The causes of panic attacks

Imagine that you're driving to get you to your job or you get the tail to pay for your grocery shopping. Suddenly, you have a similar feeling to the one you would have if your car broke down on a railway track and a goods train hurtled towards you. Your heart pounds, chest hurts you, you feel suffocated. Around you, everything is obscured, the images become blurry or seem unreal. You believe you are having a heart attack, dying or losing control of yourself, or the contact with the reality.

In the fear of losing control of your car or make a scene in the store, you flee as quickly as you can. After several minutes, the feeling of panic subsides. You calm down and you wonder what just happened to you. In addition, since at least a month, you fear that you have other episodes that are similar. This defines what is called a panic disorder.

We described the panic attacks as a signal of alarm triggered by the body without good reason – as a false alarm. When such a signal is triggered in the presence of a real danger, the reaction of overwhelming terror can be essential to survival. But in a state of panic, the reaction of terror occurs and there is no reason to give the alarm.

What panic attacks have strange and terrifying is that they often occur in a familiar setting or in a situation that does not present a real danger. It remains that the victim is taken of terror, with all its manifestations, physical and psychological.

In the absence of detection and treatment, panic disorder can progress and cause distress even greater. The constant threat of not knowing when, or where, a new crisis will occur can cause anxiety, anticipation – that is to say, the constant fear of other panic attacks. The person will be able to see that it was not enough for him to avoid situations or places that were feared to prevent this feeling of anxiety or fear.

This anticipation of doing other panic attacks must last for at least a month so that we can make the diagnosis of panic disorder.


Medically, a panic attack must include at least 4 of the symptoms in the list below, and reach a peak within 10 minutes:

  • palpitations
  • sweating
  • tremor or muscle twitching
  • sensation of shortness of breath or smothering
  • sensation of strangulation
  • pain or discomfort in the chest
  • nausea or abdominal discomfort
  • sensation of dizziness, instability, light-headed or feel faint
  • feeling of unreality or being detached from yourself
  • fear of losing control or going crazy
  • fear of dying
  • sensation of numbness or tingling in the hands
  • chills or hot flashes
    According to the DSM-IV, here are the features of panic disorder (with or without agoraphobia) : The person has experienced the following phenomena :
  • Attacks of panic that are unexpected and recurrent
  • One or more attacks have been followed by a month or more of the following phenomena
  • Ongoing concern regarding new attacks
  • Concern with regard to the implications or consequences of the attack
  • Significant change in behavior related to the attacks
  • The presence or absence of agoraphobia.
  • Panic attacks are not due to substance abuse or to a physical condition in general.
  • Panic attacks do not fall under another mental disorder.
  • Panic attacks can be present in other anxiety disorders such as social phobia or specific phobia. A panic attack may, for example, be triggered by the sight of a spider in a person who has the phobia. However, even if the people who suffer from panic disorder are also sometimes panic attacks related to or favored by a particular situation, there must be the presence of panic attacks that occur unexpectedly to establish the diagnosis.

Panic disorder can be with or without agoraphobia.

Agoraphobia is the fear of being in places where it may be difficult to escape or get help, when people experience a panic attack. Some agoraphobes only circulate in a small area or need to be accompanied by a person of trust. In this way, the disorder also affects family and friends. Other face, but at the price of anxiety important.

Normally, the victims of panic disorder remember quite well the first crisis of panic, because the physical and psychological terror was overwhelming. Some people believe that they are victims of a massive heart attack or that they lose the reason. The impulse to flee immediately or to ask for help pushes some victims to the emergency departments of hospitals, where they insist on the fact that they feared, for example, to have a heart attack. The physical tests do not usually show nothing abnormal.

The suddenness and the violence of the panic attacks lead some victims to avoid situations where they have had a seizure. They may believe that the highway or the grocery stores are scary places. They say that in the event of another crisis, at least they will not be at the wheel, or in the crowd, or locked up in a train or a plane where the leak or help would be difficult. In fear of having a seizure and lose control of themselves, the victims avoid certain activities or places. This is called avoidance agoraphobique. For example, these individuals may come to avoid to stay alone at home, to circulate in their neighborhood, to go to the grocery store, the bank, the mall or the cinema, or a venue, use public transport, travel by car, cross the bridges and tunnels, as well as take the plane and travel the world. The interference with the personal or professional life can become significant.

The consequences can be serious

The crises of panic, anticipatory anxiety and phobic avoidance may have serious consequences if they are not treated. The victims of this disorder are more likely to be depressed than the general population, with the complications that this implies. In their desperate efforts to quell the crisis and under the effect of their anticipatory anxiety, some abuse alcohol, drugs or certain medications.


Panic disorder usually appears in late adolescence or early adult life. The first attack may occur after a period of great tension, for example the loss of a loved one through death or separation, illness, accident, or childbirth. Even after the stress is gone, the panic attacks persist. Panic disorder has no single cause but is the result of the combination of several genetic, biological and psycho-social.

The researchers are trying to clarify the origins and underlying causes for panic disorder. Current research efforts focus on more effective ways to diagnose and treat panic disorder.

The specialists also want to find answers to questions such as : Why panic attacks are triggered at certain times rather than others ? What is the role of heredity ? Where are the apparent differences between the men and women who are affected by this disorder ?