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Panic Attack

Sudden, overwhelming fear, palpitations, shortness of breath, a sense of impending catastrophe – these are the experiences that can accompany a panic attack. For the person experiencing it, it is a terrifying event, often occurring unexpectedly, like a bolt from the blue, which makes it worth understanding what a panic attack is. Although the intensity of the sensations can lead to thoughts of loss of control, serious physical illness, or even death, it’s important to understand what a panic attack is and how to recognize it. panic attack and that it does not pose an immediate threat to life.

Understanding a Panic Attack

This experience, although alarming, is not uncommon. It is estimated that up to 9-10% of the population may experience a panic attack at some point in their lives. Being aware of this prevalence can help reduce the feelings of isolation and shame that often accompany people struggling with this problem. Panic attacks can significantly disrupt daily functioning, affecting work, relationships, and overall well-being.

Definition of a Panic Attack: What Is It and How to Recognize It?

A panic attack is a sudden episode of intense anxiety that can cause a variety of somatic symptoms. It is defined as a sudden episode of intense anxiety or discomfort that reaches its peak in a matter of minutes. It is a violent reaction of the body, often described as overwhelming, paralyzing and extremely unpleasant. The key characteristics of a panic attack are:

• Sudden onset: The attack occurs suddenly, often without a clear warning or obvious reason. A person may feel completely calm just before it occurs. Although often described as “unexpected”, panic attacks can also be triggered by specific situations (e.g., being in a crowd, an enclosed space) or internal stimuli (e.g., certain thoughts, physical sensations). This duality—the possibility of both spontaneous and situational attack—indicates the complexity of the underlying mechanisms. This may suggest the existence of both internal susceptibility (e.g. physiological, psychological) and the role of learned anxiety associations.
• Rapid escalation: Symptoms of a panic attack build up very quickly, reaching maximum intensity typically within 10 minutes of onset. This surge in symptoms is one of the elements that distinguishes a panic attack from other forms of anxiety.
• Limited duration: The peak of a panic attack itself is usually short-lived, lasting from a few to a dozen or so minutes. Some sources mention the possibility of recurrence in waves for an hour or two. However, even after the strongest symptoms have subsided, a person may experience fatigue, exhaustion, or anxiety for extended periods of time. This discrepancy between the clinical duration of the acute phase and the subjective sensation of prolonged discomfort is important for understanding the full impact of the attack on the person.
• Intensity: The experience is described as extremely intense, incapacitating, often combined with a sense of loss of control or impending death.

It is also worth mentioning nocturnal panic attacks, which wake a person up from sleep in a state of panic, presenting symptoms similar to those experienced during the day. They can be especially frightening due to sudden wake-up and disorientation.

Panic attack and everyday anxiety: how to distinguish between these conditions?

While both a panic attack and general anxiety or stress are associated with feelings of anxiety and can share some physical symptoms (e.g. a racing heartbeat), there are key differences between them. Understanding these differences is important for properly identifying the problem and seeking appropriate help.

• Intensity: A panic attack is characterized by extremely intense, overwhelming anxiety, often disproportionate to the real threat. General anxiety tends to be less severe, ranging from mild anxiety to significant worry.
• Beginning: A panic attack occurs suddenly, violently. General anxiety often increases gradually, in response to specific stressors or thoughts.
• Duration: A panic attack is a short-term phenomenon (peak within minutes), although its effects may be felt for longer. General anxiety can persist for a long time – hours, days, or even weeks or months.
• Triggers: A panic attack can be unexpected or triggered by a specific stimulus. General anxiety is more often associated with specific worries (e.g. financial, work), although it can also become more diffuse and pervasive.
• Symptoms: Despite some similarities, a panic attack is usually associated with the accumulation of many intense physical and cognitive symptoms (e.g., shortness of breath, chest pain, derealization, fear of death) that are more extreme than typical anxiety.
• Anxiety focus: During a panic attack , the fear often focuses on the symptoms themselves and their potential catastrophic consequences (e.g., “I’m having a heart attack,” “I’m losing my mind,” “I’m dying”). General anxiety is more likely to focus on external problems and future negative events.

