The signs and symptoms of a panic attack develop abruptly and usually reach their peak within 10 minutes. They rarely last more than an hour, with most ending within 20 to 30 minutes. Panic attacks can happen anywhere and at any time. In fact, many people suffering from panic attacks make repeated trips to the doctor or the emergency room in an attempt to get treatment for what they believe is a life-threatening medical problem.
Panic disorder is characterized by repeated panic attacks, combined with major changes in behavior or persistent anxiety over having further attacks. While a single panic attack may only last a few minutes, the effects of the experience can leave a lasting imprint.
If you have panic disorder, the recurrent panic attacks take an emotional toll. The memory of the intense fear and terror that you felt during the attacks can negatively impact your self-confidence and cause serious disruption to your everyday life. Eventually, this leads to the following panic disorder symptoms:. Anticipatory anxiety — Instead of feeling relaxed and like your normal self in between panic attacks, you feel anxious and tense.
This anxiety stems from a fear of having future panic attacks. Phobic avoidance — You begin to avoid certain situations or environments. Or you may avoid places where escape would be difficult or help would be unavailable if you had a panic attack. Taken to its extreme, phobic avoidance becomes agoraphobia. Agoraphobia was traditionally thought to involve a fear of public places and open spaces. However, it is now believed that agoraphobia develops as a complication of panic attacks and panic disorder.
Although it can develop at any point, agoraphobia usually appears within a year of your first recurrent panic attacks. Because of these fears, you start avoiding more and more situations. Although the exact causes of panic attacks and panic disorder are unclear, the tendency to have panic attacks runs in families. There also appears to be a connection with major life transitions such as graduating from college and entering the workplace, getting married, or having a baby.
Severe stress , such as the death of a loved one, divorce, or job loss can also trigger panic attacks. Panic attacks can also be caused by medical conditions and other physical causes. The following self-help techniques can make a big difference to helping you overcome panic:. Learn about panic and anxiety. Simply knowing more about panic can go a long way towards relieving your distress. Read up on anxiety , panic disorder, and the fight-or-flight response experienced during a panic attack.
Avoid smoking, alcohol, and caffeine. These can all provoke panic attacks in people who are susceptible. If you need help to kick the cigarette habit, see How to Quit Smoking. Also, be careful with medications that contain stimulants, such as diet pills and non-drowsy cold medications. Learn how to control your breathing. Hyperventilation brings on many sensations such as lightheadedness and tightness of the chest that occur during a panic attack.
Deep breathing , on the other hand, can relieve the symptoms of panic. By learning to control your breathing, you can calm yourself down when you begin to feel anxious. Practice relaxation techniques. And not only do these relaxation practices promote relaxation, but they also increase feelings of joy and equanimity. Connect face-to-face with family and friends. Symptoms of anxiety can become worse when you feel isolated, so reach out to people who care about you on a regular basis.
Exercise regularly. Exercise is a natural anxiety reliever so try to get moving for at least 30 minutes on most days three minute sessions is just as good. Rhythmic aerobic exercise that requires moving both your arms and legs—like walking, running, swimming, or dancing—can be especially effective. Get enough restful sleep. Insufficient or poor quality sleep can make anxiety worse, so try to get seven to nine hours of restful sleep a night.
The most effective form of professional treatment for tackling panic attacks, panic disorder, and agoraphobia is therapy.
Even a short course of treatment can help. Cognitive behavioral therapy focuses on the thinking patterns and behaviors that are sustaining or triggering your panic attacks and helps you look at your fears in a more realistic light. For example, if you had a panic attack while driving, what is the worst thing that would really happen? While you might have to pull over to the side of the road, you are not likely to crash your car or have a heart attack.
Once you learn that nothing truly disastrous is going to happen, the experience of panic becomes less terrifying. Exposure therapy for panic disorder allows you to experience the physical sensations of panic in a safe and controlled environment, giving you the opportunity to learn healthier ways of coping. You may be asked to hyperventilate, shake your head from side to side, or hold your breath. However, the physical and emotional effects of the attack may last for a few hours.
