Panic attack

Panic attack
A depiction of someone experiencing a panic attack, being reassured by another person
Specialty	Psychiatry
Symptoms	Periods of intense fear, palpitations, sweating, shaking, shortness of breath, numbness[1][2]
Complications	Self-harm, suicide[2]
Usual onset	Over minutes[2]
Duration	Seconds to hours[3]
Causes	Panic disorder, social anxiety disorder, post-traumatic stress disorder, drug use, depression, medical problems[2][4]
Risk factors	Smoking, psychological stress[2]
Diagnostic method	After other possible causes excluded[2]
Differential diagnosis	Hyperthyroidism, hyperparathyroidism, heart disease, lung disease, drug use, dysautonomia[2]
Treatment	Counselling, medications[5]
Medication	Antidepressant
Prognosis	Usually good[6]
Frequency	3% (EU), 11% (US)[2]

Panic attacks are sudden periods of intense fear and discomfort that may include palpitations, sweating, chest pain or chest discomfort, shortness of breath, trembling, dizziness, numbness, confusion, or a feeling of impending doom or of losing control.^[1][2][7] Typically, symptoms reach a peak within ten minutes of onset, and last for roughly 30 minutes, but the duration can vary from seconds to hours.^[3][8] Although they can be extremely frightening and distressing, panic attacks themselves are not physically dangerous.^[6][9]

The essential features of panic attacks remain unchanged, although the complicated DSM-IV terminology for describing different types of panic attacks (i.e., situationally bound/cued, situationally predisposed, and unexpected/uncued) is replaced with the terms unexpected and expected panic attacks. Panic attacks function as a marker and prognostic factor for severity of diagnosis, course, and comorbidity across an array of disorders, including but not limited to anxiety disorders. Hence, panic attacks can be listed as a specifier that is applicable to all DSM-5 disorders.^[10]

Panic attacks can occur due to several disorders including panic disorder, social anxiety disorder, post-traumatic stress disorder, substance use disorder, depression, and medical problems.^[2][4] They can either be triggered or occur unexpectedly.^[2] Smoking, caffeine, and psychological stress increase the risk of having a panic attack.^[2] Before diagnosis, conditions that produce similar symptoms should be ruled out, such as hyperthyroidism, hyperparathyroidism, heart disease, lung disease, drug use, and dysautonomia.^[2][11]

Treatment of panic attacks should be directed at the underlying cause.^[6] In those with frequent attacks, counseling or medications may be used.^[5] Breathing training and muscle relaxation techniques may also help.^[12] Those affected are at a higher risk of suicide.^[2]

In Europe, about 3% of the population has a panic attack in a given year while in the United States they affect about 11%.^[2] They are more common in females than in males.^[2] They often begin during puberty or early adulthood.^[2] Children and older people are less commonly affected.^[2]