Description

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 only have 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 known as panic disorder.

Despite the panic attacks themselves aren't life-threatening, which can be frightening and significantly affect your quality of life. But the treatment can be very effective.

Symptoms

Panic attacks typically begin suddenly, without prior notice. They can strike at any time — when you are driving a car, at the mall, sound asleep or in the middle of a business meeting. You may have occasional panic attacks, or they may occur frequently.

Panic attacks have many variations, but symptoms usually peak within minutes. You may feel tired and exhausted after a panic attack subsides.

Panic attacks typically include some of these signs or symptoms:

  • Feeling of impending doom or danger
  • The fear of loss of control or death
  • Rapid, pounding heart rate
  • Sweating
  • Trembling or shaking
  • Shortness of breath or tightness in the throat
  • Chills
  • Hot flashes
  • Nausea
  • Abdominal cramps
  • Pain in the chest
  • Headache
  • Dizziness, lightheadedness, or feeling faint
  • Numbness or tingly feeling
  • Feeling of unreality or detachment

One of the worst things about panic attacks is the intense fear that you're going to have another one. You may fear having panic attacks so much that you avoid certain situations where they may occur.

When to see a doctor

If you have panic attacks symptoms, seek medical help as soon as possible. Panic attacks, while feeling very uncomfortable, they are not dangerous. But the panic attacks are difficult to handle on their own, and that may get worse without treatment.

Panic attack symptoms can also resemble symptoms of other serious health problems, such as a heart attack, so it is important to get evaluated by your primary care physician if you are not sure what is the cause of your symptoms.

Causes

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

  • Genetics
  • Major stress
  • The temperament that is more sensitive to stress or prone to negative emotions
  • Certain changes in the way parts of your brain function

Panic attacks can occur suddenly and without warning at the beginning, but with time, usually triggered by certain situations.

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 later, his body was going to react instinctively. Your heart rate and breathing speed up as your body prepared for a life-threatening situation. Many of the same reactions occur in a panic attack. But it is unknown why a panic attack occurs when there is obvious danger present.

Risk factors

The symptoms of panic disorder often begins in adolescence or early adulthood and affects more women than men.

Factors that may increase the risk of developing panic attacks or panic disorder include:

  • The family history of panic attacks or panic disorder
  • Major life stress, such as the death or serious illness of a loved one
  • A traumatic event, such as sexual abuse or a serious accident
  • Major changes in your life, such as divorce or the addition of a baby
  • Smoking or excessive consumption of caffeine
  • The history of childhood physical or sexual abuse

Complications

Left untreated, panic attacks and panic disorder can affect almost all areas of your life. It can be so afraid of having more panic attacks that living in a constant state of fear, ruining their quality of life.

The complications that panic attacks can cause or be associated with include:

  • The development of specific phobias, such as fear of driving or leaving your home
  • Frequent medical care for health problems and other medical conditions
  • Avoidance of social situations
  • Problems at work or at school
  • Depression, anxiety disorders and other psychiatric disorders
  • Increased risk of suicide or suicidal thoughts
  • Of Alcohol or other substances of abuse
  • Financial problems

For some people, panic disorder can include agoraphobia — avoid places or situations that cause anxiety because of fear of being unable to escape or get help if you have a panic attack. Or you may become dependent on others to be with you with the order to leave your home.

Prevention

There is No sure way to prevent panic attacks or panic disorder. However, these recommendations can help.

  • Get treatment for panic attacks as soon as possible to help prevent it from getting worse or more frequent.
  • Stick to your plan of treatment to help prevent relapse or worsening of symptoms of panic attack.
  • Get regular physical activity, which may play a role in the protection against anxiety.

Diagnosis

Your primary care provider to determine if you have panic attacks, panic disorder or another condition, such as heart or thyroid problems, with symptoms that resemble panic attacks.

To help determine a diagnosis, you may have:

  • A complete physical examination.
  • Blood tests to check your thyroid and other possible conditions and tests on your heart, such as an electrocardiogram (ECG or EKG)
  • A psychological evaluation to talk about your symptoms, fears, or worries, stress, relationship problems, situations that can be avoided, and the history of the family

You can also fill out a psychological self-assessment or questionnaire. You can also ask about the consumption of alcohol or other substances.

Criteria for the diagnosis of panic disorder

Not everyone who has panic attacks have panic disorder. For a diagnosis of panic disorder, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, lists some of these items:

  • You have frequent, unexpected panic attacks.
  • At least one of the attacks has been followed by a month or more of ongoing worry about having another attack, followed by fear of the consequences of an attack, such as losing control, having a heart attack or "going crazy"; or significant changes in your behavior, such as avoiding situations that you think may trigger a panic attack.
  • Their panic attacks are not caused by drugs or substance use, a medical condition, or another mental health condition, such as social phobia or obsessive-compulsive disorder.

If you have panic attacks, but not a diagnosis of panic disorder, you may still benefit from treatment. If the panic attacks are not treated, they can get worse and become a panic disorder or phobias.

Treatment

The treatment can help reduce the intensity and frequency of panic attacks and improve your function in daily life. The main treatment options are psychotherapy and medications. One or both types of treatment can be recommended, depending on your preference, of its history, the severity of panic disorder and if you have access to therapists, who have received a special training in the treatment of panic disorders.

Psychotherapy

Psychotherapy, also called talk therapy, is considered an effective first-line treatment option for panic attacks and panic disorder. Psychotherapy can help you understand panic attacks and panic disorder and learn how to deal with them.

A form of psychotherapy called cognitive behavioral therapy can help you learn, through your own experience, that panic symptoms are not dangerous. Your therapist will help you to slowly re-create the symptoms of a panic attack in a safe, repetitive manner. Once the physical sensations of panic doesn't feel threatening, the attacks begin to resolve. The success of the treatment can also help to overcome the fears of situations that you have avoided because of the panic attacks.