The fundamental difference that helps to understand the nature of a panic attack is the interpretation of the sensations coming from the body. In a state of panic, even subtle or normal physiological signals (e.g., a slight increase in the heart rate after climbing stairs) can be misinterpreted as a harbinger of an impending catastrophe – a heart attack, suffocation, loss of control. This catastrophic interpretation triggers a powerful anxiety response that exacerbates physical symptoms, creating a vicious cycle. In the case of general anxiety, similar physical sensations may occur, but usually do not lead to such a violent, catastrophic interpretation and escalation into a full-blown panic attack. This cognitive aspect – the way we think about bodily sensations – is crucial for understanding the mechanism of panic.

The Roots of Panic: Biological, Psychological, and Environmental Causes

The causes of panic attacks are complex and multifactorial. It is rarely possible to point to one specific reason for their occurrence. It is usually the result of the interaction of various biological, psychological and environmental factors. Understanding these potential sources is crucial for effective treatment of panic attacks.

Biological factors:

• Genetics: There is evidence of a hereditary tendency to anxiety disorders, including panic attacks. The risk of developing it is higher in people whose close relatives suffer from similar disorders. Studies indicate some degree of heredity.
• Neurobiology and Brain Chemistry: Imbalances of neurotransmitters such as serotonin, norepinephrine, and GABA play a role in regulating mood and anxiety. Dysfunctions in specific areas of the brain responsible for fear processing and stress responses (e.g., amygdala, limbic system, hypothalamic-pituitary-adrenal axis – HPA, autonomic nervous system – ANS) can lead to excessive anxiety responses. Research suggests potential biomarkers, such as changes in brain image, respiratory patterns, heart rate variability, and blood markers. Increased tension of the sympathetic nervous system is also observed.
• Physiological Factors: Individual breathing patterns, a tendency to hyperventilate and increased sensitivity to physiological changes (e.g. increased heart rate, dizziness) may predispose to panic attacks.
• Comorbidities: A number of physical conditions can cause symptoms that resemble or trigger a panic attack . These include, m.in, hyperthyroidism, heart disease (arrhythmias, mitral valve prolapse), hypoglycemia, asthma, COPD, epilepsy, endocrine disorders (e.g. pheochromocytoma of the adrenal glands), and even problems with the temporomandibular joint. For this reason, it is extremely important to accurately differentiate diagnose and exclude somatic causes before diagnosing anxiety disorder with panic attacks. Overlooking a physical illness can lead to ineffective treatment and serious health consequences.

Psychological factors:

• Temperament and Personality: Traits such as neuroticism (tendency to experience negative emotions), high sensitivity to anxiety (fear of the symptoms of anxiety themselves), perfectionism, low tolerance for uncertainty and stress can increase vulnerability.
• Cognitive Factors: Catastrophic interpretation of bodily sensations (e.g., interpreting palpitations as a heart attack) plays a key role. Negative automatic thoughts, attention bias (catching threatening stimuli) and cognitive distortions (interpreting neutral situations as dangerous) also contribute to the development and maintenance of anxiety. Learned associations between certain situations and anxiety also matter.
• Life ExperiencesExperiencing trauma (especially in childhood, e.g. the cause of anxiety) can lead to serious emotional problems. violence, neglect, loss of a loved one), difficult childhood, family problems, as well as the accumulation of stressful life events can be the basis for the development of anxiety disorders.
• Stress: Chronic stress, living under pressure (e.g. at work, financially), inability to cope with tension or inability to relieve it are significant risk factors.

