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Coping With Panic Attacks

A pounding heart. Sweating, shaking hands. A sense of unreality. Abject terror that you’re having a heart attack, losing your mind or even dying. These are just some of the symptoms commonly felt during a panic attack, and if you’ve ever had one, you won’t forget it.

Unless you’re confronted by a rampaging grizzly, going through a panic attack could be the most frightening experience you’ll ever have. When one strikes, there is no marauding monster, but the sufferer’s body doesn’t know the difference, and her mind cannot will the symptoms to go away. The attacks are just as real and debilitating as if the cause were mortal danger.

Fortunately, as dramatic and unpleasant as panic attacks can be, most people who have them can stop them with a combination of therapy, medication and lifestyle changes.

If you (or someone you know) has ever undergone panic attacks—and is living in fear of having more—this report will help you understand what’s happening and get relief.

What Are Panic Attacks?

A panic attack occurs when the body goes into full-blown fight-or-flight mode without any apparent cause. The fight-or-flight physiological response is meant to save you if you’re thrust into life-threatening danger.

But during a panic attack, your body’s reactions are simply terrifying.

Symptoms may include:

• Racing heartbeat
• Shortness of breath
• Sweating or chills
• Faintness or dizziness
• Chest pain
• Nausea
• Choking or suffocating sensations
• Numbness or tingling of fingers and hands
• A feeling of unreality or dissociation from oneself
• Extreme fear or nervousness

Symptoms usually peak within 10 minutes but may last about half an hour. Because the symptoms are so emotionally and physically dramatic, many sufferers believe they’re having a heart attack.

Twice as many women as men have panic attacks, which typically begin during late teens or young adulthood. Some people have one or two in their lifetime; others experience them regularly. They can occur at any time—even during sleep.

Panic attacks are sometimes brought on by physical illness such as thyroid disease and hypoglycemia (low blood sugar). But they’re also a symptom of what’s called panic disorder. This anxiety disorder may occur in conjunction with depression and alcohol or drug abuse.

People who have had several panic attacks and who live in fear of experiencing another may have panic disorder. The National Institute of Mental Health estimates that 6 million Americans over age 18 are affected by panic disorder each year.

What Triggers Panic Attacks?

Researchers don’t know the cause of panic attacks, but certain factors are associated with them. They appear to run in families. Early childhood trauma, such as physical or sexual abuse, may encourage them.

Abusing drugs or alcohol may increase the likelihood of developing panic disorder. And stressful major life changes—such as marriage, the death of a loved one, having a baby, being the victim of a crime or an accident, or starting a new job or a business—can be triggering events for panic attacks.

Seek Medical Help

If you experience a panic attack, make an appointment with your physician as soon as possible. Don’t wait to see whether you have another one.

Your doctor will want to determine whether the episode may have been caused by a physical problem (such as low blood sugar or a thyroid imbalance), anxiety or both. If it appears that the panic attack may have been caused by panic disorder, your doctor may be able to recommend a mental health professional.

The vast majority of people who have panic attacks can be helped. But it’s essential to get medical care.

People who experience frequent panic attacks but don’t get help may begin to restrict their lives to avoid activities and locations they think might trigger an episode. As many as one-third of those with panic disorder also develop agoraphobia, the fear of certain places or situations. As a result, some agoraphobic people are afraid to leave their homes.

Making The Most Of Your Doctor Visit

Once you’ve made an appointment with your physician, prepare for it by listing the symptoms you’ve had, when they began and how often you have them. Write down any information about potential triggering events, such as major traumas in your past or stressful life changes that occurred before the first panic attack.

List any other medical conditions you’ve been diagnosed with. Jot down all medications you’re taking, including vitamins and supplements.

If you also have phobias—fears associated with places (e.g., heights, elevators), animals (e.g., spiders), specific situations, and so on—tell the doctor.

