Panic Attack: Symptoms and Treatment Methods What is a Panic Attack? Symptoms and Treatment Approaches

Panik Atak Nedir? Belirtileri ve Tedavi Yolları

A panic attack is a sudden occurrence characterized by intense fear or anxiety accompanied by various physical symptoms, classified within anxiety disorders. The severity of physical symptoms peaks within a few minutes and can last for 10-20 minutes. Panic attacks can occur not only in anxiety disorders but also in depression, social phobia, post-traumatic stress disorder (PTSD), mental disorders related to substance use, or certain conditions affecting the heart or respiratory system. During a panic attack, individuals often experience a strong fear of “dying, going crazy, or losing control.”

What is a Panic Attack?

A panic attack can occur suddenly without any warning signs, and it may not always have a specific trigger. In some cases, it can occur during sleep or periods of rest. Nocturnal panic attacks can awaken a person in a state of panic. While many people may experience multiple panic attacks, it can also be a one-time occurrence. In cases of recurring attacks, there may be a specific trigger (such as being in a crowded place, public speaking, entering a confined space, etc.). During a panic attack, there is often a sense of imminent danger or the feeling that escape is impossible. Attempted suicide or suicidal thoughts are risk factors observed when panic attacks recur.

Panic Disorder or Panic Attack?

Panic disorder is a condition where recurring panic attacks are accompanied by dominant physical and psychological stress. Contrary to common belief, a panic attack is not a disease but rather a condition that typically occurs with physical symptoms in individuals with panic disorder. Panic attacks are part of the criteria for panic disorder; therefore, they are not a standalone defining criterion.

How Common are Panic Attacks?

The frequency of panic attacks is around 2-3%, with a higher prevalence in women compared to men. Panic attacks can be observed not only in adults but also, although rarely, in children. The typical age of onset is around 22-23 years in young adults. Many individuals consult numerous doctors before receiving a correct diagnosis, and only a few are accurately diagnosed. According to research, having a low level of education and living alone increases the frequency of panic attacks, while being employed and married tends to decrease this frequency.

What Are the Physical Symptoms During a Panic Attack?

During a panic attack, various physical, emotional, cognitive, and perceptual symptoms are observed: palpitations, increased heart rate, sweating, trembling, shortness of breath and the feeling of suffocation, chest pain, or tightness in the chest area, nausea, abdominal pain, dizziness, feeling faint, tingling (numbness, tingling) in the body, altered perception of oneself and the surroundings, numbness, chills, or hot flashes, frequent urination, intense fear and anxiety, a feeling of losing control, a feeling of going crazy, and fear of death.

Panic Attack or Heart Attack?

Many people may interpret the symptoms of a panic attack as a heart attack. This is because the physical symptoms observed during a panic attack often mimic symptoms related to the heart or respiratory system. Individuals experiencing an attack may tend to visit the hospital at the time of the attack. After necessary tests are conducted under medical supervision to rule out heart or heart-related conditions, the observed symptoms may be considered indicative of panic disorder.

Even if individuals are reassured by the results of the tests, they may experience intense anxiety about experiencing the same situation again. This anxiety, coupled with stressful life events, can lead to the recurrence of panic attacks.

Causes and Risk Factors of Panic Attacks

The exact causes of panic attacks are unknown, but temperament and environmental factors are thought to make certain individuals more susceptible to panic attacks. Along with differences in brain structure and neurochemical levels, factors such as life events experienced from early childhood, parenting styles, growing up in an overly protective family environment, the presence of different diagnoses (depression, obsessive-compulsive disorder, etc.), or traumatic experiences are considered environmental factors that constitute risk factors for panic attacks.

What to Do During a Panic Attack?

Attempting slow and deep breathing may help prevent symptoms such as dizziness and blackouts. Reminding oneself that the attack will pass, especially if similar attacks have occurred before, can be reassuring. Learning relaxation and breathing exercises can facilitate coping with attacks. Closing the eyes during an attack can prevent exposure to different stimuli in the environment and be calming. Trying to relax the muscles is another way to achieve relaxation. Focusing on a specific object or image (a safe, happy place) during an attack can be helpful.

Many individuals who experience panic attacks tend to avoid the environment where the attack occurred or where they fear an attack might occur. For example, a person who thinks they will have a panic attack in a confined space may avoid such environments or may want to leave immediately if they find themselves in such a place. They may believe they cannot escape or will be in an inappropriate situation, experience intense fear, and desire to leave the environment (avoidance response). This response indicates a situation known as phobic avoidance. Although individuals may experience relief when they leave the environment, this pattern can become a long-term and restrictive pattern negatively affecting their quality of life. It is recommended that individuals with panic disorder seek psychological support. Working with a psychologist/psychiatrist can help establish the relationship between physical symptoms, thoughts, feelings, and behaviors during panic attacks, facilitating coping with panic attacks.

Treatment of Panic Attacks

Panic attacks are a treatable condition. During the treatment process, taking medication under the supervision and follow-up of a psychiatric specialist and receiving psychoeducation from a psychologist to prevent or reduce the severity of attacks can be highly beneficial. In many patients with panic disorder, psychotherapies have been shown to provide lasting improvement.

Psychotherapy support is helpful in recognizing the physical symptoms that occur during an attack, identifying triggering thoughts, establishing a connection between thoughts and behaviors, and reducing possible avoidance responses. Techniques such as relaxation exercises and proper breathing methods are taught during psychotherapy; methods that individuals can apply on their own during an attack are also practiced.

As in all treatment processes, changing or stopping medications without consulting a psychiatrist in the treatment of panic disorder may result in incomplete treatment, increasing the likelihood of recurrence of attacks.


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