Anxiety Disorders Association of Ontario

Panic Disorder

Anyone can experience a panic attack, irrespective of whether or not they have been diagnosed with an anxiety condition. Panic attacks are sudden, unexpected episodes of fear, anxiety, and discomfort that are accompanied by physical sensations.

Panic attacks can be triggered by many stimuli. The hallmark of a panic attack is that it happens in response to a perceived threat not a threat that actually exists. When your brain perceives a threat, it combines this with previous memories of the threat to send a message to your adrenal glands through your hypothalamus and pituitary gland. The adrenal glands subsequently release hormones, which prepare your body to react to the perceived threat. The physical reactions, which occur within seconds, include increased breathing rate, rapid heartbeat, digestion shutdown, sweating, increased alertness of the senses, and tense muscles. Individuals experience these physical sensations as symptoms of panic. One way to think of a panic attack is that the danger button in your brain was accidentally pushed: you are not actually in danger, but it feels like you are.

Individuals are said to have experienced a panic attack if a period of intense fear or discomfort is episodic (not ongoing) and accompanied by at least 4 of the following 13 physical symptoms:

  • Palpitations, increased heart rate or pounding heartpanic-2-300x249
  • Sweating
  • Trembling or shaking
  • Sensations of shortness of breath or smothering
  • Feeling of choking
  • Chest pain, pressure or discomfort
  • Nausea or abdominal distress
  • Dizziness, unsteadiness, lightheadedness or fainting
  • Fear of losing control or going crazy
  • Fear of dying
  • Paresthesia (numbness or tingling sensation in hands and feet)
  • Chills or hot flashes
  • Sense of feeling unreal, disconnected from one’s surroundings or body

Panic attacks are often confused with heart attacks, brain tumors, or other physiological symptoms/conditions. Panic disorder involves the presence of recurrent, unexpected panic attacks followed by at least one month of persistent concern about having additional attacks, worry about the implication of the attack or its consequences, and/or a significant change in behavior related to the attacks. Panic disorder is characterized by panic attacks that are unrelated to substance abuse, medical conditions, or another psychological condition (i.e. OCD).

Individuals who experience panic attacks often report experiencing fear that something terrible is going to happen; however, they are often unable to identify the specific cause of their fear. This typically worsens their feelings of anxiety. It is very common for individuals who experience panic attacks to fear doing something silly, to fear acting out of control, to fear fainting, and/or to fear dying. Despite the fact that panic attacks last for a short period of time, individuals who experience them are often exhausted for several hours afterward.