Psychiatrist Questions Panic Attack

What causes panic attacks in a person?

I have seen my friend getting panic attacks over weird things. What could be the cause? Does it require medication?

9 Answers

Panic disorder strictly defined occurs without an obvious trigger or "out of the blue". Panic may be brought on biologically by too much CO2 or impaired respiration including shallow breathing.
Phobias or fears may lead to panic attacks so the triggers may appear 'weird' but likely have some emotional connection to the person (conscious or unconscious connections).
It may benefit from medication.
Panic attacks are one of the major anxiety symptoms. They come either with increased stress or out of the blue. If they came with stress, this happens with other anxiety disorders like generalized anxiety disorder, PTSD, OCD, social phobia or other phobias, but panic attacks that come out of the blue, and if they happen at least once a week and more then 6 months, this usually is a panic disorder.
Usually, there is a trigger that the person is not aware of.
There are too any causes to be able to give a specific answer. However, panic attacks, in general, are an extreme fear of an unknown cause. It is important to find out that cause. Yes, medication, especially the anti-depressant Paxil, can often help.

Donald A. Moses, MD
Hi,

Thanks for your interesting question. Panic attacks are caused by severe anxiety. They can be triggered by events or come out of the blue. Basically, it is a dysfunction of the autonomic system that responds to a situation requiring a fight-or-flight response. While anxiety can be adaptive and life-preserving, panic attacks are not. Sometimes, medications are needed, but I would suggest trying psychotherapy first as a person with panic attacks can learn how to identify early indicators of anxiety and learn how to stop a panic attack.

Yvonne Hall, MD
Panic attacks can run in families. How often does your friend have them? How severe are they? Does your friend take medication for them? If they are severe enough or often enough, your friend should probably see a psychiatrist who does psychopharmacology.
There is a difference between panic attacks vs panic disorder. A panic attack is a psycho-emotional reaction to a stressor (physical, environmental, emotional, etc.) and is is manifested as intense feelings of fear, increased heart rate, increased breathing or shortness of breath, sweating, feelings of nausea, a need to get away from the situation.
Panic disorder, on the other hand, is an anxiety disorder manifested by frequent episodes of panic attacks that are usually triggered by a specific situation or stressor. This triggering situation or stressor has a specific meaning to the person (feelings of losing control, fear of abandonment, reminder of a previous traumatic event, etc.).
Medications for panic disorder can be prescribed by doctors. The underlying reason for the panic episodes can be understood in psychotherapy so that these episodes can be overcame.

Panic attacks are a way for the body to tell you that there is something else going on in your mind that needs attention. Medication is an option, but psychotherapy would be the best approach. If medication is used, it would only be temporary to stop the panic attacks from coming on full-blown.