Anxiety attacks: symptoms, causes, and when to seek help

Anxiety attacks, characterized by a rapid escalation of physical and mental distress, can strike unexpectedly. These episodes, which can last minutes or hours, are essentially the body's alarm system misinterpreting a situation as dangerous, even when no real threat exists. When these attacks are sudden and intensely severe, featuring a fear of dying or losing control, they are often clinically referred to as panic attacks.

Common symptoms include heart palpitations, chest tightness, trembling, nausea, dizziness, a sense of unreality, an urge to escape, and catastrophic thoughts. The underlying mechanism involves the amygdala, the brain's threat detector, activating the stress response. This releases adrenaline and cortisol, preparing the body for 'fight or flight' by increasing heart rate, muscle tension, and altering breathing patterns.

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When the episode is sudden, very intense and with fear strong to die or go crazy, many times it resembles a panic attack (a more specific clinical term).

The issue isn't the body's reaction itself, but what triggers it and how it's perceived. For instance, shallow breathing due to heat or confinement can lower carbon dioxide levels, leading to dizziness and tingling. If the mind interprets these sensations as a sign of danger, it can create a feedback loop, intensifying the anxiety.

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The problem is not that the body reacts, but what triggers the reaction and how it is interpreted.

Several factors can lower the threshold for these alarm responses. These include insufficient sleep, high consumption of caffeine or energy drinks, alcohol use, chronic pain, sustained stress, and a lack of breaks during the day. Societal pressures like economic uncertainty, constant connectivity, performance demands, and insufficient recovery time also play a role. Often, there isn't a clear, immediate trigger; the body may have been accumulating stress, and an attack can occur at inconvenient times, such as in a supermarket or during a meeting.

If anxiety attacks become frequent, significantly impact daily life by causing avoidance behaviors, or are mistaken for cardiac or respiratory issues, seeking professional medical and mental health evaluation is crucial. Treatments with strong evidence include cognitive-behavioral therapy, particularly interoceptive and exposure therapy, and sometimes medication prescribed by a professional. In Paraguay, the line 155 offers free, confidential, 24/7 support for mental health crises, including anxiety and suicidal ideation.

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If the crises repeat, condition your life (avoiding places, transport, work) or are confused with cardiac/respiratory symptoms, an medical and mental health evaluation is important.