Situational Vs Spontaneous Panic Disorder: How to Know

The onset of a panic attack can be an unpredictable and unnatural bodily response to a false sense of danger or, depending upon the sufferer, a predictable manifestation of a deeply ingrained or specific phobia.

A 1991 study conducted by the Psychiatry Service at West Haven Veterans Administration Medical Center, revealed that, “within a given person, situational and spontaneous panic attacks did not significantly differ over a number of characteristics, including severity, duration, frequency per week, diurnal distribution, and the number of symptoms per attack.” No apparent distinctions exist between spontaneous panic attack symptoms and situational panic attack symptoms; in both cases the attack is characterized by a terrifying experience filled with feelings of loss of control and helplessness, and similar physical and psychological responses. Treatments for both disorder types include anti-anxiety drug treatments, anti-depressant prescriptions, cognitive behavioral therapy or CBT, and exposure therapy.

Anti-anxiety self-treatment can also be helpful in alleviating anxiety that triggers both types of attacks.

Spontaneous (Uncued) Panic Attacks

Spontaneous panic attacks are unexpected, indiscriminate and random, manifesting with no apparent situational trigger and can be therefore difficult to predict and hence control. The onset of a spontaneous attack is “out of the blue” and unpredictable with no apparent phobia, environmental or situational trigger prompting it, making spontaneous panic attacks impossible to anticipate. Individuals who experience spontaneous attacks often develop agoraphobia, a fear of public places, due to the constant worry of experiencing an unforeseen panic attack in a public place. This uncertainty becomes a recurrent worry in the sufferers’ mind which continually fuels the panic disorder. Sometimes, a pattern of predictability is not immediately evident. Sufferers of spontaneous panic attacks should review the history of attacks to identify any situational similarities in prior attacks.

Situational (Cued) Panic Attacks

Situational panic attacks, on the other hand, are more often than not manifestations of specific and deeply ingrained phobias, and occur frequently in agoraphobics. Encountering or anticipating an encounter with the trigger is enough to prompt a panic attack. Sufferers find that avoiding exposure to the catalyst, the panic attack’s “cue”, can control predictable panic attacks, although simply avoiding the trigger is often impossible or inhibiting, especially when the situational fear involves every day activities such as driving, or being in public spaces. In addition, sufferers who avoid public places do so to prevent contact with a feared situational catalyst that may spark a panic response and thus develop an intense phobia of public settings. Common panic inducing situations include driving in traffic, visiting the dentist, using elevators and waiting for appointments.

While situational panic attacks are predictable, in some sufferers’ exposure to, or even the fear of exposure to, the trigger does not invariably provoke a panic attack. The anxiety sufferer is predisposed to attack but with therapy and treatment can gradually overcome and master the situational phobia that precipitates panic and feelings of vulnerability. Creating positive, anxiety-reducing habits such as replacing everyday negative thoughts with positive reinforcement thinking and consistently developing muscle control through daily isometric exercises are helpful in reducing tension and give sufferers a sense of control in a panic situation to avoid the onset of a predictable or potential attack. A great way to deal with panic attacks is to follow a good program.

Panic Away Program by Barry Joey McDonagh