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| Introduction Most sufferers of panic attacks report a fear of dying, "going crazy", or losing control of emotions or behavior. These feelings generally provoke a strong urge to escape or flee the place where the attack began ("fight or flight" reaction) and, when associated with chest pain or shortness of breath, a feeling of impending doom and/or tunnel vision, frequently result in the sufferer seeking medical attention. The panic attack is distinguished from other forms of anxiety by its intensity and its sudden, episodic nature. Panic attacks are often experienced by sufferers of anxiety disorders and other psychological conditions involving anxiety, though panic attacks are not always indicative of a mental disorder, nor are they uncommon. Up to 10 percent of otherwise healthy people experience an isolated panic attack per year, and 1 in 60 people in the U.S. will suffer from a panic disorder at some point in their lifetime. People with phobias will often experience panic attacks as a direct result of exposure to their trigger. These panic attacks are usually short-lived and self-limiting, as they will subside once the trigger is no longer present. In conditions of chronic anxiety, one panic attack can roll into another, leading to nervous exhaustion over a period of days. Symptoms The symptoms of a panic attack appear suddenly, without any apparent cause. They may include: * Racing or pounding heartbeat or palpitations * Sweating * Chest pain/PVCs * Dizziness, lightheadedness, nausea * Difficulty breathing (dyspnea) * Hyperventilation * Tingling or numbness in the hands, face, feet or mouth (Paresthesia) * A sudden feeling that everything around the person represents a threat. This can cause a person to either behave extremely defensively (perhaps even assuming the fetal position), or to become enraged and lash out violently. * The loss of the ability to react logically to oncoming stimuli, and the loss of cognitive ability in general. One suffering from a panic attack will often only feel the attack and will be unable to assess why they are feeling the attack or what they can do to stop the sensation. * Flushed face and chest * Chills * Dream-like sensation or perceptual distortion (derealization) * Dissociation, or the perception that one is not connected to the body or is disconnected from space and time (depersonalization) * Terror, or a sense that something unimaginably horrible is about to occur and one is powerless to prevent it * Vomiting * Tunnel vision * Fear of losing control and doing something embarrassing or going crazy * Fear of impending death * Feeling of impending doom * Trembling or "shivering" * Crying * Heightened senses * Loud internal dialogue * Exhaustion * Vertigo A panic attack typically lasts from 2 to 8 minutes. More severe panic attacks may form a series of episodes waxing and waning every few minutes, only to be ended by physical exhaustion and sleep. The various symptoms of a panic attack can be understood as follows. First, there is the sudden onset of fear with little or no provoking stimulus. This leads to a release of adrenaline (epinephrine) which brings about the so-called fight-or-flight response where the person's body prepares for major physical activity. This leads to an increased heart rate (tachycardia), rapid breathing (hyperventilation), and sweating (which increases grip and aids heat loss). Because strenuous activity rarely ensues, the hyperventilation leads to a drop in carbon dioxide levels in the lungs and then in the blood. This leads to shifts in blood pH which can in turn lead to many other symptoms, such as tingling or numbness, dizziness, and lightheadedness. It is also possible for the person experiencing such an attack to feel as though they are unable to catch their breath, and they begin to take deeper breaths, which also acts to decrease carbon dioxide levels in the blood. Hyperventilation alone can bring about some of the symptoms of a panic attack. However, the person experiencing the panic attack often does not realize this and sees these symptoms as further evidence of how serious their condition is. An ensuing positive feedback loop of adrenaline release fuels worsening physical symptoms and psychological distress. While the symptoms and the seriousness of panic disorder are very real, the feelings of panic or impending death that accompany many attacks are exaggerated. Many physicians tell panic disorder sufferers that while their body is affected by the attack, they are not in any risk of fatality (except due to auxiliary reactions such as crashing a car, running into traffic, committing suicide, etc). If a sufferer can anticipate an attack and find a safe place to release, there is little immediate risk. Mnemonic The symptoms of a panic attack can be remembered with the mnemonic: STUDENTS FEAR the 3 C's: Sweating, Trembling, Unsteadiness/dizziness, Derealization/depersonalization, Elevated heart rate (tachycardia), Nausea, Tingling, Shortness of breath, FEAR of dying, FEAR of losing control, FEAR of going crazy, 3 C's - Choking, Chest pain, Chills. |