What is a Panic Attack?

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A panic attack is a sudden rush of intense fear or discomfort, which reaches a peak within 10 minutes, and includes at least 4 of the following physical sensations or thoughts:

• Racing or pounding heart
• Sweating
• Shaking or trembling
• Shortness of breath or feelings of being smothered
• Feeling of choking
• Chest pain or discomfort
• Chills or hot flashes
• Nausea or upset stomach
• Dizziness or lightheadedness
• A sense of things being unreal or feeling detached from oneself (derealization)
• Numbness or tingling sensations
• Fear of losing control or “going crazy”
• Fear of dying

A panic attack is a sudden episode of intense fear that triggers severe physical reactions when there is no real danger or apparent cause. Panic attacks can be very frightening. When panic attacks occur, you might think you’re losing control, having a heart attack, or even dying.

Many people have just one or two panic attacks in their lifetimes, and the problem goes away, perhaps when a stressful situation ends. But if you’ve had recurrent, unexpected panic attacks and spent long periods in constant fear of another attack, you may have a condition called panic disorder.

Although panic attacks themselves aren’t life-threatening, they can be frightening and significantly affect your quality of life. However, treatment can be very effective.

Panic Attacks May Be Caused To Anxiety. The Treatments Are Similar

Symptoms:

Panic attacks typically begin suddenly, without warning. They can strike at any time — when you’re driving a car, at the mall, sound asleep, or in the middle of a business meeting. You may have occasional panic attacks, or they may occur frequently.

Panic attacks have many variations, but symptoms usually peak within minutes. You may feel fatigued and worn out after a panic attack subsides.

Panic attacks typically include some of these signs or symptoms:

• Sense of impending doom or danger
• Fear of loss of control or death
• Rapid, pounding heart rate
• Sweating
• Trembling or shaking
• Shortness of breath or tightness in your throat
• Chills
• Hot flashes
• Nausea
• Abdominal cramping
• Chest pain
• Headache
• Dizziness, lightheadedness, or faintness
• Numbness or tingling sensation
• The feeling of unreality or detachment

One of the worst things about panic attacks is the intense fear that you’ll have another one. You may fear having panic attacks so much that you avoid certain situations where they may occur.

When to see a doctor:

If you have panic attack symptoms, seek medical help as soon as possible. Panic attacks, while intensely uncomfortable, are not dangerous. But panic attacks are hard to manage on your own, and they may get worse without treatment.

Panic attack symptoms can also resemble symptoms of other serious health problems, such as a heart attack, so it’s important to get evaluated by your primary care provider if you aren’t sure what’s causing your symptoms.

Causes:

It’s not known what causes panic attacks or panic disorder, but these factors may play a role:

• Genetics
• Major stress
• A temperament that is more sensitive to stress or prone to negative emotions
• Certain changes in the way parts of your brain function

Panic attacks may come on suddenly and without warning at first, but over time, they’re usually triggered by certain situations.

Some research suggests that your body’s natural fight-or-flight response to danger is involved in panic attacks. For example, if a grizzly bear came after you, your body would react instinctively. Your heart rate and breathing would speed up as your body prepared for a life-threatening situation. Many of the same reactions occur in a panic attack. But it’s unknown why a panic attack occurs when there’s no obvious danger present.

Risk factors:

Symptoms of panic disorder often start in the late teens or early adulthood and affect women more than men.

Factors that may increase the risk of developing panic attacks or panic disorder include:

• Family history of panic attacks or panic disorder
• Major life stress, such as the death or serious illness of a loved one
• A traumatic event, such as sexual assault or a serious accident
• Major changes in your life, such as a divorce or the addition of a baby
• Smoking or excessive caffeine intake
• History of childhood physical or sexual abuse

Complications:

Left untreated, panic attacks and panic disorder can affect almost every area of your life. You may be so afraid of having more panic attacks that you live in a constant state of fear, ruining your quality of life.

Complications that panic attacks may cause or be linked to include:

• Development of specific phobias, such as fear of driving or leaving your home
• Frequent medical care for health concerns and other medical conditions
• Avoidance of social situations
• Problems at work or school
• Depression, anxiety disorders, and other psychiatric disorders
• Increased risk of suicide or suicidal thoughts
• Alcohol or other substance misuse
• Financial problems

For some people, panic disorder may include agoraphobia — avoiding places or situations that cause you anxiety because you fear being unable to escape or get help if you have a panic attack. Or you may become reliant on others to be with you in order to leave your home.

Prevention:

There’s no sure way to prevent panic attacks or panic disorder. However, these recommendations may help.

• Get treatment for panic attacks as soon as possible to help stop them from getting worse or becoming more frequent.
• Stick with your treatment plan to help prevent relapses or worsening of panic attack symptoms.
• Get regular physical activity, which may play a role in protecting against anxiety.

