A significant number of people with bipolar disorder will also experience panic attacks. These can occur in a number of the anxiety disorders and involve the rapid development of severe anxiety. The symptoms of panic attacks can be broken down along three lines: physical, emotional, and cognitive (thoughts).
Physical symptoms may include palpitations, increased pulse rate, shortness of breath, tingling in the fingers and toes, light-headedness, and nausea. Emotional symptoms include intense and overwhelming fear and anxiety. The cognitive symptoms include thoughts of impending doom, that something terrible is about to happen, that the person is about to lose control, or that they are having a catastrophic medical event, such as a heart attack, and are going to die. It’s common for people with panic attacks, thinking that something is medically wrong, to seek treatment in an emergency room.
The onset of symptoms occurs over a few minutes, and unless the attack is re-triggered, lasts from ten to fifteen minutes.
Panic attacks can be brought on by specific feared events, such as going outside the home, having to get up and speak in public, or having to cross a bridge. They can also occur without a specific cue, and it’s often this fear, of not knowing when an attack is coming, that can lead someone to develop a fear of leaving the house, also referred to as agoraphobia.
In terms of diagnoses, under the current DSM-IV system, panic attacks can occur in a number of disorders, including panic disorder with and without agoraphobia, obsessive-compulsive disorder, posttraumatic stress disorder, and various phobias.