Some people believe that they are having a heart attack or are about to die. An attack usually lasts from 5 to 20 minutes. But it may last even longer, up to a few hours. You have the most anxiety about 10 minutes after the attack starts. If these attacks happen often, they are called a panic disorder. Panic attacks can be scary and so bad that they get in the way of your daily activities. Treatment can help most people have fewer symptoms or even stop the attacks.
Experts aren't sure what causes panic attacks and panic disorder. But the body has a natural response when you are stressed or in danger. It speeds up your heart, makes you breathe faster, and gives you a burst of energy. This is called the fight-or-flight response.
It gets you ready to either cope with or run away from danger. A panic attack occurs when this response happens when there is no danger. Some people are more sensitive to anxiety and panic than others. Panic attacks and panic disorder may be more likely if you have a family history of panic disorder. They sometimes happen with no clear cause. You have a higher chance of getting panic disorder if you have a parent with depression or bipolar disorder.
Some people have a fear of being in crowds, standing in line, or going into shopping malls. They are afraid of having another panic attack or of not being able to escape. This problem is called agoraphobia. It can be so bad for some people that they never leave their homes. Your doctor will ask about your past health and do a physical exam. The exam may include listening to your heart, checking your blood pressure, and ordering blood tests to look for other causes of your problem.
Treatment for panic attacks and panic disorder includes counseling, especially cognitive-behavioral therapy CBT. Medicines may also help. Treatment can help most people control or even stop attacks. But symptoms can come back, especially if you stop treatment too soon. Early treatment of panic attacks is very important. It can prevent other problems related to panic disorder.
These problems include depression , anxiety disorders , and substance use disorder. The exact cause of panic disorder isn't clear. This may be from your family history or past experiences.
You may have seen your parents or other family members experience anxiety. Or you may have experienced traumatic events in your past. You may be very sensitive to how your body reacts to anxiety-causing experiences. You may mistake your body's reaction as harmful and begin to fear your body's reaction. This is called a cycle of panic. The same experiences that cause you panic may not cause panic in others.
The main symptom of a panic attack is an overwhelming feeling of fear or anxiety. This feeling occurs along with physical reactions. An attack starts suddenly and usually lasts from 5 to 20 minutes.
You feel most anxious about 10 minutes into the attack. It is possible to have one panic attack after another in waves for an extended period of time. This can seem like one continuous attack. But if you have continuous symptoms that don't go away within an hour, you probably aren't having a panic attack.
You should seek medical care right away. The symptoms of a panic attack can be similar to those of a heart attack. Many people seek emergency medical treatment for a panic attack for this reason. If you have chest pain and other symptoms of a heart attack , get medical treatment right away. For more information, see the topic Chest Problems. Panic attacks may begin without a trigger.
Or they can be linked to certain situations, such as being in large crowds of people in restaurants or stadiums. Sometimes just knowing that you'll be in a certain situation can cause severe anxiety. People who have panic attacks often learn to avoid situations that they fear will trigger a panic attack or situations where they will not be able to escape easily if a panic attack occurs.
If this pattern of avoidance and anxiety is severe, it can become agoraphobia , an intense and irrational fear of being in public places. Isolating yourself and avoiding social situations can interfere with your ability to work. It can also harm your relationships, especially with your family members and close friends.
Panic attacks aren't common in children or younger teens. But children who have panic disorder or panic attacks often have other symptoms in addition to those listed above. A first panic attack often starts without warning during an ordinary activity such as shopping or walking down the street. For many people, the first panic attack may occur a stressful time.
It may happen during a life-threatening illness or accident, the loss of a relationship, or separation from family. A woman may have her first panic attack after she gives birth. It is also possible for a first panic attack to be caused by a drug reaction or a reaction to nicotine or caffeine. But after the situation that caused the first panic attack is resolved, attacks may continue.
Recurrent panic attacks can be mild to severe. They may continue for years, especially if you also have agoraphobia avoiding places where you fear another attack will occur.
You may have long periods of time without panic attacks. And you may have other periods of time when attacks occur often. You may need longer or different treatment if you have both panic disorder and agoraphobia. You may also have other conditions linked with panic disorder and panic attacks, such as drug or alcohol problems, depression, or other mental health disorders.
You will need treatment for these conditions. Panic disorder may last a lifetime, but its symptoms can be controlled with treatment. Most people who have panic disorder get better with treatment.
