Published: 18 Jun 2025

ICD9: 300.01      ICD10: F41.0      ICD11: MB23.H

"Anxiety, Panic Attack" is a term that refers to a sudden episode of intense fear or discomfort that reaches a peak within minutes and includes a range of physical and psychological symptoms.
It's often used interchangeably with "panic attack," and the two terms describe the same phenomenon.

Here's a breakdown of what constitutes a panic attack and the role of anxiety:

Understanding Anxiety and Panic

Anxiety: A normal human emotion characterized by feelings of worry, nervousness, or unease, typically about an event or something with an uncertain outcome. It can be mild to severe and is a response to perceived threats. General anxiety can be persistent and ongoing.

Panic Attack: A sudden surge of intense fear or discomfort that comes on abruptly and reaches a peak within minutes. It is often described as feeling like you're losing control, having a heart attack, or about to die. It is distinct from general anxiety in its suddenness, intensity, and specific physical symptoms.

Key Characteristics of a Panic Attack

A panic attack is diagnosed when four or more of the following symptoms are present:

Physical Symptoms:
Palpitations, pounding heart, or accelerated heart rate
Sweating
Trembling or shaking
Shortness of breath or feeling of being smothered
Feelings of choking
Chest pain or discomfort
Nausea or abdominal distress
Feeling dizzy, unsteady, lightheaded, or faint
Chills or heat sensations
Numbness or tingling sensations (paresthesias)

Psychological Symptoms:
Derealization (feelings of unreality) or depersonalization (feeling detached from oneself)
Fear of losing control or "going crazy"
Fear of dying

Important Distinctions:

Panic Disorder: Having recurrent, unexpected panic attacks followed by at least one month of persistent worry about having more attacks or significant maladaptive change in behavior related to the attacks. Not everyone who has a panic attack has panic disorder.

Panic Attacks Can Occur in Other Anxiety Disorders: Panic attacks are not exclusive to panic disorder. They can also occur in:
Social Anxiety Disorder
Specific Phobias
Generalized Anxiety Disorder (GAD)
Post-Traumatic Stress Disorder (PTSD)
Obsessive-Compulsive Disorder (OCD)

Unexpected vs. Expected Panic Attacks:
Unexpected (uncued) panic attacks: Appear to occur without a clear trigger. They seem to come "out of the blue." These are more characteristic of panic disorder.
Expected (cued) panic attacks: Are triggered by a specific situation or object, like public speaking for someone with social anxiety, or seeing a spider for someone with a spider phobia.

Causes and Triggers

The exact cause of panic attacks and panic disorder is not fully understood, but it is likely a combination of:

Genetics: A family history of anxiety disorders increases the risk.
Brain Chemistry: Imbalances in neurotransmitters (like serotonin, norepinephrine, and GABA) may play a role.
Temperament: Some people are simply more prone to anxiety and negative emotions.
Stressful Life Events: Significant life stressors, trauma, or major changes can trigger panic attacks.
Medical Conditions: Certain medical conditions (like thyroid problems, heart conditions, or respiratory illnesses) can sometimes mimic or trigger panic attacks. It's important to rule out medical causes.
Substance Use/Withdrawal: Alcohol, drugs, and withdrawal from certain substances can induce panic attacks.
Specific Triggers: For some people, panic attacks may be triggered by specific places, situations, or sensations.

When to Seek Help

It is crucial to seek professional help if you are experiencing panic attacks, especially if:

They are recurrent.
You are worried about having more attacks.
You are changing your behavior to avoid situations that you fear might trigger an attack.
The attacks are interfering with your daily life, work, or relationships.
You have thoughts of harming yourself.

Treatment Options

Effective treatments for panic attacks and panic disorder include:

Therapy:
Cognitive Behavioral Therapy (CBT): Helps identify and change negative thought patterns and behaviors that contribute to panic. Exposure therapy, a component of CBT, helps gradually confront feared situations or sensations.
Panic-Focused Psychodynamic Psychotherapy (PFPP): Explores underlying emotional conflicts and relationship patterns that may contribute to panic.

Medication:
Selective Serotonin Reuptake Inhibitors (SSRIs): Antidepressants commonly used to treat panic disorder.
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): Another class of antidepressants.
Benzodiazepines: Anti-anxiety medications that can provide rapid relief but are generally used short-term due to the risk of dependence.

Lifestyle Changes:
Regular exercise
Stress management techniques (yoga, meditation, deep breathing)
Avoiding caffeine and alcohol
Getting enough sleep

In summary, 'Anxiety, Panic Attack' refers to a sudden episode of intense fear accompanied by physical and psychological symptoms. It is important to seek professional help if you are experiencing these attacks to get an accurate diagnosis and develop an effective treatment plan.