Panic Attacks and Panic Disorder

Please note that the information provided on these websites is intended for educational purposes only and is not a substitute for medical advice. If you are experiencing difficulty with any symptoms listed here, please consult with a healthcare provider for proper diagnosis and treatment.

What is a Panic attack?

In the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition), a panic attack is defined as a sudden onset of intense fear or discomfort that reaches its peak within minutes. 

DSM-5 diagnostic criteria for a panic attack include:

A. A discrete period of intense fear or discomfort, in which four (or more) of the following symptoms developed abruptly and reached a peak within minutes:

1. 1. 1. Palpitations, pounding heart, or accelerated heart rate.

      2. Sweating.

      3. Trembling or shaking.

      4. Sensations of shortness of breath or smothering.

      5. Feeling of choking.

      6. Chest pain or discomfort.

      7. Nausea or abdominal distress.

      8. Feeling dizzy, unsteady, lightheaded, or faint.

      9. Chills or heat sensations.

      10. Paresthesias (numbness or tingling sensations).

      11. Derealization (feelings of unreality) or depersonalization (being detached from oneself).

      12. Fear of losing control or "going crazy."

      13. Fear of dying.

B. At least one of the attacks has been followed by 1 month (or more) of one or both of the following:

• • • Persistent concern or worry about additional panic attacks or their consequences (e.g., losing control, having a heart attack, "going crazy").

    • A significant maladaptive change in behavior related to the attacks (e.g., avoiding exercise or unfamiliar situations).

C. The panic attacks are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g., hyperthyroidism, cardiopulmonary disorders).

D. The panic attacks are not better explained by another mental disorder, such as social anxiety disorder, specific phobia, obsessive-compulsive disorder, or separation anxiety disorder.

 

What's the difference between a panic attack and panic disorder?

Panic attacks and panic disorder are related but distinct concepts in clinical psychology:

A panic attack is a discrete episode of intense fear or discomfort that arises suddenly and reaches its peak within minutes. It's characterized by a cluster of physical and cognitive symptoms, such as palpitations, sweating, trembling, feelings of choking or smothering, chest pain, fear of losing control or dying, and others, as outlined in the DSM-5 criteria. Panic attacks can occur in various mental disorders, such as panic disorder, social anxiety disorder, specific phobias, and others, but they can also happen in individuals without any underlying mental health condition.

Panic disorder is a specific psychiatric disorder characterized by recurrent, unexpected panic attacks. In addition to experiencing panic attacks, individuals with panic disorder often worry about having future attacks, fear the consequences of the attacks, and may change their behavior to avoid situations or triggers associated with panic attacks. Diagnosis of panic disorder requires the presence of recurrent panic attacks along with significant worry or behavioral changes related to the attacks, as outlined in the DSM-5 criteria.

 

Panic Disorder

As described above, panic disorder is a type of anxiety disorder characterized by recurrent and unexpected panic attacks. Panic attacks are episodes of intense fear or discomfort that typically reach a peak within a few minutes and are accompanied by physical symptoms such as heart palpitations, sweating, trembling, shortness of breath, and feelings of dread or impending doom. People with panic disorder often worry about having another panic attack and may change their behavior to avoid situations or triggers that they associate with panic attacks.

DSM-5 diagnostic criteria for panic disorder:

1. Recurrent unexpected panic attacks

2. At least one of the attacks has been followed by one month (or more) of one or both of the following:

   • Persistent concern or worry about additional panic attacks or their consequences (e.g., losing control, having a heart attack, “going crazy”)

   • Significant maladaptive change in behavior related to the attacks (e.g., avoiding exercise or unfamiliar situations)

3. The panic attacks are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism).

4. The panic attacks are not better accounted for by another mental disorder (e.g., social anxiety disorder, phobia, PTSD).

 

Treatment for Panic

Psychological treatment for panic disorder typically involves cognitive-behavioral therapy (CBT) and/or exposure therapy.

CBT helps individuals to understand and challenge the negative thoughts and beliefs that contribute to their anxiety and panic attacks. This may involve learning relaxation techniques, identifying and changing negative thought patterns, and gradually facing feared situations in a safe and controlled way.

Exposure therapy involves gradually exposing individuals to the situations or triggers that they fear, in a structured and supportive environment. This helps them to learn that they can tolerate the anxiety and discomfort that they experience, and that their fears are often exaggerated or unfounded.

Other psychological interventions that may be helpful for panic disorder include mindfulness-based approaches, acceptance and commitment therapy (ACT), and psychodynamic therapy. In some cases, medication may also be prescribed in conjunction with psychological treatment.

 

Ten things you can try if you are interested in managing panic 

1. Seek professional help: If you suspect you may have panic disorder, it is important to seek professional help from a mental health provider. They can provide an accurate diagnosis and recommend appropriate treatment options.

2. Learn about panic disorder: Understanding what panic disorder is and how it affects you can help you manage the symptoms more effectively.

3. Practice relaxation techniques: Relaxation techniques such as deep breathing, progressive muscle relaxation, and mindfulness can help you reduce anxiety and manage panic attacks.

4. Exercise regularly: Regular exercise can help reduce anxiety and improve your overall physical and mental health.

5. Practice good sleep habits: Getting enough sleep and maintaining good sleep hygiene can help reduce anxiety and improve your mood.

6. Avoid caffeine and other stimulants: Stimulants such as caffeine, nicotine, and energy drinks can worsen anxiety and trigger panic attacks.

7. Avoid alcohol and recreational drugs: Alcohol and recreational drugs can also worsen anxiety and trigger panic attacks.

8. Identify and avoid triggers: Pay attention to situations or activities that tend to trigger your panic attacks and avoid them or prepare for them in advance.

9. Join a support group: Joining a support group can provide you with a sense of community and help you feel less alone in your struggle with panic disorder.

10. Practice self-care: Take care of yourself by engaging in activities that bring you joy and relaxation, such as hobbies, spending time with loved ones, or taking a bath. Taking care of yourself can help you manage stress and reduce anxiety.