Understanding Silent Anxiety Attacks: Symptoms, Causes, and Risks

In this article, we will take a close look at silent anxiety attacks, also known as silent panic attacks or non-fearful panic attacks. We will explore their symptoms, causes, and associated risks, including their potential to mimic somatic illnesses and their link to increased suicide attempts.
Frederika Malichová

Frederika Malichová

Neuroscientist at the University Of Cambridge.

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What Are Silent Anxiety Attacks?

Silent anxiety attacks are episodes of intense fear or discomfort that occur without the typical noticeable symptoms. They are also known as silent panic attacks.

Silent anxiety attacks can be sudden and overwhelming. However, they don’t need to be accompanied by the typical signs of anxiety attacks like palpitations, sweating or trembling.

Sometimes, silent anxiety attacks are very similar symptomatically to somatic illnesses which may lead to misdiagnosis.

Symptoms of silent anxiety attacks are for instance heart pounding, fainting sensations or unsteady feelings [1].

The symptoms of silent anxiety attacks occur without the typical fears like the fear of dying or going crazy which are usually the triggers for regular panic attacks [2].

Silent anxiety attacks can also occur in the context of social anxiety disorder (SAD). In these cases, panic attacks are associated with fear and avoidance of social situations. Whether the person suffering from SAD is experiencing silent anxiety attacks or normal anxiety attacks, it does not represent the severity of their social anxiety, although in silent anxiety it might be less apparent [3].

Importantly, silent anxiety attacks can be associated with increased risks of suicide attempts. This is particularly apparent when mixed with major depressive disorder or when the attacks occur without life-threatening situations [4].

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Symptoms of A Silent Anxiety Attack

Silent anxiety attacks can manifest in different ways. It usually depends on the individual, but there are some common symptoms which can help identify these attacks.

The primary symptom of a silent anxiety attack is the feeling of worry or unease over an actual or perceived danger. Such can be experiencing feelings of danger, panic or dread. This may lead to physical symptoms such as nervousness, increased body temperature, sweating or rapid breathing [5].

Silent anxiety attacks can also lead to anticipatory anxiety, which is the fear of experiencing another attack. This can result in avoidance behaviour, where the individual avoids situations or places that they associate with past attacks [2].

Causes of Silent Anxiety Attacks

Silent anxiety attacks can be caused by a wide range of factors. For instance, one common cause of the silent anxiety attack is anxiety sensitivity (fear of anxiety-related sensations). In particular, according to the studies, individuals with high anxiety sensitivity are more likely to experience random silent anxiety attacks [6, 7].

Silent anxiety attacks can be linked to mental health conditions such as panic disorders, agoraphobia or obsessive-compulsive disorder (OCD) but also others such as post-traumatic stress disorder (PTSD) and anxiety disorder [8, 4].

However, it is important to mention that also some medications and withdrawal from substances like alcohol can cause silent anxiety attacks [9].

Last but not least, silent anxiety attacks can be triggered by stress so make sure to live a balanced life [8]!

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Frederika Malichová

Frederika Malichová

Frederika is a postgraduate researcher at the University of Cambridge, where she investigates new biomarkers for Frontotemporal Dementia and other tauopathies. Her research has been published at prestigious conferences such as the Alzheimer’s Association International Conference 2023. She obtained her BSc in Biomedical Sciences from UCL, where she worked closely with the UK Dementia Research Institute.