Types of Panic Attacks: Symptoms and Coping Strategies

by | Apr 9, 2024 | Anxiety

Facing a panic attack can be an intense and terrifying experience. The overwhelming anxiety, fear, or terror can make you feel powerless and out of control. Identifying the nature of your panic attack—whether it occurs unexpectedly, in anticipation of a specific trigger, or disrupts your sleep at night—is an important step toward managing these scary episodes. Understanding the physical and emotional symptoms associated with each type of panic attack is important to managing these challenging moments.

The sense of distress and confusion that follows a panic attack is increased by its unpredictability and the physical symptoms that come with it. For example, a racing heart, difficulty breathing, and a feeling of impending doom. These symptoms disrupt your daily life and your ability to enjoy a fulfilling existence. It’s important to recognize the signs of a panic attack early and understand their causes. This knowledge can help address the anxiety and helplessness that intensify the impact of these episodes, highlighting the need for effective coping strategies.

We’ve put together useful advice and straightforward strategies to help you deal with the challenges of panic attacks. By understanding each type of panic attack and using clear, actionable techniques, you can take steps to reclaim control over your life. This guide resource offers you the tools and knowledge to face panic with confidence and resilience, leading to a stronger, more peaceful existence.

Key Takeaways

  • Panic attacks are categorized into unexpected, expected, and nocturnal types, each with distinct triggers and symptoms such as:
    • Rapid heart rate
    • Shortness of breath
    • A sense of looming danger
  • The physical and emotional symptoms of panic attacks disrupt daily life and may mimic serious health conditions; need medical evaluation to rule out other issues and start appropriate treatment.
  • Effective management of panic and anxiety disorders includes a blend of medication, such as selective serotonin reuptake inhibitors and benzodiazepines, and psychotherapy, including cognitive-behavioral therapy, with strategies customized to individual patient needs.

Classifying Panic Attacks: Understanding the Different Types

Panic disorders are classified into three types, each essential to understand for effectively managing the condition. The primary types of panic attacks are unexpected, expected, and nocturnal, each presenting with unique triggers and symptoms.

The different types of panic attacks include:

  1. Unexpected (Spontaneous): This occurs without any obvious cause or warning. It can happen at any time, in any situation, even during calm states or sleep.
  2. Situationally Bound (Cued): Panic attacks are triggered by specific situations or environments that the person finds particularly stressful or frightening. They occur almost immediately upon exposure to or anticipation of the triggering situation.
  3. Situationally Predisposed: These may not occur directly in response to a trigger or situation but are more likely to occur in certain contexts. For example, someone might not always have a panic attack in crowded spaces but feels more prone to having one in those settings.

Unexpected Panic Attacks: When Anxiety Strikes Without Warning

Unexpected panic attacks are episodes of intense fear that occur without warning. This panic attack is distinguished by its sudden and unpredictable nature, with no apparent trigger. Some physical symptoms individuals may experience include:

  • Rapid heart rate
  • Shortness of breath
  • Trembling
  • Sweating

They may also feel a profound sense of impending doom.

These attacks can strike at any moment, and the uncertainty of their occurrence can create a constant undercurrent of anxiety. This type of panic attack can make people feel as if they are at the mercy of their anxiety, contributing to a cycle of fear and worry.

Expected Panic Attacks: Triggered by Known Fears

Specific situations or phobias trigger distinct from their unexpected counterparts, situational panic attacks. The symptoms of these attacks are closely linked to the triggering situation and typically subside when the individual is removed from the circumstance.

Specific phobias, defined as fears of particular activities, objects, and scenarios to an excessive degree, can trigger expected panic attacks. For instance, someone with a fear of flying might experience a panic attack during takeoff or turbulence.

Nocturnal Panic Attacks: The Terror of the Night

A unique type of panic attack occurs during the night while an individual is asleep, known as a nocturnal panic attack. These attacks disrupt sleep patterns by waking individuals with intense fear and physical symptoms.

The cause of nocturnal panic attacks is not entirely understood, but one theory posits a link to hypersensitivity to changes in breathing rate or a fear of losing control during sleep. These attacks can create a fear of sleep, further disrupting rest and contributing to a cycle of anxiety.

Identifying Symptoms of Panic Attacks

Panic attacks can present a combination of intense physical sensations and emotional distress. The physical symptoms can include sweating, shaking, and chest pain, while emotional distress can manifest as feelings of unreality, fear of dying or going mad.

The intensity of a panic attack can often mimic symptoms of serious health issues, such as heart attacks, peaking within 10 minutes. This similarity makes it crucial for healthcare providers to differentiate panic attacks from other medical conditions, ensuring appropriate treatment.