Environmental and Social Factors:

• Psychoactive Substances: The use or withdrawal from caffeine, nicotine, alcohol, drugs (especially stimulants such as cocaine, amphetamines, LSD) can cause or exacerbate panic attacks. Certain medications (e.g. thyroid hormones, some antidepressants at the beginning of therapy) can also have this effect.
• Life events can be one of the most effective causes of anxiety.: Significant changes, both negative (divorce, job loss, death of a loved one) and positive (wedding, birth of a child, promotion) can be a source of stress and trigger attacks.
• Social Factors: Lack of social support, a sense of isolation, toxic interpersonal relationships can exacerbate anxiety. Observing anxious reaction patterns in loved ones (e.g. parents) can lead to learning them.
• Lifestyle: Irregular sleep, unhealthy diet, lack of physical activity can negatively affect the functioning of the nervous system and increase susceptibility to anxiety.
• Direct Triggers: While the causes are the factors that determine the vulnerability, the triggers are the factors immediately preceding the attack. These can be: specific places (crowds, closed spaces), situations (exam, public speaking), intense physical exertion, caffeine consumption, severe stress, intrusive thoughts, memories, and even subtle physical sensations or sensory overload (noise, intense light).

Understanding this complex web of connections between biology, psychology, and the environment is fundamental. This emphasizes that panic attacks are not a sign of weakness, but the result of a complex interaction of factors that are often beyond our direct control. Such a holistic view directs towards multidimensional treatment strategies, including both pharmacological and psychotherapeutic interventions, as well as lifestyle modifications.

Symptoms of a Panic Attack: Body and Mind Reactions

A panic attack manifests itself through a wide range of intense symptoms, both physical (somatic, vegetative) and mental (cognitive, emotional). According to commonly used diagnostic criteria such as the DSM-5, at least four of the characteristic symptoms are required to diagnose a panic attack , reaching their peak within minutes.

Physical symptoms (somatic/vegetative):

These symptoms are the result of a violent activation of the autonomic nervous system, especially its sympathetic part, which leads to the “fight or flight” response.

• Cardiovascular symptoms:
  • Palpitations, strong, uneven or rapid heartbeat (palpitations).
  • Chest pain or discomfort.
  • Increase in blood pressure.
• Respiratory symptoms:
  • A feeling of shortness of breath, shortness of breath, shortness of breath.
  • Hyperventilation (breathing too fast and deeply).
  • The sensation of choking.
• Neurological symptoms:
  • Dizziness, a feeling of lightheadedness, instability, a feeling of approaching fainting.
  • Shaking or shaking (hands, whole body).
  • Paresthesia – a feeling of numbness or tingling (often in the limbs or face).
  • Headaches.
  • Tinnitus.
  • Scotomas in front of my eyes.
• General and autonomic symptoms:
  • Excessive sweating.
  • Hot flashes or cold chills can occur during a panic attack that lasts several minutes.
  • Nausea or abdominal discomfort are common somatic symptoms that can occur during an anxiety attack.
  • Dry mouth.
  • Muscle tension or stiffness.
  • Fatigue and exhaustion after the attack subsides.

Mental/cognitive symptoms:

These symptoms reflect an intense emotional state and changes in thought processes during the attack.

• Intense Fear:
  • An overwhelming feeling of fear, terror, panic.
  • Fear of death.
  • Fear of losing control of oneself or “losing one’s mind” (“going crazy”).
  • A sense of impending catastrophe or doom.
• Cognitive and Perceptual Changes:
  • Derealization: A sense of the unreality of the world around you, as if everything were happening behind a fog or a dream.
  • Depersonalization: Feeling detached from one’s body, thoughts, or feelings; observing yourself from a distance.
  • Difficulty concentrating, feeling light-headed.
  • Disorientation.
• Emotional and Behavioral Responses:
  • Feeling overwhelmed, trapped, a strong need to escape.
  • Uncontrollable crying or screaming.
  • Communication difficulties.

This constellation of symptoms, especially the intensity of physical sensations, drives psychological fear. Heart palpitations and chest pain are mistaken for a heart attack, shortness of breath with suffocation, and dizziness and derealization with loss of control or madness. This vicious circle mechanism, where physical symptoms intensify anxiety and anxiety intensifies physical symptoms, is central to a panic attack. Particularly worrying are the symptoms of derealization and depersonalization, which constitute a deep distortion of the perception of oneself and the world, fueling the fear of losing one’s mind. Understanding that all these sensations, while frightening, are part of the anxiety response and not a sign of a real catastrophe, is crucial in the healing process.

The table below presents the diagnostic criteria for a panic attack according to the DSM-5 classification, which are the standard in psychiatric diagnostics.

