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Panic Attack

Definition

A panic attack is a sudden episode of intense fear that triggers severe physical reactions when there is no real danger or apparent cause. Panic attacks can be very frightening. When panic attacks occur, you might think you're losing control, having a heart attack or even dying.

Many people have just one or two panic attacks in their lifetimes, and the problem goes away, perhaps when a stressful situation ends. But if you've had recurrent, unexpected panic attacks and spent long periods in constant fear of another attack, you may have a condition called panic disorder.

Symptoms

Panic attacks typically include a few or many of these symptoms:

  • Sense of impending doom or danger
  • Fear of loss of control or death
  • Rapid heart rate
  • Sweating
  • Trembling
  • Shortness of breath
  • Hyperventilation
  • Chills
  • Hot flashes
  • Nausea
  • Abdominal cramping
  • Chest pain
  • Headache
  • Dizziness
  • Faintness
  • Tightness in your throat
  • Trouble swallowing

One of the worst things about panic attacks is the intense fear that you'll have another one. You may fear having a panic attack so much that you avoid situations where they may occur. You may even feel unable to leave your home (agoraphobia) because no place feels safe.

When to see a doctor

If you have any panic attack symptoms, seek medical help as soon as possible. Panic attacks are hard to manage on your own, and they may get worse without treatment.

Causes

It's not known what causes panic attacks or panic disorder, but these factors may play a role:

  • Genetics
  • Major stress
  • Temperament that is more susceptible to stress
  • Certain changes in the way parts of your brain function

Some research suggests that your body's natural fight-or-flight response to danger is involved in panic attacks. For example, if a grizzly bear came after you, your body would react instinctively. Your heart rate and breathing would speed up as your body prepared itself for a life-threatening situation.

Treatment & Drugs

The main treatment options for panic attacks are psychotherapy and medications. Both are effective. Your doctor likely will recommend one or both types of treatment, depending on your preference, your history, the severity of your panic disorder and whether there are therapists with special training in panic disorders in your area.

Psychotherapy

Psychotherapy, also called talk or behavior therapy, is considered an effective first choice treatment for panic attacks and panic disorder. Psychotherapy can help you understand panic attacks and panic disorder and learn how to cope with them.

Medications

Medications can help reduce symptoms associated with panic attacks as well as depression if that's an issue for you. Several types of medication have been shown to be effective in managing symptoms of panic attacks, including:

Selective serotonin reuptake inhibitors (SSRIs). Generally safe with a low risk of serious side effects, SSRI antidepressants are typically recommended as the first choice of medications to treat panic attacks. SSRIs approved by the Food and Drug Administration (FDA) for the treatment of panic disorder include fluoxetine (Prozac), paroxetine (Paxil, Pexeva) and sertraline (Zoloft).

Serotonin and norepinephrine reuptake inhibitors (SNRIs).These medications are another class of antidepressants. The SNRI drug called venlafaxine hydrochloride (Effexor XR) is FDA approved for the treatment of panic disorder.

Benzodiazepines. These mild sedatives belong to a group of medicines called central nervous system depressants. Benzodiazepines may be habit-forming (causing mental or physical dependence), especially when taken for a long time or in high doses. Benzodiazepines approved by the FDA for the treatment of panic disorder.

Lifestyle & Home Remedies

Some of the lifestyle and self-care steps you can take include:

Stick to your treatment plan. Facing your fears can be difficult, but treatment can help you feel like you're not a hostage in your own home.

Join a support group. Joining a group for people with panic attacks or anxiety disorders can connect you with others facing the same problems.

Avoid caffeine, alcohol and illegal drugs. All of these can trigger or worsen panic attacks.

Practice stress management and relaxation techniques.For example, yoga, deep breathing and progressive muscle relaxation — tensing one muscle at a time, and then completely releasing the tension until every muscle in the body is relaxed — also may be helpful.

Get physically active. Aerobic activity may have a calming effect on your mood.

Get sufficient sleep. Get enough sleep so that you don't feel drowsy during the day.


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