Expect your physician to inquire about:

• Your mental health history
• Family members who may have had mental health issues
• Your use of drugs and alcohol
• And other factors

All of this information will help your physician make the right diagnosis.

The Role Of Therapy

If you have an anxiety disorder, a trained psychotherapist can work with you to uncover the causes of the problem and teach you how to cope with the symptoms.

The National Institute of Mental Health notes that practitioners with training in cognitive-behavioral or behavioral therapy can be especially effective.

These professionals help their clients examine and change the patterns of thought that stimulate fear and anxiety. They also support patients in learning new behaviors so they can react differently to stressful, anxiety-provoking situations.

Therapy is targeted to each patient’s specific fears, anxieties and phobias. Behavioral therapy can take place one on one or in a group—or both.

Many patients get the best results from a combination of therapy and medicine. Read on for information on commonly prescribed medications.

Medications That Can Help

Prescription drugs play a supporting role: They can’t cure anxiety disorders, but they help keep symptoms under control while a patient undergoes therapy.

If you’ve been having panic attacks, your doctor may prescribe one of the following:

• An antidepressant, often one of the newer drugs known as selective serotonin reuptake inhibitors. Prozac, Zoloft, Lexapro, Paxil and Celexa are some brand-name medications commonly used to treat panic disorder. Older categories of antidepressants—including those called tricyclics and monoamine oxidase inhibitors—are less likely to be used, as they cause far more side effects.
• An anti-anxiety drug. Brand names Ativan and Xanax, both of which are benzodiazepines, are often used to combat panic disorder.
• A beta-blocker. Medications such as Inderal, typically used for patients with heart conditions, may help control physical symptoms associated with anxiety.

Ways To Help Yourself

Therapy and medication do a great job of controlling panic disorder, but you can also make lifestyle changes to help yourself. Consider the following strategies:

• Join a self-help or support group for people with panic disorder. Ask your therapist whether he knows of local groups—or consider joining an online community. Either way, members will understand what you’re going through and can offer support, information and encouragement.
• Learn one or more stress management techniques. Progressive relaxation, yoga, deep breathing, guided imagery and meditation are often excellent adjuncts to your treatment. All can help you reduce the anxiety in your life.
• Get regular aerobic exercise. Any form of cardio can help tame anxiety and encourage relaxation. Pick something you’ll enjoy—walking, riding a bike, using cardio machines at a gym—and start out slowly. 
• Cut out stimulants. For some people, caffeine, chocolate and cold medicines (e.g., those containing pseudoephedrine) can increase anxiety and potentially trigger a panic attack. If you take herbal medicines, ask your doctor whether any of those might also have undesirable effects.

Panic Attacks On The Job

Because we spend so much time at work, it’s inevitable that those prone to panic attacks often experience them in the workplace. And when attacks aren’t treated, people may develop phobias about the locations where they’ve had them.

If an employee is having panic attacks, try to understand her fears and to avoid increasing her anxiety. Federal and state medical-privacy laws don’t permit employers to ask questions such as “Were you having a panic attack yesterday?” or “Is it fear of a panic attack that’s making you miss work?”

But you can meet privately with an employee and ask whether he or she needs help or a workplace accommodation. Be supportive and calm. You can also let workers know that you will be flexible about their need to schedule medical appointments.

If you’re the one suffering from panic disorder, you might choose to confide in key staff, explaining that you’re having trouble with anxiety and seeking help for it. This could be a good strategy if employees have witnessed your difficulty and are concerned for your health.

Finally, commit to taking good care of yourself. Eating a healthy diet, getting exercise and making time for plenty of sleep can assist your recovery.

For More Information

To learn more about panic attacks and how to cope with panic disorder, visit these websites.

The National Institute of Mental Health
Download NIMH’s free booklet on all anxiety disorders here
Download its free booklet on panic disorder here

The National Alliance on Mental Health

The U.S. National Library of Medicine’s page on panic disorder

The Anxiety Disorders Association of America