Venus Nicolino, Ph.D. of clinical psychology, answers your questions in this section. This week: panic attacks
Dear Dr. V,
I’ve been under an enormous amount of stress. And recently, I went to the emergency room because I thought I was having a heart attack! I really thought I was going to die — at 25 — from a heart attack. I was absolutely terrified. Everything was physically fine and the doctor gave me a referral to a psychologist. He suggested that I was having a panic attack. What exactly is a panic attack?
Kelly from Arizona
Dear Kelly,
A panic attack is a sudden episode of intense fear that develops for no apparent reason and triggers severe physical reactions. Panic attacks can be very frightening. When panic attacks occur, you might think you’re losing control, having a heart attack or even dying.
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 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 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 attack symptoms can include:
- Rapid heart rate
- Sweating
- Trembling
- Shortness of breath
- Hyperventilation
- Chills
- Hot flashes
- Nausea
- Abdominal cramping
- Chest pain
- Headache
- Dizziness
- Faintness
- Tightness in your throat
- Trouble swallowing
- A sense of impending death
You may have a few or many of these panic attack symptoms. Panic attacks typically begin suddenly, without warning. Panic attack symptoms usually peak within 10 minutes and last about half an hour. But panic attacks have many variations. They may last hours or, on rare occasions, up to a day. You may feel fatigued and worn out after a panic attack subsides. One of the worst things about panic attacks is the intense fear that you’ll have another panic attack.
If you have frequent panic attacks, you may have a condition called panic disorder. Panic attacks can greatly interfere with your life — and perhaps even endanger you or others.
Panic attacks can strike at almost any time without warning – when you’re driving the school car pool, at the mall, sound asleep or in the middle of a business meeting. And you may fear having a panic attack so much that you avoid situations where they may occur. You may even be unable to leave your home (agoraphobia), because no place feels safe.
It’s not known what causes panic attacks or panic disorder. Things that may play a role include:
- Genetics
- Stress
- Certain changes in the way parts of your brain function
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 after you, your body would react instinctively. Your heart rate and breathing would speed up as your body prepared itself for a life-threatening situation. Many of the same reactions occur in a panic attack. But it’s not known why a panic attack occurs when there’s no obvious danger present.
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 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.
Good Luck,
Dr. V
Note: All information in the Ask Dr. V column is for educational purposes only. For specific medical advice, diagnosis and treatment, please feel free to call or email Dr. V, or consult your doctor.
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