Many of us are familiar with that fleeting moment of panic when we think we've left our handbag on the bus, or are going to be late for an important appointment. The panic feeling is acute and unpleasant, but comes on for an obvious reason, and subsides rapidly once the moment of crisis has passed.
But just imagine if these feelings came on out of the blue and for no obvious reason. This is the nature of a panic attack.
What are the symptoms of panic attack?
The symptoms are of similar type to anxiety symptoms, but are much more intense and overwhelming. They include:
Racing heartbeat
Breathing difficulties
A sensation of suffocating
Dizziness
Nausea
Feelings of extreme terror
Trembling
Sweating
Shaking
A feeling that you're about to die
The symptoms occur suddenly, with no warning, and can even start while you are asleep. They usually pass within a few minutes, but can recur over a period of several hours.
What is panic disorder?
Panic disorder is a term used to describe the occurrence and consequences of recurrent panic attacks. Many people will experience one or two panic attacks during their lives, which, although frightening, are of no real consequence.
Panic disorder is a more serious condition that is thought to affect around 1% of people. It most often starts in late teens or early 20s, and affects twice as many women as men. The onset may be triggered by stressful major life events such as leaving home, starting college, getting married, having a first baby etc. Bereavement and relationship failure are also common triggers. There is also a tendency for panic disorder to run in families, and it is thought there may be a genetic predisposition to anxiety disorders.
What are the effects of panic disorder?
The recurrent panic attacks can be so disabling that those affected may be afraid to leave their home in case they have an attack in a public place. Agoraphobia is a fairly common complication in this situation. Others develop other phobias - avoiding certain objects or situations that they fear may trigger another attack. They may, quite incorrectly, associate some circumstance surrounding their first attack with causing it, for example, if their first attack occurred in a train, they may develop a phobia about getting on trains.
The effects of panic disorder can range from mild social inconvenience to a total inability to face the outside world. In severe cases, the self-imposed restrictions can lead to depression, alcohol or substance abuse, and even, in rare cases, suicide.
How can this be treated?
The most effective treatment is psychotherapy, in particular, cognitive behaviour therapy (CBT). This can help people to identify possible triggers for their attacks (such as a life crisis), and can help them to realise they may have misunderstood the triggers and so be restricting themselves unnecessarily. Relaxation techniques can be taught, which help the sufferer to manage an attack better.
Simply explaining the nature of the disorder can be very helpful for many people, as they are often afraid that they are 'going crazy' or are going to have a heart attack during a panic episode.
Medications can be used to help with specific problems. Beta-blockers can reduce the severity of the physical symptoms during an attack. Anti-depressants can help those who suffer from depression as a complication, or whose panic disorder has been triggered by a bereavement or separation. Tranquillisers can be given in small quantities, for short periods of time, if a crisis occurs, but are not used routinely to treat panic disorder.
