When Anxiety Feels Like a Crisis: Understanding Panic Attacks

By Jennifer Mooney, LMHC

Panic attacks may feel like physical symptoms such as shortness of breath or heart palpations. Suddenly, your heart starts racing, your face feels warm, and you become light-headed. You may think, “Am I having a heart attack?” or “What if I lose control?” You may begin shaking uncontrollably or feel short of breath. You feel detached from your surroundings like you’re in a bubble, or detached from yourself like you are feeling robotic or out-of-body. You have chest pain and tingling sensations all over. You might think, “I’m going crazy” or “I’m afraid I’m dying.”

If you have had an episode with the thoughts, feelings, and sensations as described above, you may relate to the intense discomfort and fright that is characteristic of a panic attack.

A panic attack, as defined in the Diagnostic and Statistical Manual (DSM-5), is an abrupt surge of intense fear or discomfort that reaches a peak within minutes and is accompanied by at least four of the following symptoms:

PANIC ATTACK SYMPTOMS

Physical Symptoms:

• Palpitations, pounding heart, or accelerated heart rate
• Sweating
• Trembling or shaking
• Feeling like you are choking
• Chest pain or discomfort
• Nausea or abdominal distress
• Feeling dizzy, unsteady, lightheaded, or faint
• Chills or heat sensations
• Numbness or tingling sensations
• Derealization (feeling of disconnection from reality) or depersonalization (feeling detached from oneself)
• Fear of losing control

Cognitive Symptoms:

• Fear of losing control
• Fear of dying

Since many of the physical symptoms of a panic attack can also be signs of a medical emergency, it is important to seek emergency services or speak to a medical professional immediately if these symptoms are new or different for you.

Once you are assured that there is no medical cause of the episode, it is important to understand that what you experienced may be a panic attack. While panic attacks can be terrifying and intensely uncomfortable, they are not life threatening. The panic will pass.

A panic attack involves the same sensations and feelings that humans experience as part of the fear response, also known as the “fight or flight” response. That response is expected when there is an immediate danger in our environment. Consider what it feels like when you hear an exceptionally loud clap of thunder, a car swerves into your lane, or an aggressive dog starts running toward you. Your body’s fear response is appropriate to help you protect yourself from the immediate danger.

In the case of a panic attack, the fear response occurs even though there is no actual immediate danger in the environment. The feelings are very real and scary despite the absence of an immediate danger.

You may be able to readily identify certain situations that typically lead to an attack, such as using public transportation, being in a crowd, or seeing a reminder of a person from your past. Alternatively, there may be no known trigger and the attack seemingly happens out of nowhere. The symptoms may be different from one occurrence to the next. Even if there are less than four symptoms, the episode may be considered a limited-symptom panic attack. Start paying attention to these details.

By understanding what is happening in your mind and body during a panic attack, you may be taking the first step toward managing anxiety so that it no longer feels like a crisis.

If you are experiencing panic attacks or any other stress, depression, or anxiety symptoms, Behavioral Health Partners is here to help. Call (585)276-6900 to make an appointment.

Link: Behavioral Health Partners (BHP) - University of Rochester Medical Center.

REFERENCES

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).

Bourne, E. J. (2010). The anxiety and phobia workbook (5th ed.). New Harbinger Publications, Inc.

Mental Health First Aid Australia. (2021). Panic attacks: Mental health first aid guidelines (revised 2021). https://www.mhfa.com.au/wp-content/uploads/2023/12/MHFA_Panic-Attacks-Guidelines.pdf

Jim Riggs | 10/1/2024