DSM-5 Panic Attack Diagnostic Criteria

Criterion	Description
Definition	A sudden surge of intense anxiety or discomfort that culminates in minutes.
Required symptoms	During the episode, there are panic symptoms – symptoms that can be frightening. four (or more) of the following symptoms:
1	Palpitations, palpitations or increased heart rate.
2	Sweating.
3	Shaking or shaking.
4	Feeling shortness of breath or shortness of breath.
5	Choking sensation.
6	Chest pain or discomfort.
7	Nausea or abdominal discomfort.
8	Dizziness, feelings of instability, lightheadedness or fainting are somatic symptoms that can occur during an anxiety attack.
9	Chills or hot flashes.
10	Paresthesia (numbness or tingling sensation).
11	Derealization (feeling unreal) or depersonalization (feeling separated from oneself).
12	Fear of losing control or “losing your mind” (“going crazy”).
13	Fear of death.
Note	Culturally specific symptoms may also occur (e.g. tinnitus, stiff neck, headache, uncontrollable screaming or crying). These symptoms are not included in the required four.

Anxiety Disorder with Panic Attacks: When Do Attacks Become a Disease?

Experiencing a single panic attack, although very unpleasant, does not necessarily mean mental illness. Many people can experience such an episode in a situation of severe stress or fatigue. However, when panic attacks become recurrent and begin to significantly affect a person’s life, we can speak of an anxiety disorder with panic attacks (often also referred to as a panic attack, which is an intense episode of anxiety). panic disorder or panic disorder). Not every person who has experienced a panic attack will develop this disorder.

Panic Disorder (PD) is diagnosed based on specific criteria included in classifications such as DSM-5 and ICD-10. The key elements of the diagnosis are :

1. Recurrent, unexpected panic attacks: A person experiences more than one panic attack that comes “out of nowhere” without a clear trigger (though situational attacks can also occur).
2. Consequences of attacks: After at least one attack, for a minimum period of one month, at least one of the following occurs:
   • Constant fear or anxiety about the possibility of further panic attacks or their consequences (e.g. fear of heart attack, loss of control, “going crazy”). This condition is called anticipatory anxiety or “fear of anxiety”.
   • A significant, maladaptive change in behavior associated with attacks. The person begins to avoid situations, places, and even activities (e.g., physical exertion) that they associate with panic attacks or from which it would be difficult to escape/get help.
3. Exclusion of other causes: The symptoms are not caused by the effects of a substance (e.g. drugs, medication) or a somatic disease.
4. Exclusion of other mental disorders: Panic attacks are not better explained by another mental disorder. For example, if the attacks occur only in social situations and the anxiety is about being judged by others, the diagnosis would be more likely to be social phobia. If the attacks are triggered by a specific phobic object (e.g. spiders), the diagnosis will be specific phobia.

It is anticipatory anxiety (“fear of anxiety”) and avoidance that become central elements of anxiety disorder with panic attacks. The person begins to live in constant tension, fearing another attack, which, paradoxically, can increase the likelihood of its occurrence. This fear of fear itself and the resulting changes in behavior are what distinguish the disorder from isolated panic episodes and what leads to suffering and functional limitations to the greatest extent.

Anxiety disorder with panic attacks most often appears in young adults (typically between 25 and 44 years of age, although the first attacks may occur earlier, even in the teenage years). Statistically, they are more often diagnosed in women than in men.

The following table summarizes the diagnostic criteria for anxiety disorder with panic attacks According to the DSM-5, panic attacks occur in a variety of anxiety disorders.

Diagnostic Criteria for Anxiety Disorder with Panic Attacks according to DSM-5

Criterion	Description
A	Recurrent, unexpected panic attacks (defined in Table 1).
B	After at least one of the attacks, for a period of 1 month or more, occurs One or both of these experiences can lead to generalized anxiety disorder. <> Persistent fear or anxiety about the occurrence of further panic attacks or their consequences (e.g. loss of control, heart attack, “losing one’s mind”). <Br> 2. Significant maladaptive change in behavior associated with attacks (e.g., avoidance of physical exertion, unfamiliar situations, public places).
C	The disruption is not caused by the physiological effects of the substance (e.g. drug, medicine) or a general medical condition (e.g. hyperthyroidism, cardiovascular disease).
D	The disturbance cannot be better explained by the presence of another mental disorder (e.g., seizures do not occur only in response to phobic objects, social situations, obsessions, reminders of trauma, or separation).

