Panic Attack

A panic attack is when your body’s fight-or-flight response is activated. According to DSM-5 criteria, a panic attack is an abrupt surge of intense fear or discomfort that reaches a peak within minutes, during which time four or more specific symptoms occur.

The experience can be overwhelming. Imagine your internal alarm system suddenly blaring at maximum volume when there’s no danger. Your heart pounds, your breathing becomes rapid and shallow, you may feel dizzy or nauseous, and an intense fear of losing control or dying can wash over you.

Common Panic Attack Symptoms

The symptoms of a panic attack are very real and can include:

• Cardiovascular symptoms: Racing heart, palpitations, chest pain or tightness

• Respiratory symptoms: Shortness of breath, feeling like you can’t breathe, hyperventilation

• Neurological symptoms: Dizziness, lightheadedness, feeling faint, numbness or tingling

• Gastrointestinal symptoms: Nausea, stomach upset, feeling like you might vomit

• Psychological symptoms: Intense fear of dying, losing control, or “going crazy”

• Physical sensations: Sweating, trembling, hot or cold flashes, feeling detached from reality

A panic attack typically lasts 5-30 minutes, with symptoms usually reaching peak intensity within about 10 minutes. While the experience is incredibly frightening, panic attacks themselves are not physically dangerous or life-threatening.

Who Experiences Panic Attacks?

Research suggests that around 13.2% of people experience panic attacks at least once, with 66.5% of those experiencing them recurrently. However, only a small percentage of people who have panic attacks develop panic disorder. Panic disorder affects 2 to 3% of the population in a 12-month period and usually begins in late adolescence or early adulthood, affecting women about 2 times more often than men.

Stroke: A Critical Medical Emergency Requiring Immediate Attention

A stroke occurs when blood flow to part of the brain is blocked (ischemic stroke) or when a blood vessel in the brain bursts (hemorrhagic stroke). On average, 1.9 million brain cells die every minute that a stroke goes untreated, making rapid medical intervention absolutely critical.

Unlike panic attacks, strokes represent actual damage occurring in the brain and require immediate emergency medical care. The sooner treatment begins, the better the chances of recovery and reducing long-term disability.

Additional Stroke Warning Signs

Beyond F.A.S.T., other stroke symptoms can include:

• Sudden confusion or trouble understanding

• Sudden severe headache with no known cause

• Sudden trouble seeing in one or both eyes

• Sudden trouble walking, loss of balance, or lack of coordination

• Sudden numbness of the face, arm, or leg, especially on one side

The Challenge: When Symptoms Overlap

The difficulty in distinguishing between panic attacks and strokes lies in their overlapping symptoms. Both conditions can cause:

• Sudden onset of symptoms

• Dizziness and feeling faint

• Difficulty speaking or thinking clearly

• Numbness or tingling sensations

• Feeling of impending doom

• Nausea

This overlap is why 34.5% of emergency department patients with non-cardiac chest pain reported at least one panic attack in the past 6 months, and 77.1% of patients who reported panic attacks had visited the emergency department with non-cardiac chest pain following a panic attack.

Key Differences: How to Tell Panic Attacks and Strokes Apart

Timing and Onset

Panic Attacks: Panic attacks typically reach peak intensity around 10 minutes and then slowly fade. The buildup may be gradual, and symptoms usually resolve within 20-30 minutes.

Strokes: Strokes are almost always instant, with symptoms occurring almost immediately. The effects are typically sudden and persistent, often worsening rather than improving.

Movement and Motor Function

Panic Attacks: While you may feel weak or shaky during a panic attack, you typically retain the ability to move. You might feel like you can’t move certain muscles due to anxiety, but actual paralysis is extremely rare.

Strokes: One thing that anxiety rarely causes is paralysis. With anxiety, even though sensations can still occur, the ability to move or act is still generally present. Facial paralysis, where your face starts to “fall” and you drool or choke because you cannot move, is a stroke symptom.

Associated Symptoms

Panic Attacks: Often accompanied by other anxiety symptoms like rapid heartbeat, sweating, trembling, and psychological symptoms such as fear of losing control.

Strokes: Strokes are a loss of brain function. Though they can cause anxiety, they do not generally occur concurrently with other anxiety symptoms.

Age and Risk Factors

Panic Attacks: Can occur at any age but often begin in young adulthood. Strokes are uncommon in those under 55, those without a family history, and those without high blood pressure or high cholesterol.

Strokes: More common in older adults and those with cardiovascular risk factors.

The Psychological Impact: Health Anxiety After Panic Attacks

Experiencing symptoms that mimic severe medical conditions can create lasting anxiety about your health. Those with severe anxiety are rarely satisfied with a panic attack diagnosis. Because the symptoms are so similar and can have so much in common, it becomes too hard to believe that they are caused by something non-physical.

This health anxiety can become a cycle: fear of having another panic attack can trigger more panic attacks. Understanding this pattern is crucial for breaking free from it.

Treatment Approaches: A Whole-Person Perspective

Understanding the Mind-Body Connection

Panic attacks demonstrate the powerful connection between our mental and physical states. The most important thing to understand is that anxiety is not just a problem with the way you think. It also affects the way you feel. It can cause chain reactions that lead to symptoms so pronounced that they feel like you are suffering from a stroke.

Evidence-Based Treatment Options

Cognitive Behavioral Therapy (CBT): Effective therapies for panic disorder include cognitive behavioral therapy and antidepressants. CBT helps you understand the relationship between thoughts, feelings, and physical sensations, providing tools to manage panic attacks when they occur.

Group Therapy Benefits: Group therapy settings offer unique advantages for panic disorder treatment. In group sessions, you can:

• Learn from others who understand your experience

• Practice coping strategies in a supportive environment

• Reduce isolation and shame often associated with panic attacks

• Gain perspective on your own recovery journey

Exposure Therapy: The efficacy of exposure techniques alone, in which the patient repeatedly confronts the anxiety-provoking stimulus through imagery or in vivo (directly facing what is feared), is well established in patients with panic disorder.