Anxiety attack: symptoms, causes and treatment

Anxiety disorders are one of the most common mental disorders in society around the world. These are of different types and can significantly neutralize the life of the sufferer.

In this article we will talk about anxiety attacks or panic attacks, Very common in various anxiety disorders. Currently in DSM-5 they are considered to be a specifier of any other disorder. They are defined as the sudden onset of fear or intense discomfort, which reaches its maximum expression within a few minutes

    Anxiety attack: characteristics

    Anxiety attacks, also called panic attacks or panic or anxiety attacks, are listed in the DSM (Diagnostic and Statistical Manual of Mental Disorders). DSM-5 includes anxiety attacks as a specifier of any other disorder, and not as a disorder per se (in DSM-IV-TR, anxiety attack was considered an independent “disorder” , the so-called panic attack).

    On the other hand, the ICD-10 (International Classification of Diseases) requires, in order to diagnose an anxiety attack, that at least one of the symptoms is: palpitations, tremors, dry mouth or sweating.


    DSM-5 defines anxiety attack as the sudden onset of intense fear or discomfort, which reaches its maximum expression within a few minutes. During this time, 4 (or more) of the following symptoms occur:

    • Palpitations, heartbeat, or rapid heartbeat.
    • Sweat.
    • Tremors or tremors.
    • Feeling of difficulty in breathing or suffocation.
    • Feeling of suffocation.
    • Pain or discomfort in the chest.
    • Nausea or abdominal discomfort.
    • Scared of heights, Instability, dizziness or fainting.
    • Chills or feeling hot.
    • Paresthesia (numbness or tingling sensation).
    • Unrealization (feeling of unreality) or depersonalization (separation from oneself).
    • Fear of losing control or “going crazy”.
    • To die.

    On another side, the most common somatic symptoms in anxiety attacks these are: first palpitations, followed by dizziness-dizziness and tremors (they are common in children and adults).

    Children, unlike adults, have fewer cognitive symptoms (fear of going crazy, for example).

    Types of panic attacks

    The sudden onset of fear or discomfort can result from a state of calm or, conversely, a state of anxiety. In contrast, panic attacks are very common in various anxiety disorders.

    According to the DSM, it is possible to diagnose a panic attack in the absence of fear or anxiety, defined as “Cognitive or alexithymic panic attacks”.

    Attacks that do not show all 4 symptoms are called “limited asymptomatic seizures”.

    Differences between clinical and non-clinical population

    Panic attacks are also known to occur in the non-clinical population (without mental disorder), as well as in the clinical population (with mental disorder). These attacks are similar in a similar physiological experiment, in that they occur in times of stress and in which there is a similar family history of panic attacks.

    Regarding the differences, we note that:

    • Clinical patients present with unexpected seizures non-clinicians suffer the most from social situations (Evaluative).
    • Clinical patients express more catastrophic cognitions.

    the causes

    We find different types of causes that have been referred to in an attempt to explain the onset of anxiety attacks. These are, broadly, of 3 types (although in most cases there is an interaction between several of them which ends up causing the disorder).

    1. Organic

    The biological hypotheses allude to a certain predisposition to anxiety disorders, as well as to neurobiological aspects (alterations in GABA, hyperactivity of the locus coeruleus, hypersensitivity of serotonin receptors, etc.). neuroendocrine and psychophysiological aspects.

    2. Learning

    Learning theories refer to classical conditioning, Mowrer’s two-factor model (which includes operative and classical conditioning as initiators and maintainers of anxiety), Eysenck’s law of incubation, and Seligman’s preparation theory.

    3. Cognition

    Cognitive models refer to aspects more related to how we handle information, Referring for example to networks or brain structures of “fear” and a selectivity to respond to aversive stimuli, among others.


    The disorder of choice for treating panic disorder or anxiety attacks is a multi-component cognitive-behavioral treatment, Which includes among its components:

    • Live exposure to interoceptive stimuli.
    • Cognitive restructuring.

    On the other hand, treatments with good efficacy are considered: Barlow’s panic control treatment and Clark’s cognitive therapy.

    As slightly less effective treatments, we find:

    • Applied relaxation of OST.
    • the Exposure therapy.
    • Pharmacotherapy (SSRI).

    Finally, in the experimental phase, there are three types of treatments with favorable data to treat anxiety attacks:

    • the exposure treatment using virtual reality (For anxiety disorders with agoraphobia)
    • Sensational Intensive Therapy (by Baker Morissette)
    • Panic-augmented Cognitive Behavioral Therapy (by Levitt)

    Bibliographical references:

    • WHO (2000). CIE-10. International Classification of Diseases, tenth edition. Madrid. Panamericana.
    • Horse (2002). Manual for the cognitive-behavioral treatment of psychological disorders. Flight. 1 and 2. Madrid. 21st century
    • Belloch, A .; Sandín, B. and Ramos, F. (2010). Manual of psychopathology. Volumes I and II. Madrid: McGraw-Hill.
    • American Psychiatric Association -APA- (2014). DSM-5. Diagnostic and Statistical Manual of Mental Disorders. Madrid: Panamericana.

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