Panic disorder

A panic attack is a period of intense fear or discomfort, typically with an abrupt onset and usually lasting no more than thirty minutes. Symptoms include trembling, shortness of breath, heart palpitations, sweating, nausea, dizziness, hyperventilation, paresthesias (tingling sensations), and sensations of choking or smothering. The disorder is strikingly different from other types of anxiety disorders in that panic attacks are very sudden, appear to be unprovoked, and are often disabling. more...

Most who have one attack will have others. People who have repeated attacks, or feel severe anxiety about having another attack, are said to have panic disorder.

Introduction

Most sufferers of panic attacks report a fear of dying, "going crazy", or losing control of emotions or behavior. The experiences generally provoke a strong urge to escape or flee the place where the attack begins ("fight or flight" reaction) and, when associated with chest pain or shortness of breath, a feeling of impending doom and/or tunnel vision, frequently resulting in seeking aid from a hospital emergency room or other type of urgent assistance.

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, agoraphobia, and other psychological conditions involving anxiety, though panic attacks are not always indicative of a mental disorder. 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 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 rapidly relieved once the trigger is escaped. In conditions of chronic anxiety one panic attack can often 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 pains
• Dizziness, lightheadedness, nausea
• Difficulty breathing (dyspnea)
• Tingling or numbness in the hands, face, feet or mouth
• Flushes to the face and chest or chills
• Dream-like sensations or perceptual distortions (derealization)
• Dissociation, the perception that one is not connected to the body or even disconnected from space and time (depersonalization)
• Terror, a sense that something unimaginably horrible is about to occur and one is powerless to prevent it
• Fear of losing control and doing something embarrassing or of going crazy
• Fear of dying
• Feeling of impending doom
• Trembling or "shivering"
• Crying

A panic attack typically lasts from 2 to 8 minutes and is one of the most distressing conditions that a person can experience in everyday life.

The various symptoms of a panic attack can be understood as follows. First comes the sudden onset of fear with little or no provoking stimulus. This then leads to a release of adrenaline (epinephrine) which cause 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 carbon dioxide levels lowering in the lungs and then 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. This also acts to decrease carbon dioxide levels in the blood.)

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