Panic Attacks and Symptoms

Woman having anxiety/panic attack

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A panic attack is a sudden and intense feeling of terror, fear or apprehension, without the presence of actual danger. The symptoms of a panic attack usually happen suddenly, peak within 10 minutes and then subside. However, some attacks may last longer or may occur in succession, making it difficult to determine when one attack ends and another begins.

Panic Attacks

One way that panic attacks have been characterized into different types is as follows:

  1. Spontaneous or uncued panic attacks occur without warning or “out of the blue.” No situational or environmental triggers are associated with the attack. These types of panic attacks may even occur during one’s sleep.
  2. Situationally bound or cued panic attacks occur upon actual or anticipated exposure to certain situations. These situations become cues or triggers for a panic episode. For example, an individual who fears enclosed spaces experiences a panic attack when entering, or thinking about entering, an elevator.
  3. Situationally predisposed panic attacks don’t always occur immediately upon exposure to a feared situation or cue, but the individual is more likely to experience an attack in such situations. For example, a person who has a fear of social situations but who does not experience a panic episode in every social situation, or who experiences a delayed attack after being in a social environment for an extended period of time.

DSM-5 Criteria

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), a panic attack is characterized by a “surge of intense fear or intense discomfort that reaches a peak within minutes” and includes four or more of the following symptoms:

  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 hot sensations
  10. Numbness or tingling sensations (paresthesias)
  11. Feelings of unreality (derealization) or being detached from oneself (depersonalization)
  12. Fear of losing control or going crazy
  13. Fear of dying

The presence of fewer than four of the above symptoms may be considered a limited-symptom panic attack.

Does Having a Panic Attack Mean I Have Panic Disorder?

It is important to note that many people may experience a panic attack once, or even a few times during their lives. In order for a diagnosis of panic disorder to be made, one must experience recurring unexpected panic attacks that are not caused by the effects of drugs, alcohol or another medical or psychological condition.

It is possible to have a few isolated panic attacks without recurrence. But, since panic-like symptoms may mimic many other medical and psychological disorders, it is important to review your symptoms with your doctor.

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Article Sources
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  1. Diagnostic And Statistical Manual Of Mental Disorders, Fifth Edition. doi:10.1176/appi.books.9780890425596

  2. Locke AB, Kirst N, Shultz CG. Diagnosis and management of generalized anxiety disorder and panic disorder in adults. Am Fam Physician. 2015;91(9):617-24.

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