Shortness of breath panic attack
Shortness of Breath, Racing Heart, & More
Written by Melissa Conrad Stöppler, MD
In this Article
- How Long Do Panic Attacks Last?
- What Else Should I Know About Panic Disorder?
Panic attacks involve sudden feelings of terror that strike without warning. These episodes can occur at any time, even during sleep. People experiencing a panic attack may believe they are dying or going crazy. The fear and terror that a person experiences during a panic attack are not in proportion to the true situation and may be unrelated to what is happening around them.
You may also think you're having a heart attack, and it's true that some of the symptoms can be similar. However, most people having a panic attack have had one before, triggered by a similar event or situation.
The chest pain of a panic attack usually stays in the mid-chest area (the pain of a heart attack commonly moves toward the left arm or jaw). You may also have rapid breathing, rapid heartbeat, and fear. Panic attacks come and disappear suddenly, but leave you exhausted.
If you suddenly have four or more of these symptoms, you may be having a panic attack:
- Sudden high anxiety with or without a cause
- A "racing" heart
- Feeling weak, faint, or dizzy
- Shaking
- Tingling or numbness in the hands and fingers
- Sense of terror, or impending doom or death
- Feeling sweaty or having chills
- Nausea
- Chest pain or discomfort
- Breathing difficulties, including a "smothering" sensation or shortness of breath
- A feeling of choking
- Feeling a loss of control
- A sense of unreality
- A fear of going crazy or losing control
- A fear of dying
How Long Do Panic Attacks Last?
Panic attacks are generally brief, lasting less than 10 minutes, although some of the symptoms may last longer. An isolated panic attack, while extremely unpleasant, is not uncommon or life-threatening.
Panic attacks can be a symptom of other anxiety disorders, and people who’ve had one panic attack are at greater risk for another compared to those who’ve never had one.
Panic attacks and panic disorder are not the same thing. When the attacks happen repeatedly and you worry about having more episodes, you may have panic disorder.
What Else Should I Know About Panic Disorder?
People with panic disorder may be extremely anxious and fearful, since they are unable to predict when the next episode will occur. Panic disorder is fairly common and affects about 6 million adults in the U.S. Women are twice as likely as men to develop the condition, and its symptoms usually begin in early adulthood.
It is not clear what causes panic disorder. In many people who have the biological vulnerability to panic attacks, they may develop in association with major life changes (such as getting married, having a child, starting a first job, etc.) and major lifestyle stressors. There is also some evidence that suggests that the tendency to develop panic disorder may run in families. People who suffer from panic disorder are also more likely than others to suffer from depression, attempt suicide, or to abuse alcohol or drugs.
Fortunately, panic disorder is a treatable condition. Psychotherapy and medications have both been used, either singly or in combination, for successful treatment of panic disorder. If medication is necessary, your doctor may prescribe anti-anxiety medications, certain antidepressants or sometimes certain anticonvulsant drugs that also have anti-anxiety properties, or a class of heart medications known as beta-blockers to help prevent or control the episodes in panic disorder.
Anxiety & Panic Disorders Guide
- Overview
- Symptoms & Types
- Treatment & Care
- Living & Managing
Is My Shortness of Breath an Anxiety Attack or Coronavirus?
Information regarding COVID-19 and vaccines are continually evolving, new details may be available since this content was developed. Please visit the CDC's website for the most up to date information.
By: Larry Ginsberg
A common symptom associated with both COVID-19 and an anxiety attack (or panic attack disorder) is shortness of breath. What may have seemed like shortness of breath due to a mild anxiety attack three months ago may now be more concerning because of heightened fear related to COVID-19.
What’s the difference?
Shortness of breath from an anxiety or panic attack is different from symptoms related to COVID-19, in that it typically lasts from 10 to 30 minutes. These episodes or brief periods of shortness of breath are not accompanied by other symptoms and don’t continue over an extended period of time.