Living with Panic Attacks: Impact on Everyday Life, Work, and Relationships

Recurrent panic attacks and anxiety disorder with panic attacks can have a devastating effect on almost every aspect of a person’s life. Fear of another attack and attempts to avoid it lead to gradual reduction of activity and withdrawal from life.

• Daily Functioning: Performing simple tasks such as shopping, using public transport or even leaving the house can become a source of great anxiety. People may feel exhausted and deprived of energy, especially after a seizure. The quality of life deteriorates significantly.
• Work and Study: Panic attacks and anticipatory anxiety can make it difficult to concentrate, reduce productivity and lead to more frequent absenteeism from work or school. Avoidance can apply to professional situations such as meetings, presentations or business trips. In extreme cases, this can lead to difficulties in maintaining employment or even losing your job. Research shows that stress in the workplace is a serious problem in Poland, which can further exacerbate the difficulties of people with anxiety disorders.
• Social Life and Relationships: The fear of a panic attack in public leads to avoiding social gatherings, parties or going out with friends. This can result in social isolation and a sense of loneliness. Relationships with loved ones may be strained due to the lack of understanding of the problem by the environment, excessive dependence of the ill person on others (e.g. the need for constant company) or frustration related to limitations.
• Development of Avoidance and Agoraphobia: One of the most serious consequences of anxiety disorder with panic attacks is the development of avoidant behaviors. The person begins to systematically avoid places or situations where they have experienced an attack, or which they perceive as potentially dangerous (difficult to leave, without the possibility of getting help). This avoidance mechanism is the main driver of panic disorder-related disability. As avoidance intensifies, the person’s world shrinks more and more, which can lead to the development of agoraphobia. Agoraphobia is a fear of being in public places, open spaces, crowds, means of transport, and in extreme cases – fear of leaving the house. It is estimated that up to half of people with generalized anxiety disorder experience panic attacks. panic disorder develops symptoms of agoraphobia.
• General Well-Being and Mental Health: Chronic anxiety, feelings of helplessness and limitations in functioning significantly increase the risk of developing other mental health problems. Co-occurring depression is particularly common. Some people may try to cope with anxiety by abusing alcohol or other psychoactive substances, which leads to addiction. In the most severe cases, feelings of hopelessness and suffering can lead to suicidal thoughts or suicide attempts. This cascade of negative consequences highlights the importance of early diagnosis and effective treatment of panic attacks and anxiety disorder with panic attacks.

Controlling Anxiety: Effective Methods to Coping and Treating Panic Attacks

Although panic attacks are frightening, there are effective ways to deal with them both when they occur and in the long term. The key is to gain the knowledge and tools to regain a sense of control.

Immediate help (what to do during a panic attack):

When you feel like a panic attack is coming, or in the middle of one, try the following strategies:

• Recognize and Rationalize: Realize that this is “just” a panic attack, not a heart attack or stroke. Remind yourself that the symptoms, while unpleasant, are not dangerous and will pass. Repeating reassuring sentences (affirmations), e.g. “This will pass”, “I’m safe”, can help.
• Breath Focus: Slow and deepen your breathing. Practice diaphragmatic (abdominal) breathing: slow inhalation through the nose (counting to 4), stopping for a moment (e.g. for 2-7 seconds), long, calm exhalation through the mouth (e.g. counting to 6-8). Controlled breathing helps counteract hyperventilation and calms the nervous system. Apps or animations to support the rhythm of breathing can help.
• Grounding TechniquesDirect attention to the senses to anchor themselves in the present and help the person cope with anxiety attacks. Apply the 5-4-3-2-1 method: identify the 5 things you see; 4 things you can touch (feel their texture, temperature); 3 sounds you hear; 2 smells you can smell; 1 thing you can taste. Feel your feet on the floor, touch the wall, focus on a specific object. Contact with cold water (e.g. washing your face, applying a cold compress, sucking on an ice cube) can also help.
• Distraction: Focus on a simple task: count from 100 to 0 every 3, name all the red objects in sight, describe an object in detail.
• Safe Place and Support: If possible, move to a quiet, peaceful place. Let someone you trust know what’s going on and ask for support. A calm presence and gentle words of encouragement can be very helpful. However, avoid messages such as “Calm down” or “It’s nothing”, which can be perceived as downplaying the problem.
• Muscle Relaxation: Consciously try to relax tense muscle parts, e.g. shoulders, jaw.

