HEALTH: PANIC ATTACKS (PANIC

HEALTH: PANIC ATTACKS - PANIC DISORDER - PANIC ATTACK (SYMPTOMS)

What are Panic Attacks?

Panic attacks are sudden feelings of terror that strike without warning. These panic episodes can occur at any time, even during sleep. When panic attacks occur, you might think you're losing control, having a heart attack or even dying. The fear and terror that a person experiences during a panic attack are not in proportion to the true situation and may be unrelated to what is happening around them.

You may have only one or two panic attacks in your lifetime. But if you have panic attacks frequently, it could mean that you have panic disorder, a type of chronic anxiety disorder.

Panic attacks were once dismissed as nerves or stress, but they're now recognized as a real medical health condition. Although panic attacks can significantly affect your quality of life, treatment — including medications, psychotherapy and relaxation techniques to help prevent or control panic attacks — is very effective.

Panic attacks may be symptoms of an anxiety disorder. These attacks are a serious health problem in the U.S. At least 1.7% of adult Americans, or about 3 million people, will have panic attacks at some time in their lives, with the peak age at which people have their first panic attack (onset) being 15 to 19 years. Another fact about panic is that symptoms are strikingly different from other types of anxiety; panic attacks are so very sudden and often unexpected, appear to be unprovoked, and are often disabling.

People who have had one panic attack are at greater risk for having subsequent panic attacks than those who have never experienced a panic attack. When the attacks occur repeatedly, a person is considered to have a condition known as Panic Disorder.

Once someone has had a panic attack, for example, while driving, shopping in a crowded store, or riding in an elevator, he or she may develop irrational fears, called phobias, about these situations and begin to avoid them. Eventually, the pattern of avoidance and level of anxiety about another attack may reach the point where the mere idea of doing things that preceded the first panic attack triggers future panic attacks, resulting in the individual with panic disorder being unable to drive or even step out of the house for fear of panic.

At this stage, the person is said to have panic disorder with agoraphobia. Thus, there are two types of panic disorder: panic disorder with or without agoraphobia. Like other major illnesses, panic disorder can have a serious impact on a person's daily life unless the individual receives effective treatment.

Panic attacks in children may result in the child's grades declining, avoiding school and other separations from parents, as well as substance abuse, depression, suicidal thoughts, plans, and/or actions.

Panic attacks are real, potentially quite emotionally disabling, but they can be controlled with specific treatments. Because of the disturbing symptoms that accompany panic attacks, they may be mistaken for heart attacks or some other life-threatening medical illness. In fact, up to 25% of people who visit emergency rooms because of chest pain are actually experiencing panic. As a result, people with this symptom often undergo extensive medical tests to rule out these other health conditions.

Medical personnel generally attempt to reassure the panic-attack sufferer that he or she is not in great danger. But these efforts at reassurance can sometimes add to the patient's difficulties: If the doctors use expressions such as "nothing serious," "all in your head," or "nothing to worry about," this may give the incorrect impression that there is no real problem and that treatment is not possible or necessary. The point is that while panic attacks can certainly be serious, they are not organ-threatening.

Health: Causes of Panic Attacks (Panic)

Experts aren't sure what causes panic attacks and panic disorder. But the body has a natural response when you are stressed or in danger. It speeds up your heart, makes you breathe faster, and gives you a burst of energy. This is called the fight-or-flight response. It gets you ready to either cope with or run away from danger.

According to one theory of panic disorder, the body's normal "alarm system," the set of mental and physical mechanisms that allows a person to respond to a threat, tends to be triggered unnecessarily, when there is no danger. A panic attack occurs when this response happens when there is no danger. Scientists don't know exactly why this happens or why some people are more susceptible to the panic problem than others.

Panic attacks and panic disorder may be caused by an imbalance of brain chemicals or a family history of panic disorder. They sometimes happen with no clear cause for panic.

Panic attacks may also be brought on by:

A health problem such as an overactive thyroid (hyperthyroidism), or heart or breathing problems.

Depression or another mood disorder.

Alcohol abuse.

Using too much nicotine or too much caffeine.

Taking certain medicines, such as those used to treat asthma and heart problems.

Using illegal drugs such as marijuana or cocaine.