Shortness of breath related to COVID-19 lasts longer than a 10 to 30 minute period and might be accompanied by other symptoms, including:
- Fever (over 100)
- Dry cough
- Chest tightness
- Chills
- Repeated shaking with chills
- Muscle pain
- Headache
- Sore throat
- New loss of taste or smell
According to Magdalena Spariosu, M.
D., acting chair of the Department of Psychiatry at Hackensack University Medical Center, “During the COVID-19 crisis, it would not be unusual for anyone to experience an anxiety attack. Some people may have experienced these before or been diagnosed, and others may be experiencing them for the first time due to these highly stressful circumstances.”
She adds, “An anxiety attack usually has a quick onset and can come from a feeling of fear or discomfort. This shortness of breath can often be reduced by deep breathing exercises and other healthy coping mechanisms.”
Try 4-7-8 Breathing
A simple deep breathing exercise can help manage an anxiety attack and provides a calming sense in any stressful situation. Try this:
- Sit or lie comfortably with your back straight.
- Exhale completely through your mouth.
- Close your mouth lightly and inhale through your nose quietly to the count of 4.
- Hold your breath for a count of 7.
- Exhale audibly through your mouth for a count of 8.
- Repeat steps 3 to 6 three more times for a total of four breath cycles.
Tips to Manage Anxiety and Stress
- Maintain a healthy diet. Avoid binge eating or stress eating, which is common during periods of distress and uncertainty.
- Stay active and exercise regularly. Walk outdoors on a nice day, or dust off some of that old fitness equipment in the basement.
- Participate in hobbies and interests. Puzzles are one of the most popular items on the internet lately, which is an activity that encourages concentration and can be done alone or with others.
If you are experiencing stress or anxiety and need to determine if it is COVID-19 related, contact your primary care physician, many of whom are now offering virtual visits via phone or computer. Urgent care centers and telemedicine resources such as Convenient Care NOW are also helpful resources.
In case of emergency, contact a crisis hotline or call 911.
Next Steps & Resources:
- Meet our clinical contributor: Magdalena Spariosu, M.D., acting chair of the Department of Psychiatry at Hackensack University Medical Center
- To make an appointment with Dr. Spariosu or a doctor near you, call 800-822-8905 or visit our website.
- Hackensack Meridian Health Behavioral Health and Psychiatry
The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.
Fear of suffocation during a panic attack. Fear of lack of air, phobia to suffocate
In order to analyze in more detail such a symptom of a panic attack - lack of air and a state of suffocation, let's remember what a panic attack is, as such, and what are its main symptoms.
So, as many people know, a panic attack is a sudden attack of anxiety and fear without any objective reasons.
The state arises absolutely spontaneously, and also suddenly subsides. The main symptomatology lies mainly in the somatic field. According to statistics, 1 out of 20 people suffer from this psychosomatic disease, and young people and women experience it more often than the elderly and men.
Main symptoms:
As noted above, the symptoms of this psychopathy appear absolutely for no reason, in other words, nothing bad happens in the patient's life, the attack is not associated with a stressful situation or any real threat. In addition, unlike other similar destructions, the manifestations of a panic attack pass within 10-30 minutes and do not leave any reminders of themselves, as if they never happened. What are the basic sensations of the patient expressed in:
- Pronounced anxiety , feeling of danger, fear of death and fear of suffocation, without any objective reasons or reasonable explanations
- Tachycardia and dyspnea
- Persistent anginophobia feeling short of breath and fear of suffocation
- Feeling of a lump in the throat
- Neuralgia , chest compression, body pain
- Disorientation in space, dizziness
- Nausea attack , pain in the gastrointestinal tract
- Tremor and numbness of limbs
- Increased sweating , flushing
- Vision problems , veil before eyes
- Feeling unreality of the situation (events can be perceived as in a dream)
One of the fundamental signs, as noted above, is anginophobia.
We will talk about it in more detail in this article.