Long-term strategies for treating panic attacks:

Effective treatment of panic attacks, especially in the case of anxiety disorder with panic attacks, usually requires professional intervention. The best results are often achieved by a combination of different methods.

• Psychotherapy:
  • Cognitive Behavioral Therapy (CBT): This is recognized as the “gold standard” for treating anxiety disorder with panic attacks. It is a short-term, problem-focused therapy that teaches the patient to identify and modify negative thinking patterns and behaviors that sustain anxiety. The main techniques to learn how to deal with panic attacks include breathing and relaxation exercises. Cognitive behavioral therapy for anxiety includes:
    • Psychoeducation: Understanding the mechanism of panic attack, the fight-or-flight response, the role of hyperventilation, and the vicious cycle of anxiety. Cognitive Restructuring: Learning to identify, challenge, and change catastrophic thoughts and beliefs about panic symptoms (e.g., “Palpitations mean a heart attack” –> “It’s a normal reaction to anxiety, my heart is healthy”). It is helpful to keep a diary of thoughts. Exposure: Gradual and controlled confrontation with anxiety-inducing stimuli. This can be interoceptive exposure (deliberately inducing mild physical symptoms, e.g. by rapid breathing, spinning in circles to learn that they are not dangerous) and in vivo exposure (gradually confronting avoidant situations or places, e.g. riding a bus, visiting a supermarket). It is crucial to refrain from protective behaviors during exposure to be able to verify your anxious predictions. Coping Skills Training: Learning and regularly practicing relaxation and breathing techniques.
  • Other forms of therapy, such as psychodynamic, can explore the deeper, unconscious conflicts underlying anxiety.
• Pharmacotherapy: Medications are often used, especially in the initial phase of treatment or in more severe cases, often in combination with psychotherapy. It should be remembered that medications have a symptomatic effect – they relieve anxiety, but do not remove its causes. The following are mainly used:
  • Antidepressants (SSRIs and SNRIs): These are the first choice medications for the long-term treatment of anxiety disorder with panic attacks. Examples are escitalopram, sertraline, paroxetine, fluoxetine, venlafaxine. The full effect of their action appears after a few weeks of regular use. They require strict adherence to the doctor’s recommendations and cannot be discontinued suddenly, especially drugs from the group that regulate serotonin uptake.
  • Benzodiazepines (BDA): Drugs such as alprazolam, lorazepam, clonazepam work quickly and effectively interrupt a panic attack. They are useful on an ad hoc basis or at the beginning of treatment, before antidepressants start to work. However, due to the high risk of addiction, tolerance, withdrawal symptoms and negative effects on cognitive functions, they are not recommended for long-term use. Moreover, relying on benzodiazepines as an ’emergency pill’ can hinder the therapeutic process, sustaining the patient’s belief that they cannot cope without the drug and weakening the effects of exposure therapy. Their use should be carried out under strict medical supervision.
  • Other medications: Tricyclic antidepressants are used less frequently (older generation, more side effects), pregabalin or beta-blockers (mainly to control physical symptoms, such as palpitations, often off-label). All prescription medications require medical consultation.
• Relaxation and Mindfulness Techniques: Regular practice of Jacobson’s progressive relaxation (tightening and relaxing muscle groups), meditation, mindfulness exercises, yoga, or visualization helps reduce overall stress and tension levels, which can reduce the frequency and intensity of panic attacks.
• Lifestyle Changes:
  • Physical activity: Regular movement (e.g. walking, running, swimming) is a natural antidepressant and reduces stress levels.
  • DietEating a balanced diet, avoiding excess caffeine, sugar, processed foods, and stress can help a person manage the symptoms of anxiety. Caffeine and alcohol can increase anxiety. Some sources suggest supplementation of magnesium and B vitamins.
  • Sleep: Getting regular and sufficient sleep is crucial for mental balance.
  • Drug Avoidance: Limiting or eliminating substances that may cause or exacerbate anxiety (caffeine, nicotine, alcohol, drugs).
  • Stress Management: Identifying the main sources of stress and developing healthy coping strategies (e.g., planning, assertiveness, setting boundaries). Finding time to rest and relax.

