Panic Attacks

Season: 2003

Submitted By: Dr. Dana Thordarson

A panic attack is a sudden surge of intense fear, accompanied by symptoms such as feeling your heart racing, feeling like you are having trouble breathing, chest pain, feeling dizzy, sick to your stomach, sweaty, trembling, tingling, unreal, out of control, and feeling afraid that you might go crazy, pass out, or die. Panic attacks can happen totally out of the blue, or they may happen in situations where you tend to feel anxious (e.g., on a crowded bus, or before having to give a speech, or while worrying about problems).

A panic attack is just a sudden activation of a normal fear response (the "fight or flight" response). If you were crossing the street and looked up to see a car speeding towards you, your nervous system would respond in ways that help you to run away: your pulse quickens, your blood pressure increases, and you start breathing faster. In a panic attack, the fear response is being set off but there isn`t any danger to run away from. If you start feeling your heart pounding for no apparent reason, you might become frightened by this, then you would have more anxiety symptoms, then you would really be afraid something was seriously wrong . . . This vicious circle of anxiety symptoms and responses creates the panic attack.

Although panic attacks can be frightening, they are not dangerous, and they are actually quite common. Over the course of a year, up to 10% of people have at least one panic attack.

Unfortunately, panic attack symptoms are quite similar to symptoms of some heart problems. For most people with panic attacks, their doctor reassures them that their hearts are healthy, and they are having symptoms of anxiety and panic. However, if you have heart problems, it can be difficult for your doctor to determine whether the symptoms are related to your heart or to anxiety. For some people, their heart symptoms trigger a panic attack, and they experience a mixture of heart and anxiety symptoms. For example, you might have palpitations due to occasional episodes of an abnormal heart rhythm. If your first thought is, "Oh No! My heart is going to stop beating!" this will set off an additional anxiety response, leading to even more symptoms, leading to even more catastrophic thoughts ("I`m going to pass out and die right here!"), and so on - the vicious circle of a panic attack. If instead, you are able to reassure yourself ("Oh, I`ve had these palpitations before, the doctor said I should just sit down until they go away"), you will experience fewer symptoms and the whole episode might be over sooner.

There are several ways to treat panic attacks. Many people are able to cope with occasional panic attacks, even those that are set off by real heart symptoms, by reminding themselves that they have had these symptoms before, and if they can relax and focus on taking slow deep breaths, they will soon go away. If you have frequent panic attacks, anti-depressant or anti-anxiety medications are often helpful in preventing them by reducing the anxiety response. Cognitive-behaviour therapy for panic is also effective but if you live outside a large city finding a therapist with experience in this area can be difficult.