress such as going through the loss of a loved one, getting divorced, losing your job, having a child, etc., can be responsible for panic attacks. Moreover, there could be medical conditions and other physical causes that can be associated with panic attacks.

How do you treat panic attacks?

Panic attacks or panic disorder are generally treated with psychotherapy, medication, or a combination of both. However, discuss your options with your doctor and decide which one is the best option for you. In terms of psychotherapy, cognitive behavioral therapy or CBT has been proven to be useful as a first-line treatment for panic disorder.

What is the difference between a panic attack and an anxiety attack?

The main difference between a panic attack and an anxiety attack is, the panic attack doesn’t necessarily have a determined or evident stressor, which makes it unprovoked and unpredictable and more intense, while an anxiety attack is short-lived and when the stressor goes away, so does the anxiety attack. Moreover, the anxiety attack has a particular characteristic, unlike the panic attack, the anxiety builds up gradually and does not occur suddenly or unexpectedly and the panic attack does.

How long does it take to recover from a panic attack?

A panic attack can last between a couple of minutes up to 30 minutes but the recovery can take a bit more time. When you have a panic attack it can feel like a lifetime, the symptoms will usually peak after 10 minutes and then they begin to fade away. However, it is possible to have panic attacks that are long and others that are short.

How do you know it’s an anxiety attack?

There are certain symptoms that may indicate you are having an anxiety attack such as:

  • Having a feeling of overwhelming panic.
  • Feeling of losing control or going crazy.
  • Head palpitations.
  • Chest pain.
  • Rapid breathing rate (hyperventilation).
  • Feeling like fainting.
  • Trembling or shaking.
  • Hot flashes or chills.

References 

Nhs.uk: “Panic Disorder”

Smith, M., Robinson, L. and Segal, J. (2019, Oct.) Retrieved from helpguide.org.

Markha, M. (n.d.) Panic attacks and Panic Disorder. Retrieved from mayoclinic.org.

Burke, D. (2018, Aug.) Panic Disorder. Retrieved from healthline.com.

What causes panic attacks? (A brief guide)

Daniela Paez

Daniela Paez is a Clinical Psychologist with an MSc. In Clinical Neuropsychology from Bangor University. She has vast experience in working with children with disabilities, adolescents and their families, in extreme conditions of poverty and vulnerability. Additionally, she owns a private practice where she provides neuropsychological evaluation for children and adults, and treatment for mood disorders, anxiety, couple therapy, among other conditions.