What are Panic Attacks?
A panic attack is a sudden, intense experience of fear coupled with an overwhelming feeling of danger, accompanied by physical symptoms of anxiety, such as pounding heart, sweating, and rapid breathing. A person with panic disorder may have repeated panic attacks (at least several a month) and feel severe anxiety about having another attack.

Each year, panic disorder affects 1 out of 63 Americans. While many people experience moments of anxiety, panic attacks are sudden and unprovoked, having little to do with real danger.

Panic disorder is a chronic, debilitating condition that can have a devastating impact on a person’s family, work, and social life. Typically, the first attack strikes without warning. A person might be walking down the street, driving a car, or riding an escalator when suddenly panic strikes. Pounding heart, sweating palms, and an overwhelming feeling of impending doom are common features. While the attack may last only seconds or minutes, the experience can be profoundly disturbing. A person who has had one panic attack typically worries that another one may occur at any time.

As the fear of future panic attacks deepens, the person begins to avoid situations in which panic occurred in the past. In severe cases of panic disorder, the victim refuses to leave the house for fear of having a panic attack. This fear of being in exposed places is often called agoraphobia.

People with untreated panic disorder may have problems getting to work or staying on the job. As the person’s world narrows, untreated panic disorder can lead to depression, substance abuse, and in rare instances, suicide.

Causes
Scientists aren’t sure what causes panic disorder, but they suspect the tendency to develop the condition can be inherited. Some experts think that people with panic disorder may have a hypersensitive nervous system that unnecessarily responds to nonexistent threats. Research suggests that people with panic disorder may not be able to make proper use of their body’s normal stress-reducing chemicals.

Symptoms
People with panic disorder usually have their first panic attack in there 20s. Four or more of the following symptoms during panic attacks would indicate panic disorder if no medical, drug-related, neurological, or other psychiatric disorder is found…

• Pounding, skipping or palpitating heartbeat
• Shortness of breath or the sensation of smothering
• Dizziness or light headedness
• Nausea or stomach problems
• Chest pains or pressure
• Choking sensation or a “lump in the throat”
• Chills or hot flushes
• Sweating
• Fear of dying
• Feelings of unreality or being detached
• Tingling or numbness
• Shaking and trembling
• Fear of losing control or going crazy

A panic attack is often accompanied by the urge to escape, together with a feeling of certainty that death is imminent. Others are convinced they are about to have a heart attack, suffocate, lose control, or “go crazy.” Once people experience one panic attack, they tend to worry so much about having another attack that they avoid the place or situation associated with the original episode.

Prevention
Unfortunately, there is no way to prevent the initial onset of panic attacks. There is some suggestion that avoiding stimulants (including caffeine, alcohol, or over-the-counter cold medicines) may help prevent attacks as well.

Treatment
Cognitive-behavioural therapy is very helpful and usually runs from 12-15 sessions. It teaches patients…

• How to identify and alter thought patterns so as not to misconstrue bodily sensations, events, or situations as catastrophic
• How to prepare for the situations and physical symptoms that trigger a panic attack
• How to identify and change unrealistic self-talk (such as “I’m going to die!”) that can worsen a panic attack
• How to calm down and learn breathing exercises to counteract the physical symptoms of panic
• How to gradually confront the frightening situation step by step until it becomes less terrifying
• How to “desensitise” themselves to their own physical sensations, such as rapid heart rate
• Finally, patients can make certain lifestyle changes to help keep panic at bay, such as eliminating caffeine and alcohol, cocaine, amphetamines, and marijuana

Another approach used in several medical centres focuses on teaching patients how to accept their fear instead of dreading it. In this method, the therapist repeatedly stimulates a person’s body sensations (such as a pounding heartbeat) that can trigger fear. Eventually, the patient gets used to these sensations and learns not to be afraid of them. Patients who respond report almost complete absence of panic attacks.

A variety of other alternative therapies may be helpful in treating panic attacks. Neurolinguistic programming and hypnotherapy can be beneficial, since these techniques can help bring an awareness of the root cause of the attacks to the conscious mind. Herbal remedies, including lemon balm (Melissa officinalis), oat straw (Avena sativa ), passionflower (Passiflora incarnata), and skullcap (Scutellaria lateriflora), may help significantly by strengthening the nervous system. Homeopathic medicine, nutritional supplementation (especially with B vitamins, magnesium, and antioxidant vitamins), creative visualization, guided imagery , and relaxation techniques may help some people suffering from panic attacks. Hydrotherapies, especially hot Epsom salt baths or baths with essential oil of lavender (Lavandula officinalis), can help patients relax.