Treatments For Panic Attacks:

Treatment can help reduce the intensity and frequency of your panic attacks and improve your function in daily life. The main treatment options are psychotherapy and medications. One or both types of treatment may be recommended, depending on your preference, your history, the severity of your panic disorder, and whether you have access to therapists who have special training in treating panic disorders.

Psychotherapy:

Psychotherapy, also called talk therapy, is considered an effective first-choice treatment for panic attacks and panic disorder. Psychotherapy can help you understand panic attacks and panic disorders and learn how to cope with them.

A form of psychotherapy called cognitive behavioral therapy can help you learn, through your own experience, that panic symptoms are not dangerous. Your therapist will help you gradually re-create the symptoms of a panic attack in a safe, repetitive manner. Once the physical sensations of panic no longer feel threatening, the attacks begin to resolve. Successful treatment can also help you overcome fears of situations that you’ve avoided because of panic attacks.

Seeing results from treatment can take time and effort. You may start to see panic attack symptoms reduce within several weeks, and often symptoms decrease significantly or go away within several months. You may schedule occasional maintenance visits to help ensure that your panic attacks remain under control or to treat recurrences.

Medications:

Medications can help reduce symptoms associated with panic attacks as well as depression if that’s an issue for you. Several types of medication have been shown to be effective in managing symptoms of panic attacks, including:

• Selective serotonin reuptake inhibitors (SSRIs). Generally safe with a low risk of serious side effects, SSRI antidepressants are typically recommended as the first choice of medications to treat panic attacks. SSRIs approved by the Food and Drug Administration (FDA) for the treatment of panic disorder include fluoxetine (Prozac), paroxetine (Paxil, Pexeva), and sertraline (Zoloft).
• Serotonin and norepinephrine reuptake inhibitors (SNRIs). These medications are another class of antidepressants. The SNRI venlafaxine (Effexor XR) is FDA-approved for the treatment of a panic disorder.
• Benzodiazepines. These sedatives are central nervous system depressants. Benzodiazepines approved by the FDA for the treatment of panic disorder include alprazolam (Xanax) and clonazepam (Klonopin). Benzodiazepines are generally used only on a short-term basis because they can be habit-forming, causing mental or physical dependence. These medications are not a good choice if you’ve had problems with alcohol or drug use. They can also interact with other drugs, causing dangerous side effects.

If one medication doesn’t work well for you, your doctor may recommend switching to another or combining certain medications to boost effectiveness. Keep in mind that it can take several weeks after first starting a medication to notice an improvement in symptoms.

All medications have a risk of side effects, and some may not be recommended in certain situations, such as pregnancy. Talk with your doctor about possible side effects and risks.

Other Treatments For Panic Attacks:

Breathing Retraining

The first thing you need to do is retrain your body to breathe in a more efficient manner and learn how your breathing affects your panic attacks.

Numerous studies have shown that most panic attack symptoms come not from adrenaline, but from hyperventilation. Hyperventilation is when your body releases too much carbon dioxide. It usually occurs because you’re breathing too quickly, but in some cases, it can occur because you’re breathing in too much oxygen.

Many people with panic attacks either breathe fast because they’re in the middle of “panicking,” or they try to take very deep breaths because they feel that they need to. What makes matters worse is that one of the symptoms of hyperventilation is feeling like you cannot get enough air. This causes you to naturally want to breathe more, and unfortunately, this makes hyperventilation worse.

Other symptoms of hyperventilation play a key role in panic attacks:

• Chest pains.
• Lightheadedness.
• Shortness of breath.
• Muscle weakness and tingling.
• Difficulty concentrating.
• Rapid heartbeat.

Anyone who has had a panic attack recognizes these symptoms, and that’s why it’s so important to control and prevent hyperventilation. You can do this in two ways:

• Slower Breathing Right when you think you’re going to have a panic attack, train yourself to slow down your breathing. Breathe in for at least 5 seconds, hold for 2 or 3 seconds, and breathe out for at least 7 seconds. Make sure you’re breathing in through your nose and either out through your nose or out through pursed lips like you’re whistling. These won’t prevent panic attacks, but they’ll make them far less severe.
• Retraining You should also take time out of your day to practice this type of breathing method even when you don’t have a panic attack. Panic attacks and anxiety train your body out of its normal breathing pattern. Taking 30 minutes out of every day to practice this type of breathing can help your body relearn how to breathe this way, and should make you less likely to hyperventilate in the future.

When you have anxiety and panic attacks, your body can learn to breathe so poorly that you hyperventilate even without a panic attack. This causes panic attack-like symptoms, which can then trigger an actual panic attack. So teaching yourself how to breathe better is important.

