Panic attacks are extremely frightening. They seem to come out of the blue, strike at random, make people feel powerless, out of control, and as if they are about to die or go mad. Many people experience this problem, but many also learn to cope and, eventually, to overcome it successfully.

A panic attack is an exaggeration of the body’s normal response to fear, stress or excitement. When faced with a situation seen as potentially threatening, the body automatically gears itself up for danger, by producing quantities of adrenalin for 'fight or flight'. This would have prepared our cave-dwelling ancestors to fight or run away from danger, but it’s much less appropriate to the stresses we encounter today.

Adrenalin has the following effects on your body:

The muscles tense up.
Breathing becomes faster to take in more oxygen, which muscles need to help them transform sugar into energy.
The heart pumps harder to get blood to where it’s needed.
Blood is diverted to the muscles, away from areas that don't need it, so you become pale.
Digestion slows down and salivary glands dry up, causing a dry mouth.
Your senses become more alert; the slightest sound or touch provokes a reaction.
Sweating increases.
These reactions occur in a matter of seconds, and can happen in moments of pleasurable excitement, as well as in fear-provoking and threatening situations. When adrenalin floods your body, it can cause a number of different physical and emotional sensations that may affect you during a panic attack.

These may include:

very rapid breathing or feeling unable to breathe
very rapid heartbeat
pains in your chest
feeling faint or dizzy
sweating
ringing in your ears
tingling or numbness in your hands and feet
hot or cold flushes
feeling nauseous
wanting to go to the toilet
feelings of absolute terror
feelings of unreality, called depersonalisation and derealisation.
(During depersonalisation, people feel detached from their body and surroundings, strange and unreal. During derealisation, they feel grounded in themselves, but the world seems distant or strange, and they may feel unsteady on their feet.)

Panic attacks come on very quickly, symptoms usually peaking within 10 minutes. Most panic attacks last for between five and 20 minutes. Some people report attacks lasting for up to an hour, but they are likely to be experiencing one attack after another, or a high level of anxiety after the initial attack. You may have one or two panic attacks and never experience another. Or you may have attacks once a month or several times each week.

Panic attacks can come in the night when you are asleep. These night-time attacks occur as your body is on 'high alert' and can detect small, normal changes in your body which it then takes as a sign of danger. (The fact that you can be monitoring your bodily sensations while asleep is perfectly normal and automatic – just think about the times you have woken up and needed to go to the toilet.) Night-time attack may be particularly frightening, as you may feel confused and helpless to do anything to spot it coming. This is one of the most distressing aspects of suffering from panic attacks – they may seem completely unpredictable, and therefore uncontrollable.

During an attack, you may fear that the world is going to come to an end, or that you are about to die or go mad. The most important thing to remember is that, however dreadful you may feel during an attack, this is not going to happen. The bodily effects of panic attacks, such as breathlessness, are just part of the panic. If you would like further reassurance, see your GP, so he or she can rule out any physical cause for your symptoms.

What is panic? What are Panic Attacks?

Does that mean i am going hysterically panicky.
No.
A person having a panic attack will usually not look any different at all. In fact they will probably be a lot quieter. This is because they are dealing with a lot of internal goings-on, and so their focus is inward instead of outward towards the people or environment that they are in.

Not everyone experiences the same panic attack symptoms;
we are all different biologically and therefore react differently to each other as a response to the same or similar stimuli.

The following list identifies the most common symptoms of panic attacks.
Common symptoms of panic attacks
· Rapid heart beat, pounding heart or palpitations
· Sweating
· Shaking visibly or inside
· Choking sensations or lump in throat
· Smothering or shortness of breath sensations
· Chest pain or discomfort
· Nausea, bloating, indigestion or abdominal discomfort
· Dizziness or unsteadiness
· Feeling light-headed
· Derealisation (feeling unreal or dreamy, or as if you are not in your own body)
· Depersonalisation (feeling outside yourself or like you don't exist)
· Fear of losing control or going crazy
· Paresthesias (numbness or tingling sensations) in face, extremities or body
· Chills or hot flushes
· Skin losing colour
· Blushing or skin blotches Urgently needing to urinate or defecate

The definition of Panic Attacks ...
...is a discrete period in which there is the sudden onset of the intense apprehension, fearfulness, or terror, often associated with feelings of impending doom. During theseattacks, symptoms such as shortness of breath, palpitations, chest pain or discomfort, choking or smothering sensations, and fear of "going crazy" or losing control are present.

