Panic attack

Panic attacks are sudden periods of intense fear and discomfort that may include palpitations, otherwise defined as a rapid, irregular heartbeat, sweating, chest pain or discomfort, shortness of breath, trembling, dizziness, numbness, confusion, or a sense of impending doom or loss of control. Typically, these symptoms are the worst within ten minutes of onset and can last for roughly 30 minutes, though they can vary anywhere from seconds to hours. While they can be extremely distressing, panic attacks themselves are not physically dangerous.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) defines them as "an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes and during which time four or more of the following symptoms occur." These symptoms include, but are not limited to, the ones mentioned above.

Panic attacks function as a marker for assessing severity, course, and comorbidity (the simultaneous presence of two or more diagnoses) of different disorders, including anxiety disorders. Hence, while panic attacks cannot be applied to all disorders found in the DSM, they are a common comorbidity.

Panic attacks can be caused by an identifiable source, or they may happen without any warning and without a specific, recognizable situation.

Some known causes that increase the risk of having a panic attack include medical and psychiatric conditions (e.g., panic disorder, social anxiety disorder, post-traumatic stress disorder, substance use disorder, depression), substances (e.g., nicotine, caffeine), and psychological stress.

Before making a diagnosis, physicians seek to eliminate other conditions that can produce similar symptoms, such as hyperthyroidism (an overactive thyroid), hyperparathyroidism (an overactive parathyroid), heart disease, lung disease, and dysautonomia, disease of the system that regulates the body's involuntary processes.

Treatment of panic attacks should be directed at the underlying cause. In those with frequent attacks, counseling or medications may be used, as both preventative and abortive measures, ones that stop the attack while it is happening. Breathing training and muscle relaxation techniques may also be useful.

Panic attacks often appear frightening to both those experiencing and those witnessing them, and often, people sometimes think they are having heart attacks due to the symptoms. However, while they do not cause much immediate physical harm, they may be a predictive risk factor for cardiac and other illnesses.