Superdrug Health

Central nervous system

A panic attack is a feeling of intense, overwhelming fear that starts suddenly without warning and without any obvious cause in seemingly harmless situations. Usually, a panic attack lasts for just a few minutes and then gradually goes away. Some people experience a series of panic attacks, each of relatively short duration, but together lasting for periods of up to one or two hours.

A panic attack is not dangerous, but it can be extremely distressing for the person concerned. The panic attacks can create such a strong feeling of being out of control that they can lead to the development of other conditions such as anxiety, phobias and depression.

Panic attacks are very common. They often first develop in teenagers and young adults, but can affect anyone at any age. Women are more likely to get panic attacks than men.

The exact cause of panic attacks is not known. Some suggest that there may be a genetic reason because in some people panic attacks tend to run in families. However, many people who experience panic attacks have no other relatives with the condition. In these cases, it would appear that there is some physical or psychological event such as pain, worry or fear of failure that triggers a normal emotional response to which the person over-reacts.

Whatever the causes may be, once a panic attack starts its intensity and duration is maintained by a vicious cycle of physical symptoms, thoughts and behaviour. As the panic attack starts there is a strong sense of fear. Fear normally acts as a protective mechanism for the body because it prepares the body for action. This is termed the ‘fight or flight’ response as the body is preparing to either fight or run away from danger. A chemical called adrenaline is released in the body which stimulates the heart and increases the breathing rate to prepare the body for physical activity (fighting or running away). The sensation of the fast heart rate and fast breathing rate feeds back to the brain, reinforcing the sensation of fear which leads to the release of further amounts of adrenaline, establishing a cycle of events that leads to the panic attack. Accepting that the panic attack will not harm you is key to breaking the cycle and stopping the attacks.

When you have a panic attack, your heart races and your breathing changes. You may feel that you are short of breath and need to gulp for air, or your breathing may become very fast. You may experience chest pain and lose the feeling in your fingers and toes. Some people feel that they cannot swallow and feel sick, faint and dizzy. Another common sign is that you will sweat more and you will probably experience feelings of terror and unreality. Many think that they are going mad or suffering a heart attack. Symptoms may last for a few seconds or for 5 to 10 minutes. Attacks may occur singly or one after another.

Medicines

Learning relaxation techniques and controlled breathing can help during panic attacks. When you panic your muscles will tense and your breathing will become fast and shallow, creating a feeling of dizziness and faintness. Relaxing should help if you start to feel anxious. Some people find yoga classes useful as a method of learning to relax, others find listening to relaxing music helpful. Practising breathing techniques when you are not having a panic attack should help breathing during an attack. This means taking long, slow breaths in and very slowly exhaling. During a panic attack, you can also try and distract yourself by talking to someone or counting backwards. Try and think positive, reassuring thoughts.

If your panic attacks are frequent and seriously affect your day to day life, you should make an appointment to see your doctor. Most doctors agree that a combination of cognitive and behavioural therapies is the best treatment for repeated panic attacks, or so called panic disorder. These therapies help people identify the things that trigger the attacks and, once recognised, to learn to control their emotional and behavioural responses. The therapies help people accept that the panic attacks will not cause harm.

In some cases your doctor may prescribe a medicine to help. Antidepressants called SSRIs (selective serotonin reuptake inhibitors) such as citalopram, escitalopram and paroxetine are the most widely used. Improvement is usually seen in 6 to 8 weeks, but they may have to be continued for several months to ensure that symptoms are fully controlled. Other drugs called benzodiazepines, such as diazepam, help control anxiety that may lead to a panic attack. However, benzodiazepines are addictive and so should only be used for a few weeks. Other drugs such as beta-blockers, that are normally used to control high blood pressure or angina, may be used to slow the heart rate and by doing so interrupt the vicious cycle that intensifies the panic attack.

If you think you or a relative's life is being affected by panic attacks you should make an appointment to see a doctor. Your doctor may decide to prescribe one of the medicines described above or refer you to a specialist in cognitive and behavioural therapy.