Seeing the results of the treatment can take time and effort. You can start to see the symptoms of panic attack reduce within several weeks, and often the symptoms of the significant decrease or disappear after several months. You can schedule occasional maintenance visits to help ensure that their panic attacks remain under the control or for the treatment of recurrences.

Drugs

Medications can help reduce the symptoms associated with panic attacks and depression if that is a problem for you. Several types of medications have been shown to be effective in the management of the symptoms of panic attacks, including:

  • Selective serotonin reuptake inhibitors (Ssris). Generally safe with a low risk of serious side effects, SSRI antidepressants is generally recommended as the first choice of drugs for the treatment of panic attacks. The ssris approved by the Food and Drug Administration (FDA) for the treatment of panic disorder include fluoxetine (Prozac), paroxetine (Paxil, Pexeva), and sertraline (Zoloft).
  • The serotonin and noradrenaline reuptake inhibitors (Snris). These medications are another class of antidepressants. The SNRI venlafaxine (Effexor XR) is approved by the FDA for the treatment of panic disorder.
  • Benzodiazepines. These sedatives are central nervous system depressants. Benzodiazepines approved by the FDA for the treatment of panic disorder include alprazolam (Xanax), and clonazepam (Klonopin). Benzodiazepines are generally used only on a short-term because they can be habit-forming, causing mental or physical dependence. These medications are not a good option if you have had problems with alcohol or drug use. They can also interact with other medications, causing dangerous side effects.

If one medication does not work well for you, your doctor may recommend switching to the other or the combination of certain drugs to increase the efficacy. Please note that it may take several weeks after you start it for the first time a medication to notice an improvement in symptoms.

All drugs have a risk of side effects, and some may not be recommended in certain situations, such as pregnancy. Talk with your doctor about the possible side effects and risks.

Lifestyle and home remedies

While the panic attacks and panic disorder benefit from a professional treatment, these self-care measures may help manage your symptoms:

  • Stick to your treatment plan. Facing your fears can be difficult, but treatment can help you feel like you are not a hostage in your own home.
  • Join a support group. Join a group for people with panic attacks or anxiety disorders can connect with others facing the same problems.
  • Avoid caffeine, alcohol, tobacco, and recreational drugs. All of these can trigger or worsen attacks of panic.
  • Practice stress management and relaxation techniques. For example, yoga, deep breathing and progressive muscle relaxation — tensing one muscle at a time, and then completely release the tension until every muscle in the body is relaxed — it can also be helpful.
  • Be physically active. The aerobic activity can have a calming effect on your mood.
  • Get enough sleep. Get enough sleep so that you do not feel sleepy during the day.

Alternative medicine

Some dietary supplements have been studied as a treatment for panic disorder, but more research is needed to understand the risks and benefits. Herbal products and dietary supplements are not monitored by the Food and Drug Administration (FDA) in the same way that medications are. You can't always be sure what you're doing and if it is safe.

Before trying herbal remedies or dietary supplements, talk with your doctor. Some of these products can interfere with prescription medications or cause dangerous interactions.

Preparing for your appointment

If you have had any signs or symptoms of a panic attack, make an appointment with your primary care provider. After an initial assessment, he or she may refer you to a mental health professional for treatment.

What you can do

Before your appointment, make a list of:

  • Its symptoms, including the first time it happened, and how often you've had
  • Key personal information, including the traumatic events of his past, and any stressful of the main events that occurred prior to his first panic attack
  • Medical information, including the physical or mental health that you have
  • The drugs, vitamins, herbal products and other supplements, and dosage
  • Questions to ask your doctor

Ask a trusted family member or friend to go with you to your appointment, if possible, to give support and help to remember the information.

Questions to ask your primary care provider at your first appointment

  • What do you think is the cause of my symptoms?
  • It is possible that an underlying medical problem that is causing my symptoms?
  • I need the diagnostic tests?
  • I need to see a mental health professional?
  • Is there anything I can do right now to help control the symptoms?

Questions to ask if you are referred to a mental health professional

  • I have panic attacks or panic disorder?
  • What treatment approach do you recommend?
  • If you're going to recommend the therapy, how frequently do I need and for how long?
  • Could be useful in the therapy group in my case?
  • If you are recommending medications, there are possible side effects?
  • How long should I take the medicine?
  • How will you control if the treatment is working?
  • What can I do now to reduce the risk of my panic attacks are recurrent?
  • There are self-care steps you can take to help manage my condition?
  • Are there brochures or other printed material I can have?
  • What sites do you recommend?

Do not hesitate to ask any other questions.

What to expect from your doctor

Your primary care provider or mental health professional may ask:

  • What are your symptoms, and when it happens for the first time?
  • What is the frequency of your attacks occur, and how long they last?
  • Is there anything in particular seem to trigger an attack?
  • How often do you experience the fear of another attack?
  • Avoid places or experiences that seem to trigger an attack?
  • How do your symptoms affect your life, such as school, work and personal relationships?
  • Do you experience significant stress or a traumatic event, shortly before his first panic attack?
  • Have you ever experienced a major trauma, such as physical or sexual abuse or a military battle?
  • How would you describe your childhood, including his relationship with his parents?
  • Do you or any of your close relatives has been diagnosed with a mental health problem, including panic attacks or panic disorder?
  • Have you been diagnosed with any medical condition?
  • Does the use of caffeine, alcohol, or recreational drugs? What's the frequency?
  • Do exercise or do some other kind of regular physical activity?

Your primary care provider or mental health professional will ask more questions based on your responses, symptoms, and needs. Prepare and anticipate the questions will help you make the most of your appointment time.

The symptoms and treatment of Panic attacks and panic disorder