What is anginophobia
Anginophobia is a persistent fear of suffocation or the inability to breathe. In earlier interpretations, this term meant only the fear of suffocation against the background of a heart attack. In modern psychiatry, the anamnesis of anginophobia is expanded and includes the fear of suffocation or even choking, in general, to face any causes that can stop breathing. The cause of this phobia can be anything, moreover, that does not exist in real life: other people, poor ecology, unhealthy lifestyle, diseases that may not exist. It's important to notice. That anginophobia can also occur in people who are healthy from the point of view of somatics.
Signs and causes of anginophobia
General signs of this particular symptom of panic attacks do not differ much from the main list and include such manifestations as:
- Vertigo disease (dizziness) and disorientation in space
- Feeling sick
- Tachycardia
- Increased sweating
- Gastrointestinal disorder
- Trembling and numbness of limbs
- Numbness, fear of losing speech or inability to say anything
- Discoloration of the skin on the face or body
- Coughing fit and general feeling of being unable to breathe
- Loss of contact with reality , feeling faint
Causes of anginophobia:
It is worth noting that, according to the psychiatric community, anginophobia often comes in combination with such types of neurosis and neurasthenic disorders as anxiety, schizoid, bipolar and cardiophobic (fear of cardiac arrest).
Common causes include:
- Hazardous working conditions and occupations with real life risks, altered environments and confined spaces. Work in mines, at depth, at height (high-rise workers, submariners, miners, firefighters). A subconscious sense of danger can lead to similar neurotic changes.
- Wrong lifestyle and addictions: Alcoholism, drug addiction, substance abuse and even smoking. As well as deliberate provocation of the state of asphyxia, for example, a tendency to suffocate during intimate games.
- Presence of bronchial asthma or allergies . Subconsciously, the patient is afraid that in the end he will not be able to breathe during the next attack.
- Increased suggestibility and information rubbish. Some people attach too much importance to stories and what the media broadcasts.
- Past psychotrauma associated with suffocation. Such a stressful situation can subsequently accompany a person all his life and manifest itself when, in fact, there is no real threat.
- Real serious diseases related to the respiratory or cardiovascular system. Fear of attacks of the past.
How to overcome the fear of suffocation
With a mild course of the disease and moderate symptoms of an attack, a person is able to calm himself and reduce the symptoms to nothing in the shortest possible time.
It is in relation to panic attacks and any of their manifestations that the phrase “saving the drowning is the work of the drowning themselves” comes in very handy. In a situation of an attack, it is extremely important for a person to remember that breathing is a natural process, and by itself it cannot be interrupted. Even the presence of serious pathological changes, such as asthma, for example, cannot lead to suffocation if you monitor your condition and control the course of the disease. In order to minimize possible attacks, it is very important to treat yourself and your body with care and attention, lead a proper lifestyle, control your physical, and above all, your mental state.
Quite often, people are able to anticipate the onset of an attack and calm themselves down on their own or take a number of actions that can help.
What to do during a panic attack. How to quickly relieve a symptom
In the event of an attack, it is important:
- Move away from the edge of the road and from the main streams of people, ideally find a calm, least crowded place.
- If medication is prescribed, take medication as soon as possible.
- Independently shift the focus of attention from internal to external sensations, you can simply start counting up to 100 or look around and name the colors of the surrounding objects.
- Concentrate on sounds and sensations, say out loud what you see, feel or hear.
- Try to find tension in the body and relax.
- Decentralize attention, for example, play a game on the phone
What to do if during a panic attack you suffer from suffocation and lack of air:
- Work with breathing and try to stabilize it yourself.
For 4 seconds a slow breath and for 4 seconds the same exhalation. - Optional bag breathing method to neutralize lung hyperventilation and carbon dioxide concentration.
- Try to exhale as much as possible. Exhalation should be easy, which means that the feeling of the impossibility of inhalation is nothing more than a consequence of neurosis.
If a panic attack overtook a person next to you, the main task is to take him to a quiet deserted place and help stabilize his breathing.
As we already know, one of the most frightening signs for the patient is a feeling of lack of air. Most often, our patients describe this symptom as a state of complete destabilization of breathing.
