Surprising Facts About Panic Attacks

People talk about “having a panic attack,” but what does that really mean? Technically speaking, a panic attack is much more than an ordinary case of nerves. It’s an abrupt attack characterized by an intense fear of doom, disaster, or lost control, even when there’s no real danger. Yet the terror itself is very real. People in the grips of a full-blown panic attack may feel as if they’re literally having a heart attack, suffocating, going crazy, or even dying.

This feeling is heightened by the strong physical reaction that often accompanies a panic attack. Symptoms may include a racing heart, chest pain, shortness of breath, sweating, trembling, nausea, dizziness, choking feelings, tingling sensations, hot flushes, or chills. Many of the symptoms mimic those of other illnesses, such as heart disease or severe asthma, so panic sufferers may be convinced that they have a life-threatening medical condition.

About 6 million Americans experience repeated panic attacks in any given year, according to the Anxiety Disorders Association of America. Recent research has produced some fascinating insights into this widespread—but not widely understood—problem. Here are four findings that may surprise you.

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Fact 1: Panic attacks aren’t as out of the blue as they seem

One hallmark of panic attacks is that many seem to occur out of the blue. Yet the body may have some warning, even if the mind isn’t consciously aware of what’s coming. In a recent study, researchers at Southern Methodist University in Dallas outfitted panic sufferers with portable monitoring devices, which tracked their breathing, heart rate, and other bodily functions. Participants wore the monitors round the clock as they went about their daily activities.

Thirteen panic attacks occurred during the study. To the people having the attacks, they felt sudden and unexpected. But monitoring showed that waves of subtle physiological changes started an hour before panic sufferers felt the attacks begin.

Fact 2: Stressful events may trigger panic attacks months later

People with panic disorder have repeated panic attacks, and many worry a lot about when the next one will happen. Scientists also wonder about what sets panic in motion. In a study of adults with panic disorder, Brown University researchers found that stressful events at work or in close relationships—such as being laid off or having a big fight with a spouse—led to an increase in panic symptoms.

Surprisingly, though, symptoms didn’t spike right after the event. Instead, they increased slowly but steadily over the next three months.

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Fact 3: Regular exercise may help prevent panic disorder

Anxiety sensitivity refers to a fear of being harmed by symptoms such as a racing heart, shortness of breath, nausea, and dizziness. For people high in anxiety sensitivity, such symptoms can set off a panic reaction. In a study in Psychosomatic Medicine, participants inhaled carbon dioxide-enriched air—a harmless test procedure that typically gives rise to exactly these physical sensations. Afterward, participants rated their anxiety level.

People high in anxiety sensitivity tend to feel panicky in this situation. However, the panicky feelings were lessened among avid exercisers. This suggests that regular physical activity might keep some high-risk people from having panic attacks.

Fact 4: Breathing therapy may be useful for treating panic

A new treatment called capnometry-assisted respiratory training (CART) teaches people with panic disorder to calm their symptoms by normalizing their breathing. Hyperventilation is common in people with panic disorder. CART trains people to reverse hyperventilation with breathing exercises. In a head-to-head comparison, CART reduced panic symptoms as effectively as cognitive-behavioral therapy, the gold standard in talk therapy for anxiety.

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