Editing Panic attack (section)

==Signs and symptoms==
When people experience a panic attack, it usually comes on very suddenly and unexpectedly with a wide range of symptoms that tend to last, on average, a few minutes.<ref>{{Cite web |title=Symptoms and causes - Mayo Clinic |url=https://www.mayoclinic.org/diseases-conditions/panic-attacks/symptoms-causes/syc-20376021?p=1 |url-status=live |archive-url=https://web.archive.org/web/20220317204310/https://www.mayoclinic.org/diseases-conditions/panic-attacks/symptoms-causes/syc-20376021?p=1 |archive-date=17 March 2022 |access-date=17 March 2022 |website=www.mayocinic .org}}</ref> Typically, the symptoms of panic attacks reach their worst intensity in the first minute, then gradually subside over the next several minutes.<ref name=":2">{{Cite web |title=Panic Disorder {{!}} Anxiety and Depression |url=https://adaa.org/understanding-anxiety/panic-disorder |url-status=live |archive-url=https://web.archive.org/web/20230312024802/https://adaa.org/understanding-anxiety/panic-disorder |archive-date=12 March 2023 |access-date=12 March 2023 |website=adaa.org}}</ref> During this time, people often feel intense fear that something catastrophic will happen despite there being no immediate danger.<ref name="NIH2016" /> The frequency of panic attacks varies between individuals, with some people experiencing a panic attack as frequently as every week, while others could have one panic attack per year.<ref name=":3">{{Citation |last1=Cackovic |first1=Curt |title=Panic Disorder |date=2024 |work=StatPearls |url=https://www.ncbi.nlm.nih.gov/books/NBK430973/ |access-date=2024-10-30 |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=28613692 |last2=Nazir |first2=Saad |last3=Marwaha |first3=Raman}}</ref> The features that help define a panic attack are the collection of symptoms that accompany a panic attack as well as the fact that a panic attack occurs unprompted; meaning there is usually no triggering event that causes a panic attack.<ref name=":3" />

Panic attacks are associated with many different symptoms, with a person experiencing at least four of the following symptoms: increased heart rate, chest pain, palpitations (i.e. feeling like your heart is pounding out of your chest), difficulty breathing, choking sensation, nausea, abdominal pain, dizziness, lightheadedness (i.e. feeling like you might pass out), numbness or tingling (also called paresthesias), derealization (i.e. feeling detached from reality, like the events occurring are not real), depersonalization (i.e. feeling disconnected from your body or thoughts), fear of losing control, and fear of dying.<ref name=":3" />

These physical symptoms are interpreted with alarm in people prone to panic attacks. This results in increased [[anxiety]] and forms a [[positive feedback]] loop, meaning that the more a person experiences symptoms associated with a panic attack, the more they experience feelings of anxiety which serve to worsen their panic attacks.<ref name=":4">{{Cite book | title=Panic Anxiety and Its Treatments: Report of the World Psychiatric Association Presidential Educational Program Task Force | publisher=American Psychiatric Association | first1=Gerald L. | last1=Klerman | first2=Robert M. A. | last2=Hirschfeld | first3=Myrna M. | last3=Weissman | page=[https://archive.org/details/panicanxietyitst0000unse/page/44 44] | year=1993 | isbn=978-0-88048-684-2 | url=https://archive.org/details/panicanxietyitst0000unse/page/44 }}</ref> Panic attacks are distinguished from other forms of anxiety by their intensity and their sudden, episodic nature.<ref name="Bourne2005">[[Edmund Bourne|Bourne, E.]] (2005). ''The Anxiety and Phobia Workbook'', 4th Edition: [[New Harbinger Press]].{{page needed|date=August 2015}}</ref>  <!-- Although, it must be said that the term 'positive' feedback loop is used in the sense of describing the loop itself, since multiple episodes of panic attacks are the farthest from positive many people can get.--> <!--Removed: Anxiety generated by these internal sensations activates the SNS, creating more sensations and more SNS arousal. This causes a [[positive feedback]] loop that increases their anxiety and can lead to a panic attack or worsen one that has already developed.-->

=== Chest pain ===
People can experience a wide range of symptoms during their panic attacks; they tend to be very intense and frightening and the common symptoms of difficulty breathing and chest pain can sometimes cause people to believe they are having a heart attack, leading them to go to the emergency department.<ref name=":2" /> Because chest pain and difficulty breathing are commonly symptoms of some sort of heart disease (such as a heart attack), there is medical importance in ruling  out life-threatening reasons for their symptoms.<ref name=":5">{{Citation |last1=Ojha |first1=Niranjan |title=Myocardial Infarction |date=2024 |work=StatPearls |url=https://www.ncbi.nlm.nih.gov/books/NBK537076/ |access-date=2024-10-31 |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=30725761 |last2=Dhamoon |first2=Amit S.}}</ref> A heart attack (also called a myocardial infarction) occurs when there is a blockage in the arteries going to the heart, causing less blood to get to the heart tissue, and ultimately causing the heart tissue to die.<ref name=":5" /> This will be evaluated in the emergency department with an [[Electrocardiography|electrocardiogram]] (i.e. a picture of the electrical activity of the heart) and by measuring a hormone called troponin, which is released from the heart tissue during times of stress on the tissue.<ref name=":5" /><!-- Comment: Covered in Triggers section Panic attacks can be caused by very common problems such as low blood sugar [[hypoglycemia]], [[hyperthyroidism]], or the overuse of [[caffeine]] or [[nicotine]].{{Fact|date=July 2007}}-->