Panic attack

What is it

A panic attack is an episode of intense malaise that appears suddenly, with or without warning, and lasts an average of 10-20 minutes. In the so-called “panic disorder” the individual attacks are repeated over time.

Attacks are sudden, unexpected and, often, recurrent and, in most cases, are associated with the fear of being in places or situations from which it may be difficult to get away or in which you can not be rescued (agoraphobia).

Panic attacks are more frequent in women.

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Most common symptoms

The malaise is accompanied by anxiety and other symptoms such as palpitations, sweating, tremor, nausea, hot flashes, chills, chest tightness, difficulty breathing.

Due to the presence of these symptoms, often those suffering from panic attacks go to the emergency room with the fear of having a cardiovascular problem (especially a heart attack).

It is often associated with fear of dying, of going crazy or of losing control of one’s actions, and a momentary alteration of the perception of the surrounding environment may appear, as if one were living in an unreal world, or of oneself, as if one were detached from one’s thoughts or one’s body.

The recurrence of panic attacks can be the cause of “anticipatory” anxiety, that is, the fear that the attacks may be repeated, so that the sufferer is often tense or anxious even during the intervals between individual attacks.

Causes

As for the causes it is believed that there is a hereditary predisposition on which environmental and psychological factors act.

Often the attacks appear in crowded places such as cinemas, supermarkets or public transport, as well as in large spaces without a known and trusted person by their side.

Some substances, such as caffeine and some substances of abuse such as cocaine, amphetamines and cannabis, as well as withdrawal from drugs such as benzodiazepines and opioids, can also contribute to triggering the disorder.

Treatment

Generally, panic attacks respond well and quickly to medication, while some complications, such as agoraphobia, respond better to psychotherapy.

Only when panic attacks tend to occur sporadic can benzodiazepines be used, which must necessarily be prescribed by a psychiatrist.

In cases where the disorder is more severe, serotonin reuptake inhibitors (SSRIs) are used first, or tricyclic antidepressants, which are also prescription drugs.

Cognitive-behavioral psychotherapies, based on gradual exposure to feared situations, are useful in case of agoraphobia.

If treated properly, the disorder can regress completely.

When to consult your doctor

If the panic attack does not remain an isolated episode, it is always good to contact the doctor because, in addition to the discomfort of the attack itself and anticipatory anxiety, there is a tendency of the disorder to become chronic and evolve towards more complex disorders, in which depression, social phobia or hypochondria are associated and overlapped.