It is important to emphasize that the treatment of panic attacks, especially as part of cognitive behavioral therapy, requires the active involvement of the patient. Doing exercises, confronting fear, working on changing thoughts – all this requires effort and motivation. The success of therapy is the result of cooperation between the therapist and the patient.

Relapse prevention: how to reduce the risk of panic attacks?

After successfully treating panic attacks, it is important to take action to prevent panic attacks in the future and maintain the improvement achieved. Preventing panic attacks is crucial to minimize their frequency when a panic attack is approaching. It is not a one-time activity, but a process that requires constant attention and the application of acquired skills. Key prevention strategies include:

• Follow-up Treatment: If you are using pharmacotherapy, continue taking medication as prescribed by your doctor and do not stop taking it suddenly without consultation. Cognitive-behavioral techniques and strategies learned during therapy (e.g., thought monitoring, relaxation techniques, exposure planning) should be used regularly. Attending any follow-up or follow-up sessions can be helpful.
• Strengthening Healthy Habits: Consistent lifestyle care: regular physical activity, balanced diet, avoiding excess caffeine and alcohol, sleep hygiene. Regularly practicing relaxation techniques (meditation, mindfulness, deep breathing) in your daily routine, not just in crisis situations.
• Early Warning Signs: Learning to identify early signs of increasing stress, tension or anxiety (e.g. sleep problems, irritability, increased worry) and proactively apply coping strategies before they escalate.
• Gradual Confrontation with ChallengesGently but systematically engaging in situations that were previously avoided due to severe anxiety can help a person overcome anxiety. This helps to consolidate a sense of competence and prevents avoidance patterns from returning.
• Effective Stress Management: Developing and applying healthy strategies for coping with stress in everyday life, such as problem-solving skills, time management, assertiveness in communication.
• Building Resilience: Taking care of your overall mental health, developing self-awareness, nurturing supportive social relationships, making time for hobbies and resting.
• Relapse Prevention Plan: Together with the therapist, an individual action plan can be developed in case the symptoms return. Such a plan may include a list of early warning signs, a reminder of effective coping strategies, and contacts to people or institutions that can provide support.

An approach to preventing panic attacks should be considered as an investment in long-term mental health and quality of life, especially for those experiencing panic attacks. It is an ongoing process of taking care of yourself and using the tools gained during treatment.

Summary: Hope and the Path to Regaining Peace

Panic attack and anxiety disorder with panic attacks are conditions that can cause immense suffering and significantly limit life. Sudden waves of overwhelming anxiety, frightening physical and mental symptoms, fear of another attack, and progressive avoidance all add up to a difficult experience.

However, the key message is that panic attacks are an understandable and, most importantly, treatable phenomenon. With available treatments, such as cognitive behavioral therapy (CBT), medication and supportive lifestyle changes, it is possible to regain control of anxiety and return to a full, fulfilling life. Understanding panic mechanisms, learning to identify and change catastrophic thoughts, gradually confronting anxiety instead of avoiding it, and taking care of your overall psychophysical health are the foundations of effective coping with this problem.

If you are experiencing symptoms of a panic attack or suspect you have an anxiety disorder with panic attacks, the most important step is to seek professional help. Consultation with a psychiatrist or a qualified psychotherapist will allow you to make an accurate diagnosis (excluding other possible causes of symptoms) and develop an individual treatment plan. Remember that seeking help is a sign of strength, not weakness. With the right support and commitment to the healing process, the path to regaining peace and control over your own life is within reach.