Panic Attack

Panic Attack

Out of the other anxiety-related problem, anxiety attack or panic attack can be the most startling of them all. Panic attack is characterized by sudden rush of fear and panic happened toward someone, sometimes without any premonition or trigger at all. Panic attack doesn’t last long, typically it happens between 10-20 minutes, and only in very rare cases it can go over an hour.

However, the short time of the attack doesn’t lessen the severity of the attack. Panic attack sometimes leaves one into a debilitating, paralyzed, freezing state where she is unable to connect with the outside world until the attack passes. The severity sometimes even causes those who experience it to think that they suffer from heart attack instead of anxiety attack. Sometimes, they think that they are dying or going crazy from the overwhelming fear they feel.

Emotionally healthy people experience panic as well, especially when they face a new situation or face their fear. They will freeze and unable to do what they are supposed to do for a short time. For example, it is normal for people to freeze for several seconds before they attempt to cross a rope bridge or to jump when they do bungee jumping.

However, several people experience recurring panic attack, and sometimes they even happen without any warning or trigger beforehand. The attack can happen anywhere, anytime and at any situation, from when one is shopping, walking in the street, driving, or even when sleeping. Not only it disturbs one’s daily life, but it can be dangerous as well. Sometimes, it also affect one’s self esteem, because when panic attack comes, she will show her vulnerable side to other people.

Left untreated, this can lead to panic disorder. Panic disorder is a condition where not only one experience recurring panic attack, but also undergo behavioral change in regard to her panic. When it has come to this point, then one really should actively seek professional treatment.

If you have recurring panic attack, you don’t have to worry too much about it because it is treatable through therapy and medication. The first thing you have to do is to learn everything about panic attack from various resources, so you know what you are dealing with. The next step is to get diagnosed whether you really have panic disorder or not, and when it is confirmed that you are, the next step is to get treatment. During the treatment from professional, you can actively do some self-help actions to accelerate your healing process.

This page contains basic information you will need to know about panic attack, from the symptoms, diagnosis, treatment options, self-help actions, as well as further resources and references.

Signs or Symptomps

How do you know that you are experiencing panic attack instead of normal fear?

To help you distinguish whether your panic attack comes from a disorder or just a normal fear reaction toward a situation, look at the list below. They are the signs or symptoms of panic attack. Panic attack itself is psychological, but its symptoms show up in one’s physical body as well, to the point that people often think their panic attack is a heart attack.

Emotional Symptoms

  • Mind suddenly goes blank, unable to process anything except the fear
  • Unable to recognize the environment
  • Feeling unreal and detached
  • Feeling crippling fear, as if you’re dying or going crazy

Physical Symptoms

  • Pounding heart
  • Sweating
  • Breathing difficulty or hyperventilation
  • Dizzy, light headed
  • Chest pain
  • Trembling
  • Nausea, upset stomach, vomiting
  • Hot or cold flashes

How to differentiate between heart attack and panic attack?

When the attack passes, think again of the experience and rule out the possibility of it is being heart attack. Do you have any history of heart disease, chest pain, or heart palpitation? Is your physical condition prone to heart attack (for example, you are overweight or have genetically weak heart)? If you do, then checking yourself to the doctors for the possibility of heart attack is recommended, as well as checking yourself to psychologist.

Panic Disorder

Untreated recurring panic attack can lead someone to develop panic disorder. Panic disorder happens when someone does not only experience recurring panic attack, but changes her behavior toward panic as well. She becomes more cautious and anxious toward the possibility of the next panic attack.

Panic disorder happens after recurring panic attack as one starts to think that she will experience the attack again in the future. With this knowledge, her anxiety adds up and she starts to get worry and anticipate the next panic attack.

This worrying also creates change in her behavior. There are two behaviors that she may develop, they are anticipatory anxiety and phobic avoidance.

Anticipatory Anxiety

You are supposed to relax once your panic attack passes. Relaxing will help you to be less anxious. However, when you have panic disorder, your anxiety never leaves your body even after you physically recover after an episode of panic attack. In your mind, you know that you will experience this panic attack again, anytime, anywhere. You don’t want to feel like that again, so you will start anticipating the coming of your next anxiety attack.

However, this anticipation is somewhat useless, because the panic attack doesn’t happen due to certain trigger, so you will end up draining yourself for no apparent reason. You will feel tense and jittery even during the days when your panic attack doesn’t happen.

Phobic Avoidance

Avoidance behavior is a common behavior to be found in every type of anxiety disorder. Subconsciously, you are trying to avoid experiencing the same panic attack by avoiding the situation or places where you’ve experienced those attacks before. If you had a panic attack in a nearby mart, you will start to shop in a farther mart to avoid the place. If you had a panic attack during driving, maybe you will start hire a driver or ask someone else to drive your car.

However, similar to anticipatory behavior, this trick doesn’t really work because unlike specific phobia, your panic attack isn’t triggered by something specific. Instead, it appears anywhere and anytime it likes. So, avoiding situation and places doesn’t really help. All it does is disturbing your daily life.


A question that everyone who suffers from panic attack most often asks to themselves is why. Specifically, why does this happen to me?

There are various reasons for it, and each reason is personal. However, we can categorize them into three factors: environmental factors, medical factors, and genetic.

Environmental factors can affect how you feel in a lot of ways. Several environmental factors that can cause anxiety are listed below.

