Are All Panic Attacks the Same?

Learn About the Different Types of Panic Attacks

Not all panic attacks are the same.
Not all panic attacks are alike. Photo © Microsoft

Question: Are All Panic Attacks the Same?

Are all panic attacks the same? Not necessarily. The following describes the different types of panic attacks and how these symptoms relate to the diagnosis of panic disorder.

Understanding Panic Attacks

Panic attacks involve a complex combination of physical, mental, and emotional symptoms. For example, a person having a panic attack may experience overwhelming feelings of dread.

They may become ashamed of their symptoms, worried about how others will perceive them. Many somatic symptoms can occur, such as sweating, shaking, and tingling sensations. The person may become fearful that they are losing control of their body and mind. Overall, panic attacks can be an extremely frightening experience, causing a person to want to escape their situation.

The Diagnostic and Statistical Manual of Mental Health Disorders, 5th edition (DSM-5) is the handbook that contains the diagnostic criteria for all mental health conditions. As outlined by the DSM-5, panic attacks are experienced as four or more of the following symptoms:

The symptoms of panic attacks often occur rapidly, reaching a peak within 10 minutes before slowly subsiding. It is possible for panic attacks to last longer. A person can also have several panic attacks occur in a row, making it hard to notice when one has ended and another has begun.

Types of Panic Attacks

Aside from varying in duration, panic attacks can also differ depending on the circumstances that trigger the attack. Generally, panic attacks fall into one of three different types:

Unexpected (uncued) panic attacks: These types of panic attack occur suddenly and without cause. Unexpected attacks strike without any internal (e.g., fearful thoughts, physical sensations) or external (e.g., a situation that causes great fear and anxiety, a feared environment) cues. These panic attacks are most often associated with panic disorder.

Situationally bound (cued) panic attacks: These panic attacks occur when a person is subjected to or is anticipating exposure to a particular panic trigger. For example, a person with a fear of heights may have a panic attack when inside of a tall building or a person who has a fear of flying may experience an attack while boarding a plane, during take-off, or at some point throughout a flight.

Situationally predisposed panic attacks: Although very similar to cued panic attacks, these attacks do not always happen following subjection to a feared situation.

Additionally, these types of attacks do not always occur while a person is exposed to a specific trigger. For instance, a person who has a fear of crowds may not always have a panic attack while in a crowded area or may have a panic attack after already being in a crowded area for a long period of time.

Being Diagnosed with Panic Disorder

Many people will experience a panic attack or two within their lifespan. It is possible to only face a few panic attacks and never have one again. However, a person who goes through several panic attacks will typically encounter more again in the future.

Even though panic attacks are the main symptom of panic disorder, experiencing these attacks does not necessarily mean a person fits the diagnostic criteria for panic disorder. In order to be diagnosed with panic disorder, a person must experience persistent unexpected (uncued) panic attacks.

Likewise, situationally bound (cued) and predisposed panic attacks commonly occur with panic disorder. However, these types of panic attacks are also typical for people with other anxiety disorders too, including phobias, social anxiety disorder, and post-traumatic stress disorder (PTSD).

Aside from the required unexpected panic attacks, panic disorder can also co-occur with agoraphobia. This condition is associated with the intense symptoms and fear associated with panic attacks. A person with agoraphobia is afraid of having a panic attack in places or circumstances in which it would be very difficult or potentially embarrassing to flee from, such as in a plane or at a crowded sports event. This condition often involves avoidance behaviors that can range from staying away from crowds and certain means of transportation to more severe cases of being homebound with agoraphobia.

Whether your panic attacks are a part of panic disorder, agoraphobia, or another condition, it is important that you seek out help for your symptoms. Only a qualified professional can provide you with an accurate diagnosis and proper treatment plan. The sooner you begin your treatment options for panic disorder, the quicker you can expect to find some relief from your panic attacks.

Source:

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th ed., Washington, DC: Author.

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