Living with high levels of stress for a long time.

You have a higher chance of getting panic disorder if you have a parent with depression or bipolar disorder.

Panic disorder has been found to run in families, and this may mean that inheritance (genes) plays a strong role in determining who will get it. However, many people who have no family history of the disorder develop it. Often, the first attacks are triggered by physical illnesses, a major life stress, or perhaps medications that increase activity in the part of the brain involved in fear reactions. An increase in the frequency of panic attacks has been seen in some women during pregnancy. Panic disorder is twice as common in women as in men.

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PANIC ATTACKS FREE

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Symptoms of panic attacks (Panic)

Panic attack symptoms can make your heart pound and cause you to feel short of breath, dizzy, nauseated and flushed. Because panic attack symptoms can resemble life-threatening conditions, it's important to seek an accurate diagnosis and treatment. Panic attacks are generally brief, lasting less than ten minutes, although some of the symptoms may persist for a longer time. People who have had one panic attack are at greater risk for having subsequent panic attacks than those who have never experienced a panic attack.

The symptoms of a panic attack appear suddenly, without any apparent cause, which may include:

Racing or pounding heartbeat (palpitations)

Chest pains

Stomach upset

Dizziness, faintness, nausea

Difficulty breathing, a sense of feeling smothered

Tingling or numbness in the hands

Hot flashes or chills

Dreamlike sensations or perceptual distortions

Terror: a sense that something unimaginably horrible is about to occur and one is powerless to prevent it

A need to escape

Fear of losing control and doing something embarrassing

Fear of dying

Sweating

Trembling

Abdominal cramping

Headache

Tightness in your throat

Trouble swallowing

A panic attack typically lasts for several minutes, is one of the most distressing conditions that a person can experience, and its symptoms can closely mimic those of a heart attack. Typically, most people who have one attack will have others, and when someone has repeated attacks with no other apparent physical or emotional cause, or feels severe anxiety about having another attack, he or she is said to have panic disorder. A number of other emotional problems can have panic attacks as a symptom. Some of these illnesses include post traumatic stress disorder (PTSD), schizophrenia, and intoxication or withdrawal from certain drugs of abuse .

Anxiety attacks that take place while sleeping, also called nocturnal panic attacks, occur less often than do panic attacks during the daytime, but affect about 40%-70% of those who suffer from daytime panic attacks. Nocturnal panic attacks tend to cause sufferers to wake suddenly from sleep in a state of sudden anxiety for no apparent reason and can have all the other symptoms of a panic attack. The duration of nocturnal panic attacks tends to be less than 10 minutes, but it can take much longer to fully calm down for those who experience them.

Health: Risk Factors of Panic Attacks (Panic)

It's hard to pinpoint how many people have panic attacks or panic disorder because of diagnostic issues, but it's estimated that 2 million to 6 million Americans have panic disorder. Symptoms of panic disorder often start either in late adolescence or in your 30s. Many people have just one or two panic attacks in their lifetimes, and the problem goes away, perhaps when a stressful situation ends.

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

A family history of panic attacks or panic disorder

Significant stress

The death or serious illness of a loved one

Big changes in your life, such as the addition of a baby

A history of childhood physical or sexual abuse

Undergoing a traumatic event, such as an accident or rape

Health: Complications of Panic Attacks (Panic)

Panic attacks tend to continue for months or years. While they typically begin in young adulthood, the symptoms may arise earlier or later in life in some people. Left untreated, panic attacks and panic disorder can result in severe complications that affect almost every area of your life. You may be so afraid of having more panic attacks that you live in a constant state of fear, ruining your quality of life and health. Panic disorder also predisposes sufferers to developing heart disease.

Development of specific phobias, such as fear of driving or leaving your home

Avoidance of social situations, or public places

Problems at work, home, or school

Depression and anxiety

Increased risk of suicide or suicidal thoughts

Alcohol or substance abuse

Mounting financial problems

If left untreated, anxiety may worsen to the point where the person's life is seriously affected by panic attacks and by attempts to avoid or conceal them. In fact, many people have had problems with friends and family, failed in school, and/or lost jobs while struggling to cope with panic. There may be periods of spontaneous improvement in the attacks, but panic attacks do not usually go away unless the person receives treatments designed specifically to help people with panic conditions.

