Unexpected Panic Attacks

A panic attack is a sudden surge of intense fear or discomfort that builds to a peak within minutes. The speed of onset is characteristic: anxiety that rises gradually over hours is a different experience.

Attacks described as unexpected arrive without an obvious trigger, sometimes during rest or from sleep. Others are cued by a particular situation. Both occur in panic disorder, but unexpected attacks are the more distinctive feature, partly because there is nothing to avoid in order to prevent them.

Physical sensations dominate. Most people describe several at once, and the combination is what makes an attack so alarming. Attacks usually subside within minutes, though tiredness may persist for some time afterwards.

Panic attacks are common in the general population and occur in other conditions too, so an attack on its own does not indicate panic disorder. What matters is whether attacks recur and what happens between them.

A first attack involving chest pain, breathlessness or palpitations should be medically assessed rather than assumed to be panic.