I frequently have people come to me having already self-diagnosed themselves as having Panic Disorder because they have panic attacks. Although some people are right, just as frequently, they’re wrong.
Briefly, a panic attack is a sudden rush of acute fear and anxiety accompanied by physical symptoms such as shortness of breath, dizziness, tightness in the chest, tingling, nausea and other stomach distress, shaking, and sweating. During a panic attack, someone may be aware of thoughts spinning in their head (we’ll talk more about these in a bit) and they likely have some type of behavioral reaction (avoidance of the situation either immediately or later on).
Panic attacks usually come on quite quickly, build to a peak in approximately five to 20 minutes, and then subside. It's not uncommon to hear people say that their panic attacks last a lot longer; however, it's probably the after effects of the attack that they're feeling, such as residual anxiety and increased alertness to bodily sensations, rather than the panic attack itself.
So, if a person is experiencing panic attacks, and it’s not Panic Disorder, what else might it be?
Panic attacks can be a feature of all of the anxiety disorders. For example, a panic attack in the context of Social Anxiety Disorder may be fueled by a fear of others witnessing the attack: “What if others notice how anxious I am and they think I’m weak?” or “I’m making a fool out of myself.” A panic attack in the context of Obsessive-Compulsive Disorder may be triggered by a fear of being contaminated: “I just touched a doorknob. It’s probably covered with germs. I’m going to get sick.” In contrast, someone with Generalized Anxiety Disorder is likely to get triggered by a fear of uncertainty such as, “What if my cancer comes back?”, which can spiral out of control and end up in a full-blown panic attack. Compare these situations with a panic attack in an actual Panic Disorder. In this case, the person is most likely to be focusing on their body being out of control, fearing that they may pass out or die. In fact, many people end up in the Emergency Room believing they’re having a heart attack. To summarize, the key to knowing what anxiety disorder is at play lies in understanding the root fear.
Sometimes it helps to have a psychologist help you sort this out. But it can also be good to gather some data on your own. One good way to do this is to keep a thought diary. You can read a whole post about keeping thought diaries here. Briefly, you just note the situation you had the panic attack, what thoughts were going through your mind, and any other variable you can think of that might be pertinent (Did you sleep enough last night?; When did you last eat?; What type of mood are you in? Did the panic attack seem to be triggered by a certain situation or seem to come from “out of the blue”? What did you do after the panic attack?)
And finally, panic attacks and anxiety, in general, can mimic several physical problems, such as thyroid problems to name just one example. I always ask my clients to get a thorough physical before we start any type of treatment for an anxiety disorder.