• Anxiety

Understanding What Causes a Panic Attack: Common Triggers and How to Prevent Them

A panic attack can be an overwhelming and frightening experience, often occurring without warning. For those who have panic attacks, the fear of not knowing why they happen can add to the distress they feel afterward.

Understanding what causes panic attacks is essential in managing and preventing them. While there is no single cause, various factors — from stress and trauma to genetics and brain chemistry — can contribute to panic attacks.

In this article, we’ll explore the potential triggers and underlying causes of panic attacks. 

What is a Panic Attack?

A panic attack is a sudden and intense episode of fear accompanied by physical discomfort including chest tightness, sweating, and inconsistent breathing. It typically reaches its peak within minutes and involves feelings of overwhelming anxiety and distress.

What makes panic attacks particularly frightening is their intensity and the rapid onset of these feelings, which can make a person feel out of control, even when there’s no actual danger present.

What Happens During a Panic Attack?

During a panic attack, the sympathetic nervous system activates the fight-or-flight response — a survival mechanism that protects people against perceived danger.

The nervous system releases stress hormones like adrenaline and cortisol during the response. This leads to various chemical changes in the body to increase alertness, strength, and responsiveness.

Panic Attack Triggers and Causes

The exact cause of panic attacks can vary from person to person, and they are often linked to both psychological and physical changes. 

Here is a breakdown of the most common causes of panic attacks:

Panic disorder (PD)

Panic disorder is a mental health condition characterized by recurrent, unexpected panic attacks. People with this anxiety disorder may live in constant fear of having another attack, leading to changes in behavior to avoid certain triggers.

The exact cause of this condition is unknown, but it’s believed that people develop panic disorder from genetics, brain chemistry, and environmental stressors.

How is panic disorder diagnosed?

A healthcare provider will need to evaluate you to diagnose panic disorder. A panic disorder diagnosis involves meeting the following criteria:

• Repeated panic attacks: Sudden, intense bouts of fear and physical discomfort, usually peaking within minutes

• Persistent fear of future attacks: Constantly worrying about when the next panic attack will occur

• Behavioral changes: Avoiding situations or places where panic attacks have happened, leading to nervousness and other feelings of distress in social settings

Stress and anxiety

High levels of stress and anxiety are some of the most common triggers of panic attacks. Anxiety often builds over time, leading to heightened fear responses and panic episodes.

People who have never experienced a panic attack before may have one for the first time in high-stress situations. Life events such as the death of a loved one, job loss, or other significant transitions can trigger extreme stress, making a person more vulnerable to panic attacks. 

Trauma

Traumatic experiences, such as being involved in a car accident, physical or emotional abuse, or surviving a natural disaster, can trigger panic attacks.

Medical conditions

Certain medical conditions — such as heart disease, thyroid disease, and asthma — can cause symptoms similar to panic attacks. These conditions may directly contribute to attacks or be triggered by the fear or stress of managing them.

Substance use

Heavy substance use and withdrawal from them may cause panic attacks. Stimulants — drugs that affect neurotransmitters — and even high levels of caffeine can overstimulate the nervous system and lead to an episode.

Environmental and sensory triggers

External factors can also trigger panic attacks, especially for people with heightened sensory sensitivities to loud noises, flashing lights, or chaotic environments.

Hormonal changes

Hormonal fluctuations, especially in women, can play a role in triggering panic attacks. Changes in estrogen and progesterone levels, such as those that occur during pregnancy, menstruation, or menopause, can affect your mood and stress responses.

What are the Symptoms of a Panic Attack?

Panic attacks can more intensely affect your mental health over time. During a panic attack, multiple symptoms can make it difficult for a person to focus on anything else going on around them.

Physical symptoms

Panic attacks manifest with a variety of physical symptoms that can mimic severe health conditions, such as heart attacks. 