Panic attacks are common. A panic attack can also be called an anxiety attack. Without treatment, frequent and prolonged panic attacks can be severely disabling. The person may choose to avoid a wide range of situations such as leaving their home or being alone for fear of experiencing an attack. For many people, the feelings of panic occur only occasionally during periods of stress or illness.
A person who experiences recurring panic attacks is said to have panic disorder, which is a type of anxiety disorder. They generally have recurring and unexpected panic attacks and persistent fears of repeated attacks. The body is flooded with a range of chemicals, including adrenaline, that trigger physiological changes.
For example, heart rate and breathing are accelerated and blood is shifted to the muscles to prepare for physical combat or running away. A person may experience the symptoms of a panic attack in harmless and apparently stress-free situations, such as watching television or while asleep.
Some symptoms that are common to panic attacks may also occur in some physical conditions. Some medications and drugs — such as tranquillisers, alcohol and caffeine — may also induce panic-like symptoms.
In an emergency, dial triple zero for an ambulance. If the physical anxiety symptoms are caused by physical illnesses, such as diabetes or hyperthyroidism, proper treatment for these illnesses should stop the panic-like symptoms from recurring.
If the panic attacks are due to anxiety, treatment options can include:. This page has been produced in consultation with and approved by:. A person with agoraphobia is afraid to leave familiar environments, because they are afraid of having a panic attack.
Family and friends of people with Alzheimer's disease discuss their experiences and how to recognise the early signs. A common misconception is that anorexia nervosa only affects young women, but it affects males and females of all ages. Antipsychotic medications work by altering brain chemistry to help reduce psychotic symptoms like hallucinations, delusions and disordered thinking.
You can help your child overcome anxiety by taking their fears seriously and encouraging them to talk about their feelings.
Having recently had a baby. Having recently had surgery or been under general anesthesia. Panic attacks also can be caused by or linked with other medical conditions, including: Thyroid problems, such as an overactive thyroid hyperthyroidism.
Heart problems. Seizure disorders, such as epilepsy. Respiratory problems, such as COPD. Stopping the use of a prescription medicine, such as a heart medicine. Anxiety disorders such as post-traumatic stress disorder or obsessive-compulsive disorder.
Symptoms The main symptom of a panic attack is an overwhelming feeling of fear or anxiety. Symptoms of a panic attack may include: Rapid breathing hyperventilation , shortness of breath, or a feeling of choking or being smothered. A pounding or racing heart or an irregular heartbeat.
Chest pain. Shaking, trembling, or feeling lightheaded or dizzy. Sweating, chills, or hot flashes. Fear that you are going to die, lose control, or "go crazy. Agoraphobia Panic attacks may begin without a trigger. Symptoms in children Panic attacks aren't common in children or younger teens.
They may be overly afraid of common objects such as bugs. They may worry too much about monsters or about going to bed alone.
They may refuse to go to school or become unusually upset when they are separated from a parent. What Happens A first panic attack often starts without warning during an ordinary activity such as shopping or walking down the street. You may become confused and think you are "going crazy. You may feel a strong need to leave the area and go to a place that feels safe, such as your car or home.
You may also have physical symptoms such as shortness of breath, a pounding heart, or chest pain. It is common to think that you are having a heart attack and to seek treatment in a hospital emergency room. The intensity of these symptoms usually peaks within 10 minutes. Panic disorder Common traits in panic disorder include: Feeling exhausted from lack of sleep. Using drugs or alcohol to numb your fears or give you a false sense of courage to face feared situations.
Having depression. Having irrational fears phobias. Having other anxiety disorders , such as post-traumatic stress disorder. Having trouble relating to other people in social settings because of intense feelings of anxiety. What Increases Your Risk Your risk for panic attacks and panic disorder may be higher if you: Have a family history of panic disorder.
You are also at increased risk if you have a parent with either depression or bipolar disorder. Have other conditions associated with panic disorder or panic attacks, such as depression. Drink alcohol, use illegal drugs, chain-smoke cigarettes, or drink large amounts of coffee or other caffeinated beverages. Take medicines known to trigger panic attacks, such as those used to treat asthma or heart problems. Have had previous, unexpected panic attacks. When should you call your doctor?
