Panic attacks

Just about everyone has felt panicky at one time or another, but feeling panicky and having an actual panic attack are two different things.

Most panic attacks happen "out of the blue." You can be sitting at work, walking down the street, driving your car, and suddenly your heart is pounding, or you're sweating and shaking. You may have chest pain or queasiness. You might feel extremely afraid and think you're going to die.

Symptoms

You may be having a panic attack if you have four of these symptoms, and if the symptoms develop suddenly:

• rapid heart beat
• perspiring
• shakiness
• shortness of breath, feeling that you're smothering
• a choking feeling
• nausea
• dizziness, lightheadedness, faintness
• feeling detached (separated) from yourself
• fear of losing control
• fear of dying
• numbness or tingling
• chills or hot flashes

Symptoms of panic attack can be so severe and frightening that people often go to the emergency room because they think they're having a heart attack. The symptoms themselves often make panic attack difficult to diagnose.

What are the causes?

Panic attacks occur most often between the later teen years and the mid-30s. Nobody knows for sure exactly what causes them, but there are some theories.

• It's believed that some people inherit a tendency to have panic attacks.
• Stress may play a role as well.

Consequences of frequent attacks

Frequent panic attacks are likely to have profound effects on the way people live their lives. Fear and worry about having another attack can cause people to quit a job, stop driving, avoid physical activity and in some cases, even stop going outside.

You may have heard of a condition called agoraphobia, in which people are afraid to leave their homes. It's believed that many cases of agoraphobia trace their beginnings to frequent panic attacks. People stay home because they're afraid to have a panic attack in public. They would consider it shameful and embarrassing, and they're often afraid that it will be difficult to get help quickly.

One psychiatry textbook describes a 30-year-old accountant who had been having panic attacks for six months. He was married, successful in his work and seemed to have an enjoyable social life. But fear of having panic attacks initially kept him from driving and going to department stores. Eventually, he couldn't face the idea of leaving his home, and he took a leave of absence from work.

When panic attacks become panic disorder

If panic attacks are not the direct result of a medical condition, and if they are frequent and recurrent, it's possible that an actual panic disorder is present.

If you have been experiencing any of the symptoms of panic attack, be sure to visit your doctor.

Treatment available

Getting the appropriate treatment can prevent panic attacks in 70 to 90 percent of people with panic disorder. Treatment can consist of medication or cognitive behavioral therapy or a combination of both. Cognitive behavioral therapy teaches people how to reduce anxiety and how to view panic attacks differently.

People who don't get treatment for panic attacks and panic disorder are more likely to develop depression, substance abuse problems and other anxiety attacks. Getting early treatment can not only help you get your panic attacks under control, but also get your life on a course that's headed in a more productive, fulfilling direction.

Related Links

Allina Behavioral Health Services

Behavioral health topics

Psychiatry and psychology

First published: 02/27/2003
Last updated: 09/02/2005

Reviewed by: Tim Gibbs, MD, medical director, Outpatient Clinic, Abbott Northwestern Hospital Behavioral Health Services; Paul Goering, MD, medical director, United Hospital Behavioral Health Services; Donna Krzmarzick, RN, director, Cambridge Medical Center Behavioral Health Services; David Olson, MD, psychiatrist, Cambridge Medical Center; Susan Tabor, RN, BSN, director, United Hospital Behavioral Health Services; Dianne Timmer, RN, behavioral health services lead, Abbott Northwestern Hospital; Mark Zipper, PhD, behavioral health services director, Allina Medical Clinic