If you have any symptoms of panic attacks, seek medical help as soon as possible. Panic attacks are hard to manage on your own, and they may get worse without treatment. And because panic attack symptoms can also resemble other serious health problems, such as a heart attack, it's important to get evaluated by your health care provider if you aren't sure what's causing your symptoms.

In fact, many people visit the emergency department or seek health care from numerous doctors or hospitals because they believe they have a serious undiagnosed physical condition. You can generally seek help first from your primary care provider for panic attack. If he or she believes your symptoms are indeed related to panic attacks, you may be referred to a psychiatrist or psychologist for treatment.

If you're reluctant to seek treatment for your panic attacks, try to work up the courage to confide in someone, whether it's a friend or loved one, a health care professional, a faith leader or someone else you trust. They can help you take the first steps to successful treatment.

Health: Diagnosis of Panic Attacks (Panic)

Your doctor will ask about your past health and do a physical exam. The exam may include listening to your heart, checking your blood pressure, and ordering blood tests to look for other causes of your problem. Your doctor may ask you to do some simple things that test your memory and other mental skills. Your doctor or other health care provider must determine if you have panic attacks, panic disorder or another health condition, such as heart or thyroid problems, that resembles panic symptoms, by given you several examinations and tests, to make a correct diagnosis for your symptoms.

Tests and exams you may be given include:

Physical exam. This may include measuring height and weight; checking vital signs, such as heart rate, blood pressure and temperature; listening to the heart and lungs; and examining the abdomen.

Laboratory tests. These may include a complete blood count (CBC) as well as thyroid tests and other blood tests. You may also have tests on your heart, such as an electrocardiogram to help determine how well your heart is functioning.

Psychological evaluation. A doctor or mental health provider will talk to you about your symptoms, such as what they feel like, how often they occur, when they occur and how long you've had them. You'll also be asked about stressful situations in your life, fears or concerns you have, relationship problems and other issues affecting your life. You may fill out psychological self-assessments and questionnaires. And you may be asked about substance or alcohol abuse.

Diagnostic criteria for panic disorder
Not everyone who has panic attacks has a full-blown panic disorder. To be diagnosed with panic disorder, you must meet the criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric Association and is used by mental health providers to diagnose mental health conditions and by insurance companies to reimburse for treatment.

Diagnostic criteria for panic disorder are the following:

You have frequent, unexpected panic attacks

You worry about having another panic attack or about losing control

You avoid situations you think may trigger a panic attack

Your panic attacks aren't caused by substance abuse or another mental health condition, such as social phobia or agoraphobia

If you have panic attacks but not a full-blown panic disorder, you can still benefit from treatment. If panic attacks aren't treated, they can get worse and develop into panic disorder or phobias.

Health: Treatment for Panic Attacks (Panic)

Thanks to research, there are a variety of treatments available for controlling panic attacks, including several effective medications, and specific forms of psychotherapy. Treatment for panic attacks and panic disorder is very effective. The goal of treatment is to eliminate all of your panic attack symptoms. With effective treatment, most people are eventually able to resume everyday activities.

The main treatment options for panic attacks are medications and psychotherapy. Both are equally effective. However, as anything that is ingested carries risk of side effects, it is important to work closely with the prescribing doctor to decide whether treatment with medications is an appropriate intervention and if so, which medication should be administered.

If one medication doesn't work well for you, your doctor may recommend switching to another or combining certain medications to boost their effectiveness. Keep in mind that it can take several weeks after first starting a medication to notice an improvement in your symptoms. All medications have a risk of side effects, and some may not be recommended in certain situations, such as pregnancy. Be sure to talk to your doctor about the possible side effects and risks.

The person being treated should be closely monitored for the possibility of side effects that can vary from minor to severe and in some cases even be life-threatening. Due to the possible risks to the fetus of a mother being treated for panic attacks with medication, psychotherapy should be the first treatment tried when possible in pregnant women.

The psychotherapy component of treatment for panic disorders is at least as important as medication treatment. In fact, research shows that psychotherapy alone or the combination of medication and psychotherapy treatment are more effective than medication alone in overcoming panic attacks. To address anxiety, cognitive behavioral therapy is widely accepted as an effective form of psychotherapy. This form of therapy seeks to help those with panic disorder identify and decrease the irrational thoughts and behaviors that reinforce panic symptoms.

