Panic Attacks

In humans, the fight or flight response has evolved to protect us from danger, either by fighting the threat or running away. During fight or flight, chemicals such as adrenaline flood our bloodstream causing symptoms like increased heartbeat, rapid breathing, pale skin, and trembling. 

A panic attack is an extreme fear response. Panic attacks can be triggered by many different situations or may have no apparent cause. They may happen only occasionally, or frequently as part of an anxiety disorder called panic disorder. Panic disorder is often accompanied by other mental health conditions like, generalised anxiety disorder, agoraphobia and social anxiety.

Panic attacks are not harmful to your physical health but can be extremely frightening and upsetting for the person experiencing them. Sometimes the fear of having a panic attack can trigger further panic attacks or lead to a person avoiding certain situations like being alone or leaving the house. Panic attacks normally last between 5 and 20 minutes, but in rare cases, can last up to an hour.

Symptoms of a panic attack include:

• fast heartbeat
• sweating
• shortness of breath
• hyperventilation (over breathing) 
• nausea (feeling sick)
• sensations in the chest, such as emptiness, or tightness 
• feeling hot or cold
• shaking or trembling
• a sensation of choking
• feeling faint or dizzy
• numbness, pins and needles, or tingling in your fingers
• feeling disconnected from your body
• needing to go to the toilet
• dry mouth
• tense muscles 
• abdominal (belly) pain

• a feeling of dread or imminent danger
• a feeling of losing control
• irrational thoughts 

Panic attacks have many causes and what triggers a panic attack is different for everyone. 

Some causes of panic attacks include: 

• acute stress such as a traumatic event 
• chronic (long-term) stress 
• over breathing (hyperventilating) in response to pain or anxiety
• extreme physical exercise
• a change in environment such as being in a hot, humid, or crowded place

Some health conditions, drugs, or medications can cause symptoms similar to a panic attack. If you are having frequent panic attacks, make an appointment with a doctor to rule out any physical cause including: 

• health conditions like hormonal problems, asthma, hyperthyroidism, heart problems, inner ear problems, and epilepsy. 
• use of certain medications or recreational drugs
• alcohol intake 
• caffeine intake 

If you are experiencing panic attacks, the first step is to make an appointment with a GP. Your GP will ask you about your symptoms, how long you have been having panic attacks and how often you have them. They may also perform a physical examination and run some tests to rule out a medical cause. If your GP suspects your panic attacks are due to anxiety or panic disorder, they can give advice on dealing with panic attacks, prescribe medication or refer you for further treatment. 

Treatment for panic disorder includes talking therapy, medication, or a combination of the two. 

Talking therapy

Talking therapies such as cognitive behavioural therapy believe that our thoughts, feelings, actions, and physical sensations are connected and aims to change negative thought patterns and behaviour. Your therapist can also teach you some ways of dealing with anxiety such as breathing techniques. 

Medication 

Medications that may be prescribed to help with panic disorder include: 

• selective serotonin reuptake inhibitors (SSRIs) are a type of antidepressant that work by balancing the chemicals responsible for mood in the brain. 
• To treat the phsyical symptoms, you may be prescribed a  betablocker  such as propranolol.
• medications like pregabalin or clonazepam are medications used to treat epilepsy and are not first line treatment for anxiety. These cannot be prescribed at Medicspot for reasons of safety. 

Some things you can do that may help prevent or reduce the frequency of panic attacks include: 

• reduce your sugar, caffeine, and alcohol intake
• stop smoking
• complimentary therapies like massage, or aromatherapy
• take regular exercise 
• practice relaxation and breathing techniques
• keep a journal
• join a support group
• read a self-help book on anxiety based on the principles of cognitive behavioural therapy (CBD) 

Your local pharmacist can help you with diagnosis of early signs of anxiety, depression and panic disorder, however to receive a full diagnosis and support you might be referred to your GP and then specialised services including psychiatrist or psychologist depending on how severe your symptoms are. 

If you are experiencing panic attacks and need advice on how to cope with them and possible treatment options, make an appointment with one of our NHS-trained doctors today. 

Making an appointment with Medicspot is quick and easy online. Simply choose a time that is convenient for you, and have your appointment by video link from your phone wherever you are. 

Important: Medicspot GPs cannot prescribe medication such as pregabalin or benzodiazepines (such as diazepam or nexium) in any circumstances.

NHS: Panic disorder July 28th 2020 (Accessed August 26th 2022) 

Better Health Channel: Panic attacks May 21st 2020 (Accessed August 26th 2022)

 Mind: Anxiety and panic attacks February 2021 (Accessed August 26th 2022)

Patient: Panic disorder July 14th 2022  (Accessed August 26th 2022)

MedCrave: Nursing and Care Open Access Journal: Preventing panic attacks September 16th 2019 (Accessed August 26th 2022)