Panic Attacks (PA)

Panic Attacks: A sudden onset of intense fear that triggers severe physical reactions with no apparent cause or real danger.

Often when you have a Panic Attack it feels like you are having a heart attack.  The symptoms of a panic attack mimic some of the symptoms of a heart attack.  You may experience all or some of these similar symptoms:  Chest pain, shortness of breath, pain radiating down the neck, shoulders and arm, sweating, hot or cold flashes, numbness, choking sensation, nausea, lightheadedness, and feeling like you are going to die.  You may also experience feelings of unreality, impending doom and feeling out of control.  When an individual experiences these symptoms they often go to the Emergency Room complaining of having a heart attack when in reality it is a Panic Attack.

Panic attacks often come out of the blue and are related to underlying stress.  Other Panic Attacks are situational, e.g., when you get in an elevator or occur when you are in an area or situation where you have experienced a traumatic event, e.g., an automobile accident.

Most people have 1 or 2 Panic Attacks when they are under stress and then they go away and do not return.  If the stress continues or worsens people will experience more frequent and severe panic attacks. Because Panic Attacks are unpredictable patients develop anticipatory anxiety/ worry about when they will experience another panic attack.  A panic disorder occurs when you experience more frequent panic attacks and have the ongoing anticipatory anxiety of having more panic attacks. 

Children and the elderly may experience panic attacks as well as pregnant women and those who are experiencing postpartum depression.  Those who experience Panic Attacks often report that they last for long periods of time, when in reality they usually last a few minutes.  A common by-product of panic attacks is significant fatigue. If you experience anticipatory anxiety about having a PA you may avoid certain situations, e.g., driving, going outside, fear of closed spaces, opens space, crowds, or flying.  This type of panic disorder is diagnosed as a Panic Disorder with Agoraphobia.

Treatments for Panic Attacks and Panic Disorder often begin with simple Breath Meditation, and Imagery for relaxation.  One of the central problems with this type of anxiety disorder is the loss of control.  The panic attacks and the anticipatory anxiety come out of the blue, and the worry is often difficult to turn off.  By teaching patients simple breath meditation it restores the internal locus of feeling in control and gives them something concrete that they can do to reduce the sense of panic and anxiety.  Having individuals track their panic attacks, the triggers, and their thoughts before, during and after the PA also increase their sense of control.  Mastery of Your Anxiety and Panic Workbook (Treatments That Work) David H. Barlow is the handbook that I use with patients.  Short-term anti-anxiety medications are used as adjunctive treatment.