What is Panic Attack?

Panic attack, sudden onset of unexpected symptoms, rapid exacerbation of symptoms, lasting about 30 minutes, palpitations, shortness of breath, sweating, chest pain, suffocation, nausea, abdominal pain, tremor, headache. It is a condition accompanied by at least four of the 13 symptoms described below, accompanied by physical symptoms such as dizziness, numbness, hot flashes, etc., as well as fears such as fear of death, fear of going crazy, and fear of having a heart attack. Patients usually experience intense physical symptoms, and this is often accompanied by intense fear. The medical literature calls the condition that patients define in various ways, such as attacks, seizures, seizures, as panic attacks.

According to DSM-5, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association, at least four of the following symptoms must accompany the picture for the diagnosis of panic attack.

  1. Panic attack

  1. Palpitations, pounding heart or increased heart rate

  2. Sweating

  3. shaking or shaking

  4. The state of being short of breath or suffocating

  5. state of suffocation

  6. Chest pain or tightness in the chest

  7. nausea or abdominal pain

  8. Dizziness, inability to stand, lightheadedness, or fainting

  9. Sweating, trembling, chills or hot flashes

  10. Conflicts

  11. unreality (state of detachment or alienation)

  12. Fear of losing control or going crazy

  13. The fear of death


Many scientific studies on panic attacks generally divide panic attack symptoms into five groups: nocturnal type, respiratory type, cognitive type, fearless type, and vestibular type.

  1. nocturnal subtype

At night, the person wakes up with the complaints of intense panic attacks. As soon as the person wakes up from sleep, the complaints are quite severe before he can come to his senses. In order not to experience this situation again, he starts to avoid sleep and does not want to sleep. He fears that when he goes to sleep he will experience the symptoms of that nocturnal attack again. As sleep is avoided, sleep problems begin to accompany nocturnal attacks. Having sleep problems makes the attacks worse, becoming a vicious circle that escalates. It is a known medical fact that sleep problems trigger attacks and anxiety. Regulating sleep will reduce attacks and anxiety. We have said that nocturnal attacks are severe attacks that occur while the person is sleeping and wake the person. Over time, daytime panic attacks begin to accompany nocturnal attacks.

In those with nocturnal panic attacks, the disease is much more severe, and avoidance behaviors and reassurance-seeking are also high. Loss of control, feeling of going crazy, feeling of drowning, palpitations, pain/discomfort, numbness, tingling and dizziness were observed more in those with nocturnal panic attacks than in those without.

  1. Respiratory Subtype

Panic attacks, in which complaints about breathing are at the forefront, are defined as respiratory type panic attacks. The fact that four of the symptoms such as shortness of breath, suffocation, shortness of breath, chest pain, distress, fear of death, numbness-tingling are prominent and prominent may suggest that panic attack is a respiratory subtype. It has been shown that people with respiratory type panic attacks have a higher familial genetic load, and chest diseases such as asthma, bronchitis, and COPD are more common than those without respiratory type panic attacks. This type of chest disease can lead to an increase in the partial pressure of carbon dioxide. In people who are prone to panic attacks, this can cause a woefully suffocating false alarm. The continued increase in the amount of carbon dioxide can lead to panic attacks and panic disorder. This can increase the body’s sensitivity to carbon dioxide. Thus, the situation can become a vicious circle.

It has also been reported that patients with respiratory panic attacks are more likely to apply to non-psychiatry departments for health care services, diagnosis confusion increases, and health expenditures increase. As these people apply to chest diseases and other medical departments, and a disease related to these departments cannot be detected, as well as complaints continue, the patient’s anxiety may increase due to uncertainty and the disease may intensify.

While smoking and alcohol use rates were found to be higher in some studies in people with respiratory panic attacks, this difference could not be detected in some studies.


  1. Fearless panic attacks

Although some of the patients with panic attack experience physical symptoms prominently and distinctly, the fear of death, the fear of having a heart attack, the fear of losing control, etc., which are incompatible with this, do not accompany the somatic symptoms. Since these patients do not have symptoms of fear, it is more difficult to think that the condition may be psychiatric, which increases the confusion of diagnosis. Psychiatric treatment of these people is delayed.

  1. cognitive subtype

It is the opposite of the situation seen in fearless panic attacks. That is, bodily symptoms are very few, but again, inconsistent with this, intense fear and distress dominate the situation at that moment.

  1. Vestibular Type

It is a type in which symptoms related to otorhinolaryngology, namely dizziness and problems with balance, are at the forefront in attacks. Dizziness may be accompanied by nausea, vomiting, hot flashes, sweating, and chills.

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