Spontaneous / Uncued Panic Attacks

Written by HealthyPlace.com Staff Writer

This type of attack is associated to Panic Disorder. This attack comes without any warning, day or night, irrespective of what the person is doing. The spontaneous attack is not related to, and is not induced by, any particular situation or place.

Many people diagnosed with Panic Disorder report that the panic attacks happen 'out of the blue'. They may be woken up from sleep by a spontaneous panic attack, which is said to occur between stage two and stage three of rem sleep. Many people report that the panic attacks happen when they are relatively 'calm' or 'relaxed,' eg., when they are watching TV or relaxing. In fact, a study we undertook in 1993 on the uncued/ spontaneous panic attack showed that 78% of Panic Disorder participants reported experiencing panic attack energy when relatively 'calm'. 69% of Panic Disorder participants report they experience the panic attack energy while going to sleep and 86% report that the panic attack wakes them from sleep at night.

The symptoms of a panic attack are described in the DSM-4 as a "discrete period of intense fear or discomfort in which four (or more) of the following symptoms developed abruptly and reached a peak within ten minutes:

1. Palpitations-pounding heart or accelerated heart rate;
2. Sweating, trembling or shaking;
3. Sensations of shortness of breath or smothering, feeling of chocking, chest pain or discomfort, nausea or abdominal distress, feeling dizzy, unsteady, lightheadedness or faint; and
4. Derealization or depersonalization, fear of losing control or going crazy, fear of dying, numbness or tingling sensations, chills or hot flushes.

Three internationally recognized experts in Panic Disorder describe a panic attack as follows:

"Intense recurring spasms of panic that start just below the breastbone and seem to spread like a white hot flame passing through the chest, up the spine, into the face, down the arms and even down into the groin to the tips of the toes" C.Weekes.

"The attacks start with a tingling feeling going up my spine which enters my head and causes a sensation of faintness and nausea" J.Hafner.

"A rushing sensation of a hot flash through the body sometimes associated with a sick feeling and a sensation of fading out from the world, but this faintness is more like a 'white out' than a 'black out' in that the head may literally feel light." Sheehan

1. C. Weekes (1962): Self Help for your Nerves. London: Angus & Robertson pp33.
2. J. Hafner (1986). Marriage and Mental Illness. New York: The Guildford Press pp 39
3. Sheehan (1983). The Anxiety Disease. Charles Scribner's Son N-1.

In our research into the subjective experience of the spontaneous panic attack, we found that many people with Panic Disorder experienced a panic attack as 'energy' moving through their body - either before or during the actual panic attack. The 'energy' descriptors are as follows:

• "unusual" intense flows of energy throughout the body
• rushes of 'energy' shaking the body
• electric current moving through the body
• tingly sensation moving through the body
• creeping sensation moving through the body
• hot prickly sensation moving through the body
• intense heat or burning pain moving through the body
• wave-like motion of energy moving through the body
• vibration moving through the body
• white hot flame through the body
• ice cold sensation through the body
• "ants crawling" sensation over the body

It was also found that there were dissociation experiences that were linked with the uncued panic attack. These can include a feeling of being the 'witness' of what is happening to you, a feeling of falling into a void, a feeling of being "outside of body;" either situated alongside, above or behind it; feel as if you are floating; feel as if you and your surroundings do not seem real; experience your surroundings through a diffused light, fog or mist; or experience a visual sensation where stationary objects appear to move. These Dissociative experiences may occur before or during the actual panic attack. Refer to Dissociation for more details.