  • Traumatic events (abuse, violence, hostage situation, near-death situation)
  • Stress in relationship with other people such as spouse, children, family, friends, or colleague
  • Stress from work or school
  • Stress about economical life and finance
  • Stress from accident or natural disaster

Medical factors can also cause anxiety in variety of ways, for example:

  • Natural association from several illness such as heart mitral valve prolapsed, hyperthyroidism, and hypoglycemia
  • Stress from serious, life threatening or disabling illness
  • As side effect from medication withdrawal
  • As symptom from another medical illness

Some research finds out that genetic also has a role in causing anxiety, but the research is still not extensive yet.

However, from the list above, it is clear that most of the causes, whether from environmental or medical factor, come from the stress.


To get the accurate diagnosis whether you have panic attack or panic disorder, you should go to your doctor or health provider and ask them to run a test for you. While you request the test, they may ask you to do either one of these or all of them: complete physical exam, blood test, electrocardiogram, and psychological evaluation in order to give you the most accurate diagnosis.

Not everyone who has panic attacks has a panic disorder. When you only experience panic attack once in a random year, then you may have panic attack but not panic disorder. To be qualified as having panic disorder, you should fulfill the three conditions of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association. They are:

  • Frequent, unexpected panic attacks.
  • The panic attack isn’t caused by drugs or other harmful substance, not as side effect from medication, not a medical condition or another mental health condition.
  • At least one of the attacks has been followed by one month or more of worry of having another attack as well as fear of the consequences of an attack, such as losing control, having a heart attack, feeling like going crazy, or significantly changing your behavior.

If you are not diagnosed with panic disorder and only diagnosed with panic attack, it is still better for you to continue the treatment. Left untreated, panic attack can occur more often and lead you into panic disorder.


There are two major treatments psychologist use to treat anxiety. The first one is therapy, and the second is medication. Therapy is more recommended because they are effective and non-intrusive, therefore it doesn’t leave any side effect toward the body. However, in the case that therapy only is not enough, psychologist will recommend medication or the mix of both.

The psychologist’s choice of therapy is usually behavioral therapy. It means that the therapy will focus to form a better behavior for the patient in coping with their anxiety, instead of trying to find out the root of the anxiety itself. Furthermore, there are two types of behavioral therapy that are widely used to treat anxiety. They are Cognitive-Behavioral Therapy and Exposure Therapy.

CBT (Cognitive-Behavioral Therapy)

In CBT, the therapist will guide you to learn the connection between your feeling, your mind, and your behavior and how the interaction of these factors will create a thought pattern inside your mind. When you have an anxiety disorder, your thought pattern shows connection between a certain situation you are afraid of and your anxiety. With the guide from your therapist, you will break this thought pattern down and build a new one, where such connection don’t exist.

Exposure Therapy

While CBT is effective for almost every type of anxiety disorder, exposure therapy works especially well with phobia. Just like the name suggest, in exposure therapy you will be exposed toward your very own fear. The exposure will be done gradually in order to avoid shock. The idea of the therapy is so you can have a proof that your fear won’t be able to harm you, therefore you lose any reason to fear it anymore.

Self Help

Panic attack is the manifestation from anxiety that builds up in your mind. What you can do to help yourself is by relieving those anxiety and worry through various self-help methods and techniques. In the list below, there are various thing you can do by yourself to cope with your anxiety.

Ask For Help

It is important to seek help when you have panic attack. When panic attack happens, usually you will feel detached from your surrounding, so having another person to help you whether during or after the attack will be so much of a help. Tell your immediate family first about your condition and what you are going through. Ask them to support you and help you throughout the recovery period. Once you are comfortable to tell other people, you can join support group.

Learn Relaxation Techniques

Panic attack happens in unpredictable manner, therefore learning a few of relaxation techniques can be a tremendous help when you start detecting the presence of panic attack. Some of the recommended techniques that have been scientifically proven are guided imagery, breathing technique, as well as mindfulness meditation. Learn them from professional by joining classes or learn by yourself using free resources from the book or internet.

Physical Exercise

Physical exercise releases certain hormones that can make you relaxed and happy, which in turn will help you to be less anxious as well. Experts agreed that 30 minutes a day is the recommended time to spend for physical exercise. You can break it into several shorter sessions to fit into your packed schedule.

Quality Sleep

Surprisingly, many people don’t know how much a good sleep can help reduce stress and anxiety as well. Lacking sleep can exacerbates your negative thought and worrying. Experts agree that adult needs seven until nine hours of sleep to get their system fully restored the next day. If you have difficulty sleeping, check our resource for better sleep in the References and Resources below.

Positive Thinking

Anxiety can be caused by being overly worried over certain situation. This can be exacerbated by negative thinking, when you keep going over and over again how things will certainly go wrong and how you aren’t capable to handle that. You should stop negative thinking and aim for positive thinking instead. Learn to always see that the outcome of situation always have two outcomes, positive and negative, instead of only negative. Using positive thinking, you can learn to stop worrying and therefore stop getting overly anxious as well.

More Help

When you have already done all the lists in the self help and you find your anxiety still remains, then maybe your anxiety is more severe than you think. In this case, you should contact professionals to help you treat this anxiety. Professionals will have license to prescribe you the right medication, as well as have ability to perform therapy on you.


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