Anxiety Disorders,
You may not have an anxiety disorder (do not assume that you have) - however they are often associated with Panic Attacks, and are characterized by a severe increase in the level of stress or anxiety.
This increase can be related to the presence of particular events or items (triggers) and can also exists without being prompted by any known triggers.

Contrary to the popular misconceptions about Anxiety Disorders today, Anxiety Disorder is not a purely biochemical or medical disorder. It is now thought to be related to the emotional aspects of a person.

Currently there are three main schools of thought regarding the aetiology of Anxiety Disorders:

1) The Biological Theory, (includes the genetic predisposition in panic disorder and presupposes a chemical imbalance in the brain),

2) The Psychodynamic Theory (looks at childhood issues as being the cause)

3) The Behavioural Theory (sees the cause as learned behaviour, including our negative thought patterns).

Description of Categories and Types of Panic Attacks Diagnostic And Statistical Manual of Mental Disorders, 4th edition recognizes three different types of Panic Attacks:

1) Un-cued (spontaneous) Panic Attacks (relates to Panic Disorder).

2) Cued (specific) Panic Attacks (relates to Social Anxiety Disorder, Obsessive-Compulsive Disorder and Posttraumatic Stress Disorder).

3) Situational predisposed Panic Attacks (may occur on exposure to the situational cue or trigger, but do not necessarily occur immediately after the exposure).

Panic Disorder is defined as the recurrent experience of "un-cued" spontaneous panic attacks, which is often intensified by the resulting fear of the next impending attack.

The fear itself of having a spontaneous panic attack often leads to Panic Disorder. The spontaneous panic attack is generally NOT prompted by a "trigger", and is now recognized as not being associated with specific situations and places. The intensity of the attack can be extremely severe; resulting in the feeling of having a heart attack along with intense feelings that one is going to die. Even though I now how distressing and disturbing these panic attacks are, and how you may think that it is putting a lot of stress on your body, you WILL NOT die of a panic attack. Your body is having a good workout, and is getting fitter (although there are nicer ways to get fitter, e.g. gym)

Panic Attacks suddenly overtake the person with a sense of imminent doom, death or destruction. They can strike outside the home, and the person feels they are in a life-threatening situation from which escape is necessary.

Although the timing of the Panic Attacks is unpredictable, there may be situational stressors that set them off on a regular basis. These are called situational panic attacks. Situational Panic Attacks are indicative of social and specific phobias.

Panic Attacks that appear without any specific cues are more likely to be indicative of Panic Disorder. Panic Disorder is defined as having recurrent panic attacks with no situational key, and persistent worry about future attacks, change in behaviour related to the attacks, or a worry about the implication of the attacks.

There is also the possibility of having Panic Disorder with Agoraphobia, which means that the client has a fear of being in places from which escape is difficult, and situations such as travel are restricted.

Panic Attacks are very common.
Panic Attacks affect many people, with 2 - 3 times more women than men, and it is most common between the ages of 16 and 40.
It may be genetically bound, as there is a 20% risk of having Panic Attacks if a 1st degree relative has panic attacks.

Physically, the heart begins to pound, the victim may scream, some just go very quiet. Most feel as if they are not getting enough air or space - and may gasp, hyperventilate, feel dizzy and/or lightheaded.

Most attacks last 3 to 10 minutes, with 30 minutes being the general longest they may last.

Each person will have their own set of symptoms, and they usually remain the same each time you have a panic attack.

Additionally, depression affects up to 50% of those with Panic Attacks.

Panic Attacks are caused by a number of different items in the environment:
drugs,
caffeine,
and postpartum period.
(Caffeine can cause Panic Attacks, as does marijuana, cocaine, and amphetamines).

Women with thyroid disorder may experience their first panic attack in the immediate postpartum period after delivering a child.

Treatment of Panic Attacks
Treatment is through psychosocial treatment, i.e. by having sessions with a trained, accredited and experienced counsellor or psychotherapist.

In the sessions you can talk about and discover an explanation of how the attacks occur,and gain reassurance that the attacks are not life threatening, and not a precursor to insanity (in other words just becaue you are having panic attacks it does not mean that you have, or that you will get, a mental illness).

Additionally, you and your counsellor / psychotherapist can uncover the underlying reasons for the anxiety producing the attacks so that they diminish and eventually disappear from your life for ever.

Interpersonal situations
Panic attacks can be caused by harrassment, abuse or bullying. If you are in a situations like this, or you keep remembering it (or rather your body 'remembers'), then counselling or psychotherapy sessions can help you understand the interpersonal dynamics, and help you with assertiveness, (rather than aggressiveness) with communication, and with managing your physiology.