Physical Reactions During Panic Attacks

Physical reactions during panic attacks can be intense and frightening. Symptoms include:

  • Rapid heartbeat
  • The feeling of constriction in the chest
  • Breathing difficulties
  • Dizziness
  • Numbness
  • Tingling sensations
  • Unpleasant feelings

These symptoms contribute to the overwhelming nature of limited-symptom panic attacks, which can be particularly distressing for those experiencing repeated panic attacks.

Increased heart rate and muscle tension can serve as early warning signs of an impending panic attack. Following a panic attack, individuals often experience fatigue, feeling completely worn out by the ordeal.

Emotional Turmoil and Panic Attack Triggers

In addition to physical symptoms, panic attacks often come with emotional turmoil. Panic attacks often lead to the experience of unexplainable fear and anxiety, which are common emotional symptoms. These feelings can be overwhelming for those affected.

Certain triggers can bring about panic attacks. Phobias, which are exaggerated fears of specific objects, activities, or scenarios, can trigger panic attacks. Additionally, anticipatory panic attacks often occur in the context of anxiety about an upcoming event, such as the fear experienced prior to public speaking.

The Impact of Panic Disorder on Mental Health

Panic disorder can have a substantial impact on mental health. Diagnosing panic disorder involves specific criteria, which must be met beyond the occurrence of panic attacks. Initial evaluation includes a discussion of symptoms, known triggers, and the overall impact on daily life and functioning.

Without appropriate treatment, panic disorder can evolve into an extremely debilitating condition, potentially leading to additional mental health issues. These may include agoraphobia or other phobias, which further affect the patient’s quality of life.

Coexisting Conditions: Anxiety Disorders and Panic

Panic disorder often coexists with other mental health conditions, and understanding panic disorder symptoms is crucial. For instance, freeze mode or dissociative panic attacks, which result in feelings of detachment from the body or environment, can mirror Post-Traumatic Stress Disorder (PTSD) symptoms.

Symptoms of Obsessive-Compulsive Disorder (OCD), such as overwhelming unwanted thoughts and repetitive behaviors, can be associated with the intense anxiety also present in panic disorder. Panic disorder can also exist alongside social anxiety disorder, characterized by extreme fear in social interactions.

Feeling worried without a particular reason, a hallmark of generalized anxiety disorder is a distressing experience affecting individuals with panic disorder.

The Vicious Cycle: Fear of Future Panic Attacks

Beyond the immediate distress of a panic attack, the fear of future attacks can create a vicious cycle of anticipatory anxiety. This fear can lead to avoidance behaviors, such as:

  • Steering clear of situations that might trigger panic attacks
  • Avoiding crowded places or social events
  • Limiting travel or avoiding certain modes of transportation
  • Avoiding exercise or physical exertion
  • Restricting diet or avoiding certain foods or drinks

These avoidance behaviors further entrench the cycle of panic.

Avoidance reinforces the misconception in the brain that certain situations are genuinely dangerous, strengthening the cycle of fear and the likelihood of future panic attacks. This cycle can have detrimental consequences, compromising a person’s overall well-being and resulting in social isolation.

Coping Strategies for Managing Panic Attacks

Coping strategies can be a lifeline for individuals experiencing panic attacks. Here are some strategies that can be beneficial during a panic attack:

  • Using focus objects
  • Repeating an internal mantra
  • Practicing progressive muscle relaxation
  • Mindfulness exercises

These strategies can help individuals manage their panic attacks and regain a sense of calm.

Other techniques that can assist in coping with panic attack symptoms include:

  • Distraction methods like counting backward or recalling words from a song
  • Deep breathing exercises
  • Progressive muscle relaxation
  • Mindfulness and meditation

In addition, exposure therapy, a controlled method of gradual exposure to fear-inducing situations, is a highly effective approach for treating panic attacks.

Recognizing Early Warning Signs

Recognizing early warning signs can be a key strategy in managing panic attacks. Before a panic attack, individuals may excessively focus on minor bodily sensations and catastrophically misinterpret them, igniting a nervous system response.

Anxiety symptoms such as heightened vigilance, irrational thinking, and a sense of impending doom can signal the onset of a panic attack. Triggers for panic attacks can include:

  • Over breathing
  • Long-term stress
  • Intense physical responses
  • Abrupt environmental changes like entering a crowded space.

Implementing breathing exercises and relaxation techniques can be effective strategies for preventing the escalation of a panic attack.

