Panic attack and anxiety: a complete guide

A panic attack is an intense episode of fear that can occur suddenly, often without a clear cause. A panic attack is a severe form of anxiety and often causes physical symptoms such as a racing heart, sweating, shaking, and feelings of breathlessness. A panic attack can also cause emotional distress, including severe fear and a sense of losing control. While panic attacks can affect anyone, they are particularly common in individuals with anxiety disorders.

What is anxiety?

Anxiety is a normal emotion that everyone experiences. It involves feelings of tension, worried thoughts, and can even affect your body, making your heart beat faster, for example. It originally helped humans survive by making them alert to danger, but too much anxiety can start to interfere with daily life, signalling an anxiety disorder.

Types of anxiety disorders

Anxiety disorders are some of the most common mental health problems around the world. Each type involves a lot of fear and worry, but they each have their own specific symptoms. Here’s a brief look at the main types of anxiety disorders:

• Generalised anxiety disorder (GAD): generalised anxiety disorder is when someone feels worried almost all the time about everyday things, whether they’re big or small. People with GAD often can’t control this worry, and it might make them feel overwhelmed when doing daily tasks like going to work or managing household chores.
• Social anxiety disorder: this disorder makes someone extremely scared of social situations where they might have to interact with others or perform in front of them. They worry a lot about being embarrassed or judged by others. This fear can be so strong that they might avoid going to parties, speaking up in groups, or even just talking to new people.
• Specific phobias: a specific phobia is a very strong fear of a particular thing or situation that usually isn’t dangerous, like spiders, heights, flying, or getting an injection. This fear can cause a person to avoid normal situations to stay away from whatever they are scared of.
• Panic disorder: panic attacks are sudden and intense episodes of fear that can happen without warning. These are so severe that they can feel like a heart attack. Symptoms during a panic attack can include:
  • A racing or pounding heartbeat
  • Sweating
  • Shaking
  • Feeling short of breath or choked
  • A fear of disaster or losing control even when there is no real danger
  • Feeling detached from reality
  • Numbness or tingling sensations

These symptoms usually peak within minutes and can be very frightening, making people fear another attack, which can increase overall anxiety.

Why do you get physical symptoms with anxiety and panic attacks?

When you experience anxiety or a panic attack, it’s not just your thoughts and emotions that are affected, your body also reacts in several physical ways. Being aware of these symptoms can help you recognise when you’re experiencing anxiety or a panic attack and take steps to manage it. Here are some common physical symptoms you might experience:

• Palpitations: one of the most common symptoms during an episode of anxiety or a panic attack is heart palpitations. You might feel like your heart is beating too hard, too fast, or skipping beats. This can be alarming, but it’s a common response to stress and typically isn’t harmful.
• Sweating: anxiety and panic can trigger increased sweating. This isn’t just a little perspiration; you might find yourself sweating a lot, which can be uncomfortable and add to your stress.
• Trembling or shaking: you might notice that your hands, legs, or even your whole body starts to shake or tremble. This shaking is a natural response to the adrenaline that floods your body when you feel anxious.
• Shortness of breath: feeling like you can’t get enough air is another common symptom of anxiety and panic attacks. You might start to breathe quickly or it might feel like you’re being suffocated or choked, which can increase your panic.
• Chest discomfort: during a panic attack, you might feel tightness or discomfort in your chest. While this can feel similar to heart attack symptoms, it’s generally caused by muscle tension and high levels of anxiety.
• Dizziness or feeling lightheaded: you may feel dizzy or as if you’re going to faint when you’re anxious. This can be due to changes in your breathing patterns or a decrease in blood flow to the brain when you’re under stress.
• Nausea: anxiety can upset your digestive system, leading to feelings of nausea or even stomach pain. You might feel queasy or like you need to vomit, especially during intense moments of anxiety.
• Numbness or tingling: anxiety can cause sensations of numbness or tingling, often in your hands or feet. This is a common physical response to extreme stress

What are the causes of panic attacks and anxiety?

