Panic Attacks
Chapter 16. Mental Health Conditions

A panic attack is a brief period of acute anxiety that comes on all of a sudden. It occurs when there is no real danger. It comes without warning. A panic attack lasts only a few minutes, but seems to last for hours.

Symptoms
Four or more of the following symptoms come with a panic attack:
Shortness of breath or smothering sensations
Sweating
Choking feeling
Racing heart rate or palipitations
Chest pain or discomfort
Feeling dizzy, faint, or light-headed
Trembling or shaking
Nausea or abdominal distress
Hot flashes or chills
Numbness, tingling in the hands or feet
Feelings of unreality or being detached from oneself
Fear of going crazy or losing control
Fear of dying

A person having a panic attack may rush to an emergency room because they think they really are having a heart attack or feel like they are going to die.

 Persons who have repeated panic attacks begin to avoid situations they associate with past attacks. For example, if the panic attack took place in a grocery store and the person had to leave the store to get home to feel safe, the person avoids future trips to the grocery store. This can lead to a phobia called agoraphobia. (See Phobias.)

A person who has 4 or more panic attacks in any 4 week period could have panic disorder. The disorder can also be present if the person has less than 4 panic attacks in 4 weeks, but is afraid of having another panic attack.

Panic attack symptoms can be symptoms of many medical conditions. These include heart attack and low blood sugar. The symptoms can also be a side effect of drug abuse or some medications. It is important, then, to rule out any other medical reasons for panic attack symptoms to know what the real problem is. Most persons who have panic disorder consult with their doctor 10 or more times before their condition is accurately diagnosed.

Treatment
Treatment for panic disorder includes:
Medication. Certain antidepressants and antianxiety medicines are used.
Therapy. One type helps the person "reshape" the way they think to avoid panic attacks. Another type uses relaxation methods and a gradual exposure to situations they have avoided due to fear of another panic attack.
Support groups. These provide understanding and positive feedback to the sufferer.

Questions to Ask

Do all of these apply to you?
You have been to your doctor more than once with symptoms like those of a heart attack such as chest pain, irregular heartbeat, and shortness of breath.
You've been told that your heart and physical health are fine from a thorough examination and proper testing.
You continue to have panic attack symptoms.

OR
Do you have recurrent panic attacks that come when you don't expect them and have 1 or more of these problems?
Continued concern about having more attacks
Worry about what will happen as the result of a panic attack such as having a heart attack, losing control, or "going crazy"
A noted change in things you normally do because of past panic attacks
Do you avoid certain situations or places because they make you feel anxious and you think they will put you in danger?
Do you use alcohol or drugs to help you deal with situations that provoke the thought of another panic attack?

Self-Care Tips

These can help you or someone else.
{Note: Many of these tips are used in the context of therapy first before the person can do them on their own.}

Ways to Deal with Panic that has Limited Symptoms and Duration:
Talk over the source of your anxiety with family, friends, and clergy. If this is not enough, you may need the help of a professional counselor.
Face the fear. Accept it. Don't fight it. (This may need external help.)
Remind yourself you are in no real danger.
Try to imagine that you are "floating" on water.
Let time pass. Try to think ahead to what tasks you need to do when the panic will be gone.
Keep things with you that will provide comfort and a sense of control in case another panic attack occurs. Examples:
Keep a paper bag handy if you think you might hyperventilate (overbreathe). Breathe into
the paper bag slowly and rebreathe the air. Do this in and out at least 10 times. Remove the
bag and breathe normally a few minutes. Repeat breathing in and out of the paper bag as needed.
Keep the name and phone number of a person to call in case of an emergency.
Do one or more mental "stress rehearsals." Imagine yourself feeling calm and handling the situation well.
Minimize your exposure to things that cause you distress.
Prepare for stressful situations. For example, if you need to give a group talk or presentation:
Have materials you will need ready ahead of time. Make sure you have the equipment, such as
slides and a slide projector. Check to see that they are in working order.
Write an outline and key points on note cards, if necessary.
Anticipate problems that could occur and prepare to address them ahead of time.
Rehearse what you will do and say.
Learn and practice relaxation techniques such as:
Deep breathing exercises
Tensing and relaxing muscles
Yoga
Self-hypnosis
Limit caffeine.

{Note: see "Places to Get Information & Help" under Anxiety/Phobias.}

HEALTH AT HOME - Your Complete Guide to Symptoms, Solutions, and Self-Care © 2000 by Don R. Powell. American Institute for Preventive Medicine. 

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Date updated 02/01/01