Behavioral techniques that are often used to decrease anxiety include relaxation techniques and gradually increasing exposure to situations that may have previously precipitated anxiety in the individual. Helping the anxiety sufferer understand the emotional forces that may have contributed to developing symptoms (panic-focused psychodynamic psychotherapy) has also been found to be effective.

Often, a combination of psychotherapy and medications produces good results. Improvement is usually noticed in a fairly short period of time, about two to three months. Thus, appropriate treatment for panic disorder can prevent panic attacks or at least substantially reduce their severity and frequency, bringing significant relief to 70%-90% of people with panic disorder.

There are also things that people with panic disorder can do to help make treatment more effective. Since substances like caffeine, alcohol, and illicit drugs can worsen panic attacks, those things should be avoided.

In addition, people with panic disorder may need treatment for other emotional problems. Depression has often been associated with panic disorder, as have alcohol and drug abuse. Recent research also suggests that suicide attempts are more frequent in people with panic disorder. Fortunately, these problems associated with panic disorder can be overcome effectively, just like panic disorder itself.

Psychotherapy
Psychotherapy, also called counseling or talk therapy, can help you understand panic attacks and panic disorder and how to cope with them. The main type of psychotherapy used to treat panic attacks and panic disorder is cognitive behavioral therapy. Some experts recommend that you have therapy with a psychiatrist or psychologist with experience in treating panic disorder.

Cognitive behavioral therapy can help you change thinking (cognitive) patterns that trigger your fears and panic. It can also help you change the way you react (behave) to anxious or fearful situations. During therapy sessions, you learn to recognize things that trigger panic in you, or make them worse, such as specific thoughts or situations. You also learn ways to cope with the anxiety and physical symptoms associated with panic attacks. These may include breathing and relaxation techniques.

In addition, working carefully with your therapist, you may re-create the symptoms of panic attacks in the safety of his or her office. This is an important step because it can help you learn to control and master the symptoms so that they don't continue to be a source of intense panic. Doing this can also help you overcome fear of certain situations that you may avoid, such as crowded malls or driving.

Your therapist may suggest weekly meetings when you first start treatment. You may start to see improvements in panic attack symptoms within several weeks, and often symptoms go away within several months.

As your symptoms improve, maintenance therapy with visits once a month can help ensure that your panic attacks remain under control. Eventually you can stop therapy when your symptoms completely go away, which may be a year or so. However, panic attack symptoms do sometimes come back. Seek prompt treatment if they do, and make sure that you're managing any stressful life situations.

Tragically, many people with panic attacks do not seek or receive treatment for whatever reasons.

Health: Lifestyle Changes During Treatment of Panic Attacks (Panic)

While panic attacks and panic disorder benefit from professional treatment, you can also help manage your symptoms on your own. Some of the lifestyle changes 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 for people with panic attacks or anxiety disorders so that you can connect with others facing the same panic problems.

Avoid caffeine, alcohol and illicit drugs, all of which can trigger or worsen panic attacks.

Practice stress management and relaxation techniques.

Get physically active, since aerobic activity may have a calming effect on your mood.

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

Health: Prevention of Panic Attacks (Panic)

Behavioral treatment appears to have long-lasting benefits. Regular exercise, adequate sleep, and regularly scheduled meals may help reduce the frequency of the attacks.

If you get panic attacks, avoid the following:

Alcohol

Stimulants such as caffeine and cocaine

These substances may trigger or worsen the symptoms of panic.

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Disclaimer: This information is not presented by a medical practitioner. Therefore any content of this site is strictly intended for educational and informational purpose only. Any access to this site is strictly on a voluntary basis and at the sole discretion of the user. No content of this site is intended as a substitute for medical advice, diagnosis or treatment, nor constitute the practice of any medical profession or health care provider. The information provided on this site is here to educate visitors on health issues that may affect their lives. Otherwise, always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition. And never disregard professional medical advice or delay in seeking it because of something you have read.

Sources: NIH News In Health/National Institutes of Health/National Library of Medicine/Dept of Health and Human Services

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