What happens after panic attacks fades

Panic attack (Panic disorder)

Palpitations, dizziness, sweating, tremors, shortness of breath, sensory disturbances and the feeling that suddenly everything is completely strange accompany the fear of losing control or dying.

Panic attacks usually come suddenly and unexpectedly and usually go away on their own after a few minutes. For most sufferers, panic comes out of nowhere. They cannot explain why they suddenly “freak out” completely. Hence the fear of having a dangerous physical illness that no doctor can discover.

A long journey from doctor to doctor, known as “doctor shopping”, usually begins. But when people with panic disorder accept after a while that they suffer from a mental illness and go to therapy, they learn to take their bodies and their feelings seriously and to take them seriously. They are slowly realizing that they are often under prolonged tension that makes panic attacks more likely.

How is Panic Disorder Defined?

Panic disorder is characterized by repeated panic attacks (at least once a month) and the resulting fear of a new approach or a serious illness (e.g. heart attack or pulmonary embolism) that triggers the attacks.

A distinction is made between panic disorder without agoraphobia and panic disorder with agoraphobia. Agoraphobia is a mental illness that is characterized by fear of public places, crowds or fear of traveling alone or far away. These are situations in which a sudden escape would be impossible or embarrassing and no help can be sought nearby.

Panic attacks often also occur in the context of physical illnesses, such as cardiac arrhythmias and thyroid dysfunction, or other mental illnesses, such as depression or obsessive-compulsive disorder. If panic attacks occur as part of these conditions, the doctor or therapist will not diagnose panic disorder. They are then viewed as a symptom of the underlying disease.

How common is panic disorder?

Panic attacks are relatively common. Up to 22% of people will have an anxiety attack at least once in their life. But an attack does not constitute a panic disorder. The chance of developing panic disorder throughout life is 5.5% in women and 2.2% in men. Panic disorder usually develops around the age of 20.

If someone has panic disorder, they are often not the only one in the family. The panic disorder occurs in families. It is believed that this disease can be both genetically inherited and caused by certain living conditions.

What are the typical symptoms of a panic attack?

A panic attack is a phase of intense anxiety that peaks in ten minutes or less. After a certain time - a panic attack usually lasts a few minutes, but it can also last for hours - it subsides on its own. It is accompanied by at least four of the following symptoms, which appear simultaneously and suddenly:

  • Racing heart
  • intense, uncomfortable feeling of the heartbeat
  • Tremble
  • Shortness of breath
  • Suffocation
  • Sensory disturbances
  • Hot flashes
  • Chill
  • sweat
  • Chest pain or tightness
  • Nausea and other gastrointestinal complaints
  • Derealization: the feeling that the situation and the surroundings are not real
  • Depersonalization: the feeling of not being yourself or that the mind is separating from the body
  • Fear of death
  • Fear of losing control

What can trigger a panic attack?

Panic disorder often occurs in people during or after stressful life situations, e.g. death of a loved one or divorce, but also after moving or being laid off - especially if this situation is perceived as very stressful or frightening. Those affected are usually under extreme tension, which they often do not really notice themselves.

People who suffer from panic disorder usually perceived physical signals more sensitively and classified them as more frightening than other people before they became ill. Most of the time, even the smallest physical changes trigger fear in those affected, even if they are not fully consciously perceived - for example an acceleration of the heartbeat when climbing stairs or dizziness after getting up.

++ More on health trends: Tips - Fight panic attacks in 10 seconds ++

People with agoraphobia who are afraid of being in large squares, on the subway or on a plane develop sudden frenzied fear in such places because they cannot bear not to be able to leave this place unhindered or unnoticed. The fear triggered in this way becomes more and more intense and can no longer be suppressed. This can also lead to the fear of completely losing control and becoming “crazy”. The physical sensations can also be experienced more and more intensely, and those affected are afraid of dying.

How is panic disorder diagnosed?

In order to be able to diagnose panic disorder, the doctor must first rule out other physical and mental illnesses. For example, diseases of the cardiovascular system or metabolic disorders can trigger symptoms similar to panic attacks.

++ More on the topic: Diagnosis of panic disorder ++

How is Panic Disorder Treated?

Panic disorder should be treated as early as possible so that better treatment results can be achieved. A combination of psychotherapy and medication is the first choice in acute phases. The same applies to long-term therapy.

++ More on the topic: Treatment for panic disorders ++

What is the prognosis for panic disorder?

Panic disorder rarely develops on its own. Many sufferers regularly use alcohol or sedative medication to combat anxiety. In addition to panic disorder, alcohol or drug addiction can develop.

If panic disorder is treated, the prognosis is good. Most patients experience great improvement in symptoms or are cured. When panic attacks occur as part of other mental illnesses, treatment is more difficult.

Find out here why mental illness is not a taboo and why it is important to speak openly about it.

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Dr. med. Lisa Demel
Medical review:
Univ.-Doz. Dr. Margot Schmitz, specialist in psychiatry and neurology
Editorial editing:
Mag. (FH) Silvia Hecher, MSc

Status of medical information:

Schmidt-Traub S: Panic disorder and agoraphobia - a therapy manual. 3rd edition, Hogrefe Verlag GmbH & Co. KG, 2008

Heinrichs N, Alpers GW, Gerlach AL: Evidence-based guideline for the psychotherapy of panic disorder and agoraphobia. Hogrefe Verlag GmbH & Co. KG, 2009

American Psychiatric Association (APA): Practice guideline for the treatment of patients with panic disorder. 2nd ed., Washington (DC) 2009

Meulenbeek P et al: Early intervention in panic: Pragmatic randomized controlled trial. Br J Psychiatry, 2010 Apr; 196 (4): 326-31

Computerized cognitive behavior therapy for depression and anxiety. Review of Technology Appraisal 51st National Institute for Health and Clinical Excellence, February 2006

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ICD-10: F41.0