Some of the most common physical panic attack symptoms include:

• A racing or pounding heart: A rapid or irregular heartbeat — or arrhythmia — can lead to heart palpitations, dizziness, and lightheadedness.

• Hyperventilation: A feeling of being unable to catch your breath or breathing rapidly, sometimes resulting in lightheadedness.

• Chest pain or discomfort: This symptom often leads to pain in the chest cavity that can feel like a heart attack.

• Sweating: Excessive sweating — even in a cool environment — occurs commonly under the arms and on the hands.

• Trembling or shaking: Many people experience uncontrollable trembling of their hands, legs, or other parts of the body.

• Chills or hot flashes: Sudden changes in body temperature, leading to cold sweats or flushes of heat.

• Nausea or upset stomach: Some individuals feel nauseous or experience gastrointestinal discomfort, including stomach cramping.

• Dizziness: Panic attacks may make people feel dizzy or as if they're about to faint or fall.

• Numbness or tingling: Tingling sensations can occur and are most commonly experienced in the hands, feet, or face.

Emotional and psychological symptoms

Along with physical symptoms, panic attacks also cause severe emotional and psychological distress, including:

• Overwhelming fear: A sense of impending doom or extreme fear that something terrible is about to happen, even without a clear reason

• Fear of losing control: The fear that a person is not in control of their own actions or the environment they are in

Panic attacks can also affect how a person perceives their environment or themselves:

• Derealization: This is a sensation where the world feels strange, distorted, or unreal. It may feel as if the environment around a person is dreamlike or far away.

• Depersonalization: A feeling of being detached from oneself, almost like a person is watching themselves from the outside or feeling disconnected from their body.

How Long Do Panic Attacks Last?

While most panic attacks peak within 10 minutes and rarely last longer than 20 to 30 minutes, the aftermath can leave you feeling exhausted and emotionally drained afterward.

How to Prevent Panic Attacks

Preventing panic attacks involves a combination of lifestyle adjustments, therapy, and stress management techniques to reduce overall anxiety and address the root cause of the attacks.

Panic disorder is usually treated with a combination of therapy and medications like antidepressants. It may not be possible to completely prevent panic attacks from occurring, but the following strategies can help significantly reduce their frequency and intensity:

• Cognitive behavioral therapy (CBT): Using therapeutic techniques to prevent panic attacks to challenge irrational thoughts or beliefs that trigger panic. CBT also teaches you coping strategies and new thought patterns to reduce anxiety.

• Stress management and relaxation techniques: Since stress is a significant trigger for panic attacks, stress management techniques like deep breathing exercises, progressive muscle relaxation, mindfulness meditation, or yoga and tai chi can help prevent panic attacks.

• Regular physical activity: Exercise helps regulate the body’s stress response and reduces cortisol levels.

• A healthy diet: What you eat can influence your anxiety levels and reduce the likelihood of experiencing panic attacks. Try to limit your caffeine intake and eat regular, balanced meals.

• Adequate sleep: Getting enough quality sleep is essential for mental health and may help reduce panic attacks. Lack of sleep can heighten anxiety and make you more vulnerable to episodes. 

• Identifying and avoiding triggers: Identifying the patterns and triggers that precede your panic attacks can help you prevent them. By becoming aware of specific situations, thoughts, or sensations that cause you to panic, you can take steps to avoid or prepare for them.

• Medications: For some people, medications may be necessary to manage panic attacks, especially in combination with therapy. Common medications prescribed include antidepressants and anti-anxiety drugs.

• Support groups: Connecting with others who have experienced panic attacks can help you gain emotional support and new coping strategies.

Where Can I Learn More About Panic Attacks?

LifeMD can provide expert advice, treatment, and prescription medication options for dealing with stress and anxiety. 

Through LifeMD, you can connect with a licensed healthcare provider who can help you develop a treatment plan, techniques, and the right medications to manage your panic attacks.

Get in touch now to book an appointment today and develop a plan for any symptoms of anxiety and stress you're feeling.

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