Difficulty breathing during panic attacks
Shortness of breath is one of the most common and frightening symptoms. In a state of suffocation, it is important for the patient to remember that everything that happens and even real sensations in the body are a consequence of his neurotic state at the moment.
The most dangerous moment is the possibility of a real attack of asphyxia associated with a physical condition, but even here there is a way to calm yourself. Take, for example, a disease such as asthma, which can actually be a symptom of suffocation. So, in this aspect, it is important to know that in a state of neurosis, a person, first of all, cannot inhale, although he does not feel any problems with exhalation, and there may also be a “lump in the throat.” So, with asthma, everything happens the other way around: inhalation is easy, but the asthmatic can no longer exhale or does it with great difficulty.
Is it possible to suffocate from a panic attack
No. If asthma attacks are associated specifically with a panic attack, then this is not dangerous to health. All symptoms disappear as soon as the patient manages to calm down.
Lack of air and the inability to breathe evenly affect the mental state, anginophobia and unregulated fear can prolong the attack and eventually lead to a more severe stage and chronic pathology, for example, develop a generalized disorder, the duration of an attack in which can reach up to 1 hour.
That is why it is extremely important to monitor your condition and try to prevent the development of the chronic form of various disorders.
What can I do to prevent a panic attack from turning into a panic disorder?
First of all. It is necessary to follow the rules of prevention, which we have already talked about in this article: control of one's own condition, the right lifestyle, accompanying body-oriented practices (meditation, yoga, massages, hydrotherapy), correct thinking and avoiding an overabundance of information. However, if the choking attack provoked by a panic attack has happened more than once, then you should immediately contact a specialist. Professional timely treatment can not only prevent the development of various disorders, but also completely nullify the symptoms.
How to treat panic attacks and when to see a specialist
In fact, it is necessary to see a specialist even if you are experiencing an attack for the first time.
There can be a huge number of reasons for a panic attack, which can only be determined by resorting to professional diagnostics. Timely initiation of treatment can save a person from many further problems. It is also worth paying attention to the symptoms. If asthma attacks, accompanied by a feeling of inability to inhale, occur more than 1 time, then this is the sign in which you should immediately contact specialists: a psychotherapist, a neurologist and a psychiatrist. A psychologist will not help in this case, since he works exclusively in the mental field. A panic attack is a psychosomatic disease that affects not only the mental, but primarily the physical plane. Psychotherapeutic treatment includes an integrated approach consisting of medication and psychotherapy.
Definitely will be in the development of a treatment plan. The initial causes that led to the development of panic states, as well as concomitant diseases and individual characteristics of the patient's psyche, were taken into account.
Psychotherapeutic approach
Most often, the most popular method in psychotherapy is the method of CBT (cognitive - behavioral therapy), the main purpose of which is to correct the patient's behavior during an attack and change his perception of what is happening. In other words, this technique can be called fear management lessons. Next, classical psychoanalysis is applied, aimed at finding the underlying causes and possible psychotraumas that led to the current state. Also mandatory will be body-oriented practices that help to relax and learn to be aware of the processes occurring in the body. Quite often, psychotherapy also includes gestalt therapy, which can identify unmet needs and family sessions, in which the specialist works with the patient's relatives in order to teach them first aid and general support.
Drug therapy
A well-chosen course of drugs helps to reduce the frequency and intensity of panic attacks. Most often in modern drug psychotherapy drugs of the following clusters are used:
- Cluster of tranquilizers .
It is used for immediate relief of an attack. It is advised to use with caution and only in a situation of urgent need, since this group has a number of side effects: decreased attention, deconcentration. - Cluster of antidepressants . The use of course therapy is allowed. Aimed at improving mood, relieving anxiety and relieving symptoms of depression.
- Cluster of beta-blockers . Aimed at stopping seizures with pronounced somatics: increased blood pressure, tachycardia, shortness of breath.
- Nootropic Cluster . It has an anti-stress effect, activates the brain and increases the effectiveness of other medicinal groups.
