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Panic Attacks

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.

Four or more of the following symptoms define a panic attack:

  • Shortness of breath or smothering sensations
  • Sweating
  • Choking feeling
  • Racing heart rate or palpitations
  • 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 are having a heart attack, feel like they are going to die or think they are going crazy.

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.

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

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

 

Treatment

Medication. Certain antidepressants and anti-anxiety 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.

 

Self-Help

(Note: Many of these tips should be used only once therapy has begun.)

Ways to deal with panic with limited symptoms and shorter term 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 require 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.
  • Do one or more mental "stress rehearsals." Imagine yourself feeling calm and handling the situation well.
  • Use bibliotherapy - read a self-help book on panic attacks.
  • Minimize exposure to things that cause distress.
  • 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 (over breathe). Breathe into the paper bag slowly and re-breathe 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.
  • Prepare for stressful situations. For example, if you need to give a group talk or presentation:
    • Have necessary materials and equipment ready ahead of time. Check to see that they work.
    • Put an outline with key points you want to make on note cards.
    • Anticipate problems that could occur and prepare to address them ahead of time.
    • Rehearse what you will do and say.
  • Be well prepared for exams or work demands. Prioritize tasks so you're not overwhelmed.
  • Learn and practice stress management and control techniques.
  • Limit your caffeine intake.

 

What You Can Do for a Friend or Relative

  • Remain calm during the panic attack. Get emergency care if he or she is having heart attack warning signs:
    • Feeling of pain (may spread to or be felt in the arm, neck, tooth, jaw, or back), tightness, burning, squeezing or heaviness in the chest that lasts more than a few minutes or goes away and comes back
    • Chest discomfort with fainting, lightheadedness, nausea, shortness of breath or sweating
    • Unusual chest, abdominal or stomach pain
    • Dizziness, nausea, trouble breathing, jaw or arm pain (in the absence of chest pain)
    • Fast or uneven heartbeat or pulse
    • Sweating for no reason; pale, gray or clammy skin
  • If your friend or relative is being treated for panic attacks, remind them to do the things their care provider advised during a panic attack.
  • Do not "force" your friend or relative to stay in or go to a place they cannot handle. Be willing to accept their need for "a way out" of a situation which they can't deal with. For example, choose aisle seats and plan ahead of time what you are willing and able to do in case your friend or relative has an anxiety attack in a crowded theater.
  • Do not force your friend or relative into a direct, sudden confrontation with their anxiety-provoking situation.