Many forms of anxiety exist, one of which comes "out of the blue," not connected with any particular event. This free-floating or unexplained anxiety is separate from situational or phobic anxiety, according to Edmund Bourne, Ph.D., author of "The Anxiety and Phobia Workbook," who has more than20 specializing in the treatment of anxiety. The diagnostic terms for this type of anxiety include panic attack or panic disorder.
Robert Leahy, Ph.D., who has 25 years treating anxiety, and is the author of "Anxiety Free Unravel Your Fears Before They Unravel You," says panic disorder, like the rest of the anxiety disorders, comes from our evolutionary history. In other words, the sense of panic, the thoughts it evoked and physical reactions it produced served a purpose: keeping humans alive.
Nearly all situations that trigger a panic attack, such as heights, closed spaces and being crushed in a crowd link back to primitive dangers. For example, looking down off a tall bridge evokes a natural dizziness from heights. In prehistoric days, this response helped to keep ancestors away from cliffs they could fall off of and cause their death.
Bourne says symptoms of a panic attack include shortness of breath, pounding or racing heart, faintness or dizziness, trembling, feeling of choking, sweating, nausea, feeling of unreality, numbness or tingling in extremities, hot and cold flashes, chest pain, fears of losing control or going crazy and fears of dying. Diagnosis of a full-blown panic attack requires presence of four symptoms. A limited-symptom attack has three or fewer symptoms.
Diagnosis of panic disorder, according to Dr. Bourne, occurs following two panic attacks, and one month or more of worry that another attack will occur.
Panic attacks typically peak within 10 minutes, though some symptoms can linger. Panic attacks can occur during wakeful and sleeping hours, according to the NIMH.
Leahy says evidence suggests that your first panic attack tends to happen after the loss of a relationship, illness, increased responsibilities, hangover, drug withdrawal or fatigue. Finding the cause of a panic attack usually does not happen. The lack of knowing where the panic attack came from leads to more anxiety. You fear panic strikes without warning, and believe when it does it will debilitate you.
According to Dr. Bourne, a large number of medical conditions can cause panic attacks, including various cardiac conditions, hypogylcemia, hyperventilation syndrome, imbalance in hormones, PMS, pulmonary conditions and deficiencies in certain vitamins or minerals.
According to the NIMH, panic disorder is one of the most treatable of all the anxiety disorders. Bourne says treatment can include any or all of the following: relaxation training, panic-control therapy, interoceptive desensitization--getting used physical symptoms of panic--as well as medications and lifestyle changes, such as monitoring and challenging anxiety provoking thoughts.
To begin treatment, the NIMH recommends you first see your family doctor. The doctor can investigate whether the cause of your symptoms is due to anxiety and medical condition, or both.
The next step to finding treatment, according to NIMH, involves seeing a mental health practitioner, such as a licensed psychologist or social worker. The practitioner can provide behavioral therapy.
Panic Disorder can lead to another type of anxiety disorder, agoraphobia. To manage the panic attacks, a person may begin to avoid leaving the home unless accompanied by a "safe person," or may avoid leaving the home altogether. Everyday activities, such as shopping, attending school or going to work, become impossible.
According to the NIMH, treating the panic disorder early plays a role in preventing agorophobia.
Panic disorder often occurs with other behavioral health issues, including depression, drug abuse or alcoholism. These issues will need treatment along with the panic attacks, according to the NIMH.
- "The Anxiety & Phobia Workbook"; Edmund J. Bourne, Ph.D.; 2000
- "Anxiety Free Unravel Your Fears Before They Unravel You"; Robert L. Leahy, Ph.D.; 2009
- NIMH: Panic Disorder