Cluster of nootropics. It has an anti-stress effect, activates the brain and increases the effectiveness of other medicinal groups.
What to do in case of a panic attack?
. Psychologist's adviceUpdated October 27, 2022, 13:24
Shutterstock
Fear, fright and anxiety are evolutionarily necessary for a person to survive.
However, sometimes high anxiety can provoke panic disorder, in which there are repeated bouts of severe anxiety - panic. If attacks occur frequently, the quality of life is rapidly reduced, so it is important to learn how to cope with them.
RBC Life, together with experts, understands how you can help yourself and your loved ones when faced with this destructive state.
Contents
- What is it
- Symptoms
- Causes
- What to do
- How to help a person
What is a panic attack
Pexels
A panic attack is a sudden attack of anxiety, an acute fright, which is accompanied by a deterioration in well-being, unpleasant sensations in the body and autonomic disorders - rapid breathing, tachycardia, sweating, weakness, decreased pressure, tremor or a feeling of suffocation, lasting, as a rule, from 5 to 30 minutes.
Usually a person is afraid of such a condition and perceives the symptoms as a manifestation of a heart attack or stroke.
In this case, an uncontrollable fear of death may appear.
“A panic attack is not a diagnosable disease, but a symptom that may indicate that a person has an anxiety disorder, emotional exhaustion, or chronic stress. At its core, this is not a disease, it is a misinterpretation of the condition. And this condition arises due to chronic emotional overstrain,” explains Alexey Krasikov, founder of the School of Emotional Intelligence and Psychotherapy, consultant psychologist in the field of anxiety disorders and the development of stress resistance.
Psychologist Andrei Chernyshev tells how important it is to distinguish a panic attack from an attack of fear. In the first case, the episode will be limited in time: the attack usually lasts 15–20 minutes. This is due to the release of hormones - adrenaline, norepinephrine, cortisol.
Panic attacks are the result of destructive thoughts that a person constantly scrolls in his head. Concentrating on these scripts can cause impotence, headaches, or nausea.
In addition, panic attacks can cause immediate harm to health, as attacks occur suddenly, sometimes while driving or in a dream, the expert notes.
Panic attacks are a manifestation of phobias or anxiety-depressive disorders, says Sergey Pozdnyakov, head of the Center for Psychological Correction of Diseases at Medsi Group. Previously, panic attacks were diagnosed mainly in women aged 20–45, but today they appear in children of seven–eight years, as well as in people aged 70+. The increase in the number of disorders is influenced by the accelerating rhythm of life and the increase in the information flow, which constantly affects the nervous system. According to WHO, 30% of the world's population has experienced a panic attack at least once in their lives.
Panic attack symptoms
Shutterstock
As Aleksey Krasikov notes, a panic attack is often confused with a heart attack. But there are a number of nuances. For example, pain in angina pectoris is described as a “burning sensation in the chest”, and during a vegetative crisis, they may not be at all.
Patients report feelings of anxiety, a feeling that the heart is not working “correctly”, but do not experience symptoms of angina pectoris. A panic attack is an emotional, not a physiological, disorder, so sedatives help to correct the situation. Drugs that stop cardiac symptoms are useless in this case, the psychologist adds.
Anastasia AfanasyevaPsychiatrist, psychotherapist, clinical director of the psychological platform Alter
“Panic attacks manifest through physical and mental symptoms. You can understand that this is a panic attack if there are at least two physical signs and at least one of the mental ones.
