Panic attacks

Panic attacks are severe attacks of fear and anxiety occurring suddenly and without warning. It's estimated that around 1 in 10 people experience panic attacks and they tend to occur mostly in young adults. Panic attacks are also more likely to affect women than men. There may be specific triggers for the panic attack or they may happen for no apparent reason. The effects of panic attacks vary but may also include some physical symptoms.

Common symptoms of panic attacks include (but are not limited to),

Chest pains
Dizziness, faintness or feeling unsteady
Hot flashes or chills
Nausea or abdominal pain
Palpitations or an accelerated heart rate
A choking sensation or a tightness in the throat
Shortness of breath or hyperventilation
Shaking or Trembling
Sweating
Tunnel vision

The physical causes of panic attacks are still unclear but research is ongoing and a number of contributing factors have been identified. There's strong evidence that the disorder is hereditary with research showing that panic attacks run in families. But some may also develop them without any family history of the disorder. Stressful events such as the death of a loved one or job loss can also trigger panic attacks as can transitional events like moving house or graduating. Panic attacks can also be associated with certain situations or places, making it more likely to experience an attack when in them. Another common theory is that the attacks are caused by a chemical imbalance in the brain but, as mentioned, panic attacks can also occur for seemingly no reason at all.

Panic attacks can also be triggered by biological causes. Hyperthyroidism, hypoglycemia and mitral valve prolapse have all been shown to induce panic attacks. Also use of stimulants such as caffeine or amphetamines can trigger attacks as can drugs such as cocaine or cannabis. Other health issues such as menopause or pregnancy may also cause panic attacks and low blood sugar or a viral infection may contribute. Panic attacks can also be a side effect of medications like antibiotics or ritalin and could also be triggered by withdrawal from drugs or alcohol.

Panic attacks may also be a symptom of agoraphobia, an anxiety disorder where the sufferer fears embarrassing or difficult situations from which they can't escape. It was once thought that agoraphobia was a phobia of open spaces but it's now thought that agoraphobia is a fear of panic attacks, especially if these occur in a public place. The sufferer may feel they can't escape and can feel very embarrassed at having an attack in public. This can extend to certain foods or exercise which the sufferer may believe can trigger panic attacks and as such avoid them.

Panic attacks are usually treated with a combination of cognitive behavioural therapy and medication. Therapy will focus on the behaviours or thought patterns which are triggering the panic attacks. A common treatment in this therapy is a gradual exposure to the place or situation which causes fear for the sufferer. These treatments are based on the theory that by exposure the sufferer can unlearn the behaviours to which they've conditioned themselves.

The most common medications used to reduce the symptoms of panic attacks are antidepressants but these take time to build up an effect and shouldn't just be taken during panic attacks. Other medications usually prescribed include benzodiazepines, these anti-anxiety drugs act very quickly and taking them during an attack can rapidly relieve symptoms. However they may cause serious withdrawal symptoms amongst other side effects and should be used with caution.

In addition to these treatments there are a number of self-help tips commonly suggested such as;

Controlled Breathing - Hyperventilating causes many of the symptoms of a panic attack (like dizziness), deep breathing through the nose can relieve many symptoms and relax you.
Avoid stimulants - Be careful with coffee or other caffeinated drinks as these can trigger panic attacks as can medications containing stimulants like cold medications or diet pills.
Relaxation techniques - Such as meditation or yoga have been shown to promote relaxation and reduce panic attacks.
Questioning your thoughts - Work out your most anxious thoughts and worst fears, challenge them with more realistic thoughts so that you no longer believe them.