The exact reasons why people have panic attacks and anxiety disorders are not completely understood, but they are believed to be caused by a combination of different factors. While we don’t know all the details, here’s what researchers think might contribute to these conditions:

• Genetic factors: anxiety can run in families. This means if your parents or brothers and sisters have had anxiety, you might be more likely to experience it too. Having family with anxiety doesn’t mean you’ll definitely have it, but you have a higher chance than someone with no family history of anxiety.
• Environmental factors: the things that happen to you in life and where you live can also impact your anxiety levels. Experiencing stressful events like going through a trauma, losing someone close, or having a tough time at work or school can lead to anxiety disorders. Growing up in a stressful or abusive home can increase this risk even more.
• Psychological factors: your personality and the way you view the world can affect your likelihood of developing anxiety. People who often see danger or negativity around them or who generally feel more negative emotions might be more prone to anxiety disorders. Also, having other mental health issues, like depression, can increase your risk.
• Physical health problems: sometimes, physical health issues can make anxiety worse or even cause symptoms that look like anxiety. For example, thyroid problems, which affect your hormones, can trigger anxiety symptoms. Chronic illnesses can also make you anxious, especially if you worry a lot about your health and what the future holds.
• Brain chemistry: experts believe that changes in brain chemistry, especially related to neurotransmitters like serotonin and dopamine, might be linked to anxiety. These chemicals help control your mood, and if they’re out of balance, it can lead to feelings of anxiety.
• Substance use: using certain substances such as caffeine, alcohol, and recreational drugs can trigger or increase anxiety symptoms. Anxiety can also get worse when the effects of these substances wear off or during withdrawal.

FAQs on panic attacks and anxiety

How are panic attacks and anxiety diagnosed?
Panic attacks and anxiety are diagnosed by discussing symptoms and their impact with your GP, who reviews your medical history to rule out physical health issues. Questionnaires like GAD-7 may assess symptom severity, with ongoing monitoring for effective management.

What are the treatment options for panic attacks and anxiety?
Treatment options include CBT therapy for changing negative thoughts, antidepressants like sertraline, lifestyle changes such as exercise and relaxation techniques, support groups, and self-help resources like books and websites.

What causes anxiety and panic attacks?
Anxiety and panic attacks can be caused by a variety of factors, including genetics, environmental influences, psychological stress, and physical health conditions. High levels of stress or significant life changes can also trigger these episodes.

Are anxiety and panic attacks the same thing?
Anxiety is ongoing worry and tension triggered by daily stressors, while panic attacks are sudden, intense bouts of fear with physical symptoms like palpitations and sweating. Panic attacks can be part of various anxiety disorders, including panic disorder.

How do I know if I am having a panic attack or a heart attack?
Panic attack and heart attack symptoms can overlap, like chest pain and palpitations, making them hard to tell apart. But heart attack symptoms typically include chest pressure, pain radiating to the arm or shoulder, and severe weakness, which are symptoms not usually linked to panic attacks. If unsure, seek immediate medical help, as heart attacks need urgent care.

What are some strategies to manage anxiety on a daily basis?
Daily anxiety management involves mindfulness, exercise, regular sleep, and relaxation techniques like deep breathing. Connecting with loved ones or joining a support group offers emotional support.

How long do panic attacks last?
Panic attacks usually peak within minutes, lasting between five to 20 minutes, with varying frequency among individuals.

Can children have anxiety and panic attacks?
Children can have anxiety and panic attacks, showing symptoms like behavioural changes. Early help from a doctor can manage symptoms and prevent more severe anxiety later.

Is it possible to prevent anxiety or panic attacks?
Although you can’t always prevent anxiety or panic attacks, managing stress, self-care, and treatment adherence can reduce their frequency and severity. Recognising early signs of anxiety and using coping strategies promptly can also help.