Exercise:

Exercise may not sound like a home remedy for panic attacks, but it absolutely is. Though some people do experience anxiety and panic as a result of exercise, others will find that exercise itself is exactly what they need to permanently control their anxiety symptoms.

Exercise has several benefits that are crucial for anxiety:

• It reduces excess muscular and mental energy.
• It releases endorphins that calm the mind and body.
• It promotes better sleep.
• It improves hormone regulation and may burn stress hormones.
• It helps your breathing improve.

These are all very important strategies for anxiety control, and there is some evidence that one of the main causes of panic attacks and anxiety is a lack of exercise, indicating this may be more important than some people are willing to give it credit for. Ask yourself if you exercise daily. If you don’t, strongly consider it.

Avoid smoking, alcohol, and caffeine. These can all provoke panic attacks in people who are susceptible. If you need help to kick the cigarette habit. Also, be careful with medications that contain stimulants, such as diet pills and non-drowsy cold medications.

Natural Remedies for Panic Attacks:

Kava

A plant that’s been hailed as “nature’s valium” was the first thing I tried, not long after the first attack. Initially, I took it exactly as the bottle indicated: diluted, before bed. After a few weeks, I felt no difference, so I started taking it whenever I felt that tightening in my chest or clamminess in my palms. It’s likely I was starting to abuse the kava, which I didn’t even really consider.

Valerian Root

Like kava, valerian root has a reputation for easing restlessness and stress.

Chamomile

If you have a jittery moment, a cup of chamomile tea might help calm you down. Some compounds in chamomile (Matricaria recutita) bind to drugs like Valium.

L-theanine (or green tea)

Research shows that L-theanine helps curb a rising heart rate and blood pressure, and a few small human studies have found that it reduces anxiety. In one study, anxiety-prone subjects were calmer and more focused during a test if they took 200 milligrams of L-theanine beforehand.

Hops

Yes, it’s in beer, but you won’t get the tranquilizing benefits of the bitter herb hops (Humulus lupulus) from a brew. The sedative compound in hops is a volatile oil, so you get it in extracts and tinctures—and as aromatherapy in hops pillows.

“It’s very bitter, so you don’t see it in tea much unless combined with chamomile or mint,” says Blumenthal. Hops are often used as a sedative, to promote sleep, often with another herb, valerian. Note: Don’t take sedative herbs if you are taking a prescription tranquilizer or sedative, and let your doctor know any supplements you are taking.

Lemon balm

Named after the Greek word for “honey bee,” lemon balm (Melissa officinalis), has been used at least since the Middle Ages to reduce stress and anxiety, and help with sleep. In one study of healthy volunteers, those who took standardized lemon balm extracts (600 mg) were calmer and more alert than those who took a placebo.

While it’s generally safe, be aware that some studies have found that taking too much can actually make you more anxious. So follow directions and start with the smallest dose. Lemon balm is sold as a tea, capsule, and tincture. It’s often combined with other calming herbs such as hops, chamomile, and valerian.

Passionflower

In spite of the name, this herb won’t help you in love. It’s a sedative; the German government has approved it for nervous restlessness. Some studies find that it can reduce symptoms of anxiety as effectively as prescription drugs. It’s often used for insomnia.

Like other sedatives, it can cause sleepiness and drowsiness, so don’t take it—or valerian, hops, kava, lemon balm, or other sedative herbs—when you are also taking a prescription sedative.

Be careful about using more than one sedative herb at a time, and don’t take passionflower for longer than one month at a time.

Lavender

The intoxicating (but safe) aroma of lavender (Lavandula hybrida) may be an “emotional” anti-inflammatory. In one study, Greek dental patients were less anxious if the waiting room was scented with lavender oil. In a Florida study, students who inhaled lavender oil scent before an exam had less anxiety—although some students said it made their minds “fuzzy” during the test.

In one German study, a specially formulated lavender pill (not available in the U.S.) was shown to reduce anxiety symptoms in people with Generalized Anxiety Disorder (GAD) as effectively as lorazepam (brand name: Ativan), an anti-anxiety medication in the same class as Valium.

Eat Omega-3s

Salmon is rich in protein, heart-helping omega-3 fatty acids, and vitamin D. Plus, this recipe is low in carbohydrates!

Personal Note:

I suffer from panic attacks. They sometimes feel like I am having a heart attack. Panic attacks are closely related to anxiety disorders. I personally do not like to take prescription medications, but for some, they may be necessary. I do practice Yoga and Meditation and I have found this helpful in avoiding panic attacks.

Always consult with your doctor if you suffer from panic attacks or anxiety.

Thank you for reading.

Michael.

Comments are welcome