A response to extreme anxiety. Both mental and physical symptoms occur. The difficulty is that early on the attacks may come out of the blue... there is no obvious reason for them. Once a few attacks have occurred we may become increasingly anxious about getting more. We may avoid situations that we believe will cause them, or where wehave had them before, especially crowded places (a fear of being trapped is often experienced).

The attacks and the fear of them happening may become so bad that even going outside can be frightening. In fact the fear of having another attack can be worse than the attacks themselves! Sometimes people turn to alcohol or drugs to 'help'. This may prevent them briefly but just makes things worse in the long run.

There are associations with drug abuse (cannabis, amphetamines, MDMA and LSD) and too much caffeine (cola, stimulant drinks, coffee) which can cause or worsen panic attacks.

Sometimes people will only have one or two attacks and then no more. Others will have many and be seriously disabled by them.

Mental Symptoms

• A sense that something awful is about to happen, either to you or to someone else (often someone who is close to you).
• Intense fear about the physical symptoms that you experience during the attack.
• You may be convinced that you are going to die, that you are having a heart attack or some other serious physical problems.
• You may feel that everything around you is unreal or that you are removed from yourself at times... the descriptions of this experience are as though people are standing outside of themselves observing what is going on. You may believe that you are going to lose control of yourself in some way, for example do something violent.
• A fear of going mad is common.

Physical Symptoms

• A fast heart rate that you can feel (sometimes people worry that their heart will explode)
• Lots of sweating
• Butterflies in the tummy
• Flushing,
• Rapid breathing that may feel as if you are really short of breath and can’t get enough oxygen in.
• Dizziness, numbness or pins and needles in the arms may follow if your breathing is fast.
• You may even get chest pain.
• Weakness is common the feeling that your body will no longer do what you tell it.

Attacks usually last 15 to 30 minutes but can last a lot longer.

They usually run in families and are more common in people who have other anxiety problems. Females are affected twice as much as males. They are common; many people get them occasionally.

The good news is that treatment usually works well, at least in the short term.

The first thing to do is talk to someone you trust, then see your doctor. Your doctor will want to rule out serious physical conditions. One of the challenges for health professionals about panic attacks is that many of the symptoms look like those found in other physical conditions. Working out what is actually going on may take a while.

Cognitive Behavioural Therapy, behaviour therapy and their offshoots usually work well. If they do not then then one of the SSRI’s usually will (see our Anti-Depressants page). In a crisis, if talking and reassurance don’t work then a tranquiliser such as benzodiazepine may be used, however, these types of tranquilisers may become addictive.

If you are aware that a panic attack is about to start then simple measures like breathing deeply and slowly, and untensing your muscles will work. It is impossible to have a panic attack if a person's muscles are relaxed. Once a panic attack starts, people tend to brace themselves against the attack by tensing their muscles. This increases the panic reaction.