Preventative Measures and Lifestyle Changes

Preventative measures and lifestyle changes can significantly reduce the likelihood of panic attacks. Improvements in diet, increased exercise, and proper sleep can assist in controlling symptoms of panic disorder.

Avoiding caffeine, engaging in daily exercise, and maintaining a balanced diet can decrease the likelihood of panic attacks. By preventing certain situations or regulating exercise to maintain a lower heart rate, individuals can reduce triggers that may lead to panic attacks.

Treatment Options for Panic and Anxiety Disorders

Effective treatment for panic and anxiety disorders can involve a combination of medication and psychotherapy. Antidepressants, including selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs), along with benzodiazepines, are commonly prescribed medications for treating panic attacks.

Psychotherapy, particularly cognitive-behavioral therapy, is frequently recommended for panic disorder and can be used in conjunction with medication, depending on individual needs. Creating a comprehensive treatment plan for panic disorder involves considering the patient’s specific circumstances, such as their history, severity of the disorder, and potential interactions with other medications or supplements being taken.

Medication Management: Antidepressants and Benzodiazepines

Medication management is a crucial aspect of treating panic disorder. Selective serotonin reuptake inhibitors (SSRIs) and benzodiazepines are used to manage symptoms, with treatment choices tailored to the individual’s response.

However, being aware of potential side effects and risks is important. People who take antidepressants may experience side effects such as weight gain, upset stomach, and sleepiness. Other potential side effects may include nausea, sexual dysfunction, and headaches. Benzodiazepines can lead to side effects such as over-sedation and addiction and carry a risk of abuse and counter-effectiveness for panic disorders. Sudden discontinuation of benzodiazepines may result in withdrawal symptoms like extreme depression, exhaustion, and flu-like symptoms.

Mixing anxiety medications with alcohol, painkillers, or sleeping pills can pose a lethal risk.

Psychotherapy Approaches for Panic Attacks

Psychotherapy, particularly cognitive-behavioral therapy (CBT), is recognized as an effective primary treatment for both individual panic attacks and overall panic disorder.

Through CBT, patients can learn to understand their panic symptoms by experiencing them in a safe environment. This understanding helps in dispelling fears and misconceptions about the dangers of panic symptoms, reducing the frequency and intensity of panic attacks.

When to Seek Professional Help

Seeking professional help is a crucial step towards recovery, not a sign of weakness. Healthcare professionals create tailored recovery treatment plans for individuals with panic disorder.

A variety of support is provided by therapists, counselors, and mental health experts to guide and support those with panic disorder. While self-screening tests can be a starting point, they must be followed by professional assessment for accurate diagnosis.


In conclusion, panic attacks can be a deeply distressing experience, but understanding their types, symptoms, impacts, and coping strategies can help manage them. Recognizing early warning signs, implementing coping strategies, and seeking professional help can make an enormous difference in mitigating the impact of panic disorder on your life. Remember, seeking help is not a sign of weakness but a step towards recovery.

Frequently Asked Questions

What causes a panic attack?

Various factors, such as over-breathing, prolonged stress, intense physical activity, and sudden environmental changes can trigger panic attacks. Avoiding these triggers can help reduce the likelihood of panic attacks.

How do you get out of a panic attack cycle?

To break free from a panic attack cycle, practicing deep breathing, grounding techniques, light exercise, or repeating a mantra can help alleviate symptoms and establish a sense of control when the attacks occur. Creating a plan for dealing with panic attacks can also make them easier to manage.

What is the difference between an anxiety attack and a panic attack?

The main difference between an anxiety attack and a panic attack is their severity and cause. Panic attacks can be more intense and can occur with or without a trigger, while anxiety attacks are a response to a perceived threat.

What are the symptoms of a silent panic attack?

The symptoms of silent panic attacks may include sudden overwhelming fear, a sense of impending doom, dizziness, nausea, and derealization. It’s important to be aware of these signs for proper management.

What are the 4 different types of panic disorders?

Panic disorders are often classified into six types: Panic Disorder, Generalized Anxiety Disorder, Obsessive-Compulsive Disorder, Phobias, Social Anxiety Disorder, and Post-Traumatic Stress Disorder. Each type has its own set of characteristics and symptoms

Anastasiya Palopoli
Written by Anastasiya Palopoli

Anastasiya Palopoli, a board-certified Psychiatric Nurse Practitioner, has extensive experience in nursing and psychiatric care, with degrees in Nursing from UCF and Psychiatric Mental Health from the University of Cincinnati. Following a residency in General and Child Psychiatry in Florida, she specializes in treating Dementia, psychosis, depression, and anxiety through holistic approaches. Beyond her professional life, she enjoys hiking, tennis, and traveling with her family.