Can panic attacks be random?

What causes panic attacks?

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) categorizes panic attacks as ‘expected’ or ‘unexpected’. ^[1]

Expected panic attacks are typically triggered by a known entity, such as crowds, small spaces, or performances. Unexpected panic attacks appear to have no identifiable cause. ^[1]

There is no definitive cause of panic attacks, but there are certain factors which may contribute to their occurrence, such as genetics, mental health conditions and heavy stress. ^[1]

Panic attacks can be scary experiences whose symptoms lead individuals to believe they are in grave physical or emotional danger. ^[1]

What you feel during a panic attack?

Panic attack symptoms may include: ^[3]

• Pounding or racing heart
• Sweating
• Trembling
• Breathing difficulties
• Dizziness
• Nausea
• Chills
• Hot flushes
• An out-of-body sensation
• A choking sensation
• A fear that you’re dying
• Tingling
• Numb hands, feet or legs
• Abdominal pain

If your heart pounds, you struggle for breath, or you’re overcome by intense fear, it’s understandable that people suffering panic attacks often think they are having heart attacks. However, despite how similar the symptoms feel, panic attacks are not life threatening. ^[3]

Panic attacks usually pass after several minutes, but their effects can be felt for hours. They are draining and exhausting. Resting afterwards may help replenish your energy. ^[2]

What to do when experiencing a panic attack

The next time you feel a panic attack coming on, the following steps may help you get through it. ^[2]

• Do not fight it – Allow the sensation to wash over you, accepting that it won’t abate if you struggle against it.
• Stay in one place – Movement may exacerbate symptoms or cause confusion.
• Breathe slowly and deeply – Deep breathing exercises can trick your brain into returning to a calmer state.
• Remind yourself that the panic attack will pass – Repeat this to yourself over and over to calm yourself down.
• Focus on positive and relaxing imagery – Pick a place, memory, person, or other positive entity to focus your energy on.
• Remind yourself this is not life threatening – However tumultuous your physical symptoms may feel, this panic attack is not life threatening and will pass

Panic disorder & how to treat it

If you are having frequent, unexpected panic attacks, you may have panic disorder. Panic disorder often begins in the late teens or early adulthood and affects women more frequently than men. ^[4]

People with panic disorder have: ^[4]

• Sudden and recurrent panic attacks characterized by overwhelming fear.
• Feeling as though they’ve lost control of their bodies.
• A feeling of impending doom during a panic attack
• Intense stress and angst over when the next panic attack will occur.
• An avoidance of places or situations where they had panic attacks previously.

Effective treatment for panic disorder include: ^[4]

• Psychotherapy – Cognitive behavioral therapy and exposure therapy are two examples of effective therapeutic interventions. These can teach you to react differently to feelings experienced during a panic attack. The attacks may become less prevalent once you learn how to manage physical sensations of anxiety.
• Medications – doctors may prescribe medications such as antidepressants, beta-blockers, or benzodiazepines to combat panic disorder. Take exactly as your doctor prescribes.

In addition to these treatment plans, a healthy lifestyle, solid understanding of the subject matter, and regular checkups with medical or mental health professionals can all help you manage panic attacks.