Physical symptoms of a panic attack may include: The following manifestations are considered to be mental signs of a panic attack: Shutterstock Aleksey Krasikov notes that the main cause of a panic attack is fear. A person experiences unusual experiences and misinterprets them - believes in a catastrophe or feels the proximity of death. In this case, the balance between the sympathetic and parasympathetic nervous systems shifts towards the first. In fact, a panic attack is an instinct of a person who scared himself. A person does not have a predisposition to panic attacks, a study by the US National Institute of Mental Health has proven [1]. Among the risk factors for the development of panic attacks [2]: Anastasia Afanasyeva: “A panic attack is an excessive reaction of the body to a stimulus that our brain regards as a danger to life. That is why one of the characteristic signs of a panic attack is the fear of dying or not getting help. The brain receives a signal that it labels as a threat to our existence, and begins to secrete norepinephrine, which, in turn, stimulates the adrenal glands to produce stress hormones - adrenaline and cortisol. When adrenaline enters the bloodstream, it triggers automatic survival responses: fight, run or freeze. In order for the body to perform these actions, adrenaline acts on various body systems, making them work faster and more intensively. For example, in order to strike or run away, our muscles must actively contract, for this they need energy, which is taken from oxygen and glucose in the blood. Therefore, the lungs begin to breathe faster, and the heart begins to beat harder to pump blood faster. These are the physical signs we see in a panic attack.” Unsplash If you suspect that you have an anxiety disorder, psychologist Alexei Krasikov advises you to see a doctor. It is necessary to conduct an examination of the body: get advice from a cardiologist and a neurologist, evaluate clinical blood indices, hormone levels, and do an ultrasound scan. If health problems are identified at this stage, the patient will be referred to a specialized specialist for the selection of therapy. If no diseases are detected, psychotherapists and psychologists are involved. They will teach you how to respond appropriately to life's circumstances. Such therapy includes: According to the psychologist, sedatives are required only at the beginning of therapy or in especially severe cases. Duration of admission depends on the specific case and usually takes from several months to a year. Pexels Here are some tips from psychologist Aleksey Krasikov on how to deal with an attack on your own: Andrey Chernyshev says that the fear that causes panic is accompanied by tunnel thinking. In this case, a person cannot be distracted from experiences. Anastasia Afanasyeva: “It's ironic that the key rule for coping with a panic attack is not to react to it in any way. In fact, this is biologically justified: when adrenaline rages in the body and causes all those signs of a panic attack that we talked about, a person perceives these symptoms as a sign that something terrible will happen to him now, and begins to worry even more. So we find ourselves in a vicious circle: adrenaline is released again in the body, and all sensations are intensified. If we realize that there is no direct threat to our life and that our brain is just "playing it safe", then the panic will go away in just a few minutes. Therefore, at the moment of great stress, it is important to remember that this is only an adrenaline rush and nothing threatens us physically. This reaction will quickly end if we stop feeding it. Try to imagine that this feeling of anxiety is like a wave that rolls in and gradually fades. It also helps at times like this to just keep doing what you were doing, like walking down the street. Breathing practices are very helpful. They activate the parasympathetic system, which creates a sense of security. Physical activity is also important, especially outdoors. Walk, run, jump, dance - movement helps to work off excess adrenaline and complete the cycle of stress response. Finally, look to others for support. If there is someone around to talk to, or better yet, hug, don't hesitate to ask for it. What you definitely shouldn't do is eat up panic or fight it with alcohol or other substances. This may provide temporary relief, but in the end it will only aggravate your condition and lead to other unpleasant consequences. The best way to deal with anxiety is to allow yourself to experience those emotions and reactions rather than trying to dull them. If you have panic attacks on a regular basis and you feel that you cannot cope with them on your own, do not hesitate, contact a psychotherapist. Pexels Anastasia Afanasyeva: “If we see that someone has a panic attack, the main thing we can do is help the person survive it.
Causes of panic attacks
Their main cause is a general anxiety condition caused by various circumstances.
How does a panic attack occur?
How to deal with a panic attack
Panic Attack Self Help
This in itself is completely safe. 
It's like blinders that are put on horses to keep them looking straight ahead. A person who has succumbed to panic also perceives information. Therefore, in order to stop an attack, it is important to stop and think in time. It is difficult to do this at the moment of panic, but you can think over the tactics of behavior while in a calm state. The psychologist advises to remember people, events or things that give a sense of security. Or set a reminder on your phone and write anything that will help you feel better. 
How to help a person with a panic attack
