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Are panic attacks mental or physical?

Sheri Van Dijk
Psychiatry

Panic attacks are a mental health problem, but that doesn't mean they aren't real, or that they're not distressing.

A panic attack is defined as having four or more physiological (e.g. racing heart, shortness of breath, dizzy/lightheadedness, nausea, shakiness, tight or heavy feeling in the chest) and cognitive symptoms (e.g. fear of dying, going crazy, passing, out, or making a fool of oneself, intense fear or panic, or the need to escape) all at the same time. Because so many of these symptoms are physiological, people often mistake this panic for a physical condition.

If you have a panic attack, it's very important to see your doctor for a check-up. You might have heard the old saying, "if it quacks like a duck, walks like a duck, then it's a duck" - while this is true, when it comes to the heart, we never take chances! So get yourself checked out to be safe, and to ensure that what you experienced actually was a panic attack and not some kind of physical problem.

Once you have the physical ruled out, you need to look at reducing your stress. Panic attacks come from anxiety, and anxiety is worsened by stress. So evaluate your life and see what stressors you're currently experiencing; see if you can take some of those stressors out of the picture - delegate, ask for help, say no to some requests.

Cut caffeine out. Caffeine is a stimulant and usually worsens anxiety. Some people can't bear to go without their coffee; if this is you, I suggest you do a two-week experiment: slowly wean yourself off caffeine (to prevent symptoms of withdrawal); and remain off caffeine for two weeks to see if this changes your anxiety, sleep, and irritability. If you don't notice any change, you may just be a person who isn't that sensitive to caffeine, and you can slowly re-introduce it into your life, paying close attention to any changes as you do. If you do notice a difference, you know you're more sensitive and should make this a permanent change.

Breathing properly is also extremely helpful with panic attacks and other anxiety problems. Google abdominal breathing or diaphragmatic breathing to get some instructions on breathing exercises.

If you've made these changes and continue to have panic attacks, it's likely time to see a therapist. Of course, medications can be very helpful with anxiety and you may need this short-term assistance; but psychotherapy is usually highly effective in treating panic and other anxiety disorders.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.