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Panic

What is a Panic Attack?

A panic attack is a discrete period of intense fear that occurs in the absence of real danger with four or more of the following symptoms: an increased heart rate, sweating, trembling or shaking, shortness of breath, feeling like you are choking, chest pain, nausea, feeling dizzy, feelings of unreality or being detached from oneself, fear of going crazy, fear of dying, numbness, and/or chills or hot flashes.

There are three types of panic attacks:

  1. Unexpected (uncued) panic attacks (i.e., those that occur "out of the blue");
  2. Situationally bound (cued) panic attacks (i.e., these almost always occur immediately in anticipation of, in response to, or during an exposure to certain situations);
  3. Situationally predisposed panic attacks (i.e., these tend to-but don't always-occur in conjunction with certain situations).

Those suffering from Panic Disorder experience recurrent, unexpected panic attacks followed by at least one month of persistent concern about having another attack, worrying about the meanings or consequences of the attacks (e.g., "I'm going crazy"), and/or significant changes in behavior related to the attacks. These panic attacks are not due to the direct effects of a substance (e.g., caffeine) or a general medical condition (e.g., hyperthyroidism). In terms of variable diagnoses, panic disorder either occurs as "Panic Disorder Without Agoraphobia" or "Panic Disorder With Agoraphobia".

For specific treatment options, please refer to the “Anxiety – General Symptoms” table

Examples of Panic

Panic Disorder with Agoraphobia

Jen is a 13-year-old eighth grader with a history of both unexpected (uncued) panic attacks and situationally induced panic attacks. She suffers from a panic attack or similar symptoms approximately 3 - 4 times per week. During these panic attacks, Jen perspires, shakes, feels as if she were suffocating, feels dizzy, and fears that she is dying or "going crazy". Jen often worries about having future panic attacks and has developed a great deal of worry about going to public or crowded places. Jen hates riding on airplanes or buses, eating in the cafeteria or a restaurant, and going to concerts or parties because she worries that a panic attack in these places will be horribly embarrassing and escape will be difficult. Although Jen sometimes regrets missing out on a lot of fun activities with her friends and family, she usually feels as though it is not worth the risk of "being trapped" if her symptoms reappear.

Panic Disorder without Agoraphobia

Joan is a 16-year-old high school junior who suffers from approximately 5 - 7 unexpected (uncued) panic attacks per week. These panic attacks started about two years ago and, ever since, she has constantly worried about having additional panic attacks. During a panic attack, Joan's experiences a number of unpleasant bodily sensations, including perspiration, trembling, numbness, and hot flashes. She fears she is going to die and sometimes feels as if she has become detached from her own body. Joan does not worry particularly about having these symptoms in crowded places; her worry instead focuses more on the panic attack themselves and their repercussions.

 

 
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