They are able to get back to a normal lifestyle. But relapse can occur, especially if treatment is stopped too soon. It can be hard to tell the difference between the symptoms of a panic attack such as shortness of breath and chest pain and the symptoms of a heart attack or another serious medical problem.
If you have symptoms of a panic attack, be sure to get medical care right away so that other medical conditions can be ruled out. The following health professionals can diagnose panic attacks. They may work together with other health professionals to treat panic attacks and panic disorder:.
Many community mental health centers, hospital outpatient clinics, and family service agencies have treatment programs for people with panic disorder.
You may be diagnosed with panic disorder if you have at least two unexpected panic attacks along with fear or worry about having another panic attack and avoiding situations that may trigger it.
The doctor will ask you questions about your symptoms. He or she will listen to your heart and check your blood pressure. You may get blood tests. The doctor may need to rule out other physical conditions that have symptoms similar to panic disorder, such as a heart attack or hyperthyroidism.
Successful treatment reduces how many panic attacks you have and how often you have them. It lowers the anxiety you feel because of the fear of future attacks. And it improves the quality of your life.
Treatment may include:. Unfortunately, many people don't seek treatment for anxiety disorders. You may not seek treatment because you think the symptoms aren't bad enough.
Or maybe you think that you can work things out on your own. But getting treatment is important. If you need help deciding whether to see your doctor, see some reasons why people don't get help and how to overcome them. If your panic attacks were caused by a specific trigger, such as a medicine reaction, you may not need treatment after the trigger has been removed.
In this case, that would mean stopping the medicine with the help of your doctor. But sometimes panic attacks caused by outside factors can continue after the trigger has been removed. And that would be the biggest thing I'd say. You know, when someone comes in saying, "I'm just feeling really anxious," they're hyperventilating, that's my first question. Interviewer: But the panic attack itself and the hyperventilation, that's not a breathing issue, generally?
Madsen: Well, that's a great question, and I think there are kind of two things here. There may be a person who's had panic attacks before, they've been diagnosed with anxiety, they're familiar with this feeling. If you're in that situation, you may have medication, you may know how to kind of control things at home. Maybe you've tried some deep breathing, things to calm yourself down. Now, on the other hand, if, just out of the blue, you've never experienced this and you suddenly start to feel extremely anxious, you're hyperventilating, you know, you may think to yourself, "Well, maybe this is just a panic attack," but something like a blood clot in the lungs can cause a person to feel very anxious, very short of breath.
Some have been reported to last up to an hour. The number of attacks you have will depend on how severe your condition is. Some people have attacks once or twice a month, while others have them several times a week.
Although panic attacks are frightening, they're not dangerous. An attack will not cause you any physical harm, and it's unlikely you'll be admitted to hospital if you have one.
Be aware that most of these symptoms can also be symptoms of other conditions or problems, so you may not always be experiencing a panic attack. For example, you may have a racing heartbeat if you have very low blood pressure. They'll ask you to describe your symptoms, how often you get them, and how long you have had them. They may also carry out a physical examination to rule out other conditions that could be causing your symptoms. It can sometimes be difficult to talk about your feelings, emotions and personal life, but try not to feel anxious or embarrassed.
You may be diagnosed with panic disorder if you have regular and unexpected panic attacks followed by at least a month of continuous worry or concern about having further attacks.
Treatment aims to reduce the number of panic attacks you have and ease your symptoms. Talking therapies and medicine are the main treatments for panic disorder. Your treatment will depend on your symptoms. You can refer yourself directly to a psychological therapies service for treatment based on cognitive behavioural therapy CBT.
Your therapist may discuss with you how you react when you have a panic attack and what you think about. They can teach you ways of changing your behaviour to help you keep calm during an attack. Antidepressants can take 2 to 4 weeks before they start to work, and up to 8 weeks to work fully. Keep taking your medicines, even if you feel they're not working, and only stop taking them if your GP advises you to do so.
If your symptoms do not improve after CBT, medicine and connecting with a support group, your GP may refer you to a mental health specialist such as a psychiatrist or clinical psychologist. The specialist will carry out an assessment and devise a treatment plan to help you manage your symptoms. Animated video explaining self-referral to psychological therapies services for stress, anxiety or depression. For more help, read how to deal with panic attacks.
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