Call your doctor if you have: Attacks of intense fear or anxiety that seem to come on without a reason. A panic attack or worry that you will have another one, and your worrying interferes with your ability to do your daily activities. Occasional physical symptoms such as shortness of breath and chest pain , and you are not sure what is causing them. Watchful waiting It can be hard to tell the difference between the symptoms of a panic attack such as shortness of breath and chest pain and the symptoms of a heart attack or another serious medical problem.
Who to see The following health professionals can diagnose panic attacks. They may work together with other health professionals to treat panic attacks and panic disorder: Emergency medicine specialist Family medicine physician General practitioner Physician assistant Nurse practitioner Treatment for panic attacks and panic disorder may also be provided by a: Psychiatrist.
Licensed professional counselor. Exams and Tests You may be diagnosed with panic disorder if you have at least two unexpected panic attacks along with fear or worry about having another panic attack and avoiding situations that may trigger it. Treatment Overview Successful treatment reduces how many panic attacks you have and how often you have them. Treatment may include: Professional counseling , such as cognitive-behavioral therapy.
To learn more, see Other Treatment. Medicines, such as an antidepressant or a benzodiazepine. Home treatment, such as relaxation exercises.
Prevention Panic disorder cannot be prevented. Home Treatment Here are steps you can take to decrease the number of panic attacks you have. These steps can also reduce the severity of your symptoms when an attack does occur: Reduce anxiety. Do tension-reducing activities, and lower the amount of stress in your life. Do relaxation exercises. These involve 10 to 20 minutes of deep breathing and muscle relaxation each day. Changing how you think can change how you feel—and that can reduce your anxiety.
Noticing negative thoughts and replacing them with helpful ones is one way to do this. Get your breathing and heart rate up several times a week. Limit alcohol and caffeine or avoid them completely. Eat a balanced diet.
This means eating fresh, healthy foods and limiting your intake of foods that are high in sugar and fat. Support for the family When a person has panic attacks, his or her entire family is affected. Medications Medicines for panic disorder are used to control the symptoms of panic attacks, reduce their number and severity, and reduce the anxiety and fear linked with having another attack.
Medicine choices Medicines used most often to treat panic attacks include: Antidepressants , such as Paxil, Prozac, or Zoloft. Benzodiazepines, such as Ativan, Valium, or Xanax. Medicines sometimes used to treat panic disorder include: Antidepressants , such as Anafranil, Norpramin, and Tofranil.
Antidepressants with mixed neurotransmitter effects, such as Effexor. Other Treatment Counseling Medicines to treat panic disorder often may prevent another panic attack. Support groups and self-help Support groups are often good places to share information, problem-solving tips, and emotions related to panic disorder. Online discussion forums and websites may also offer information and support.
Relaxation exercises Body-centered relaxation exercises can be useful for reducing anxiety and treating symptoms of stress. They include: Breathing exercises , such as roll breathing a type of deep breathing.
Progressive muscle relaxation. This reduces muscle tension by relaxing individual muscle groups. This uses the aroma-producing oils essential oils from plants to promote relaxation.
Yoga , tai chi, and qi gong , and other forms of exercise and meditation. They typically require initial instruction. Mindfulness activities Mindfulness activities are techniques that help relax the mind.
These techniques include: Meditation , where you focus your attention on the things that are happening right now in the present moment. One way to do this is by paying attention to your breathing. Stress Management: Doing Meditation Guided imagery visualization. This is a method of using your imagination to help you relax and release tension caused by stress.
Your body responds to the images in your mind. Practice guideline for the treatment of patients with panic disorder. Huppert JC, et al. Anxiety disorders: Cognitive-behavioral therapy. In BJ Sadock et al. Philadelphia: Lippincott Williams and Wilkins. Clinical features of the anxiety disorders. Anxiety disorders: Somatic treatment. Department of Health and Human Services Washington, DC: U. Government Printing Office. Vannice GK Medical nutrition therapy for psychiatric conditions.
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