What are panic attacks ?

Panic attacks are extremely frightening. They seem to come out of the blue, strike at random, make people feel powerless, out of control, and as if they are about to die or go mad. Many people experience this problem, but many also learn to cope and, eventually, to overcome it successfully.

A panic attack is an exaggeration of the body’s normal response to fear, stress or excitement. When faced with a situation seen as potentially threatening, the body automatically gears itself up for danger, by producing quantities of adrenalin for 'fight or flight'. This would have prepared our cave-dwelling ancestors to fight or run away from danger, but it’s much less appropriate to the stresses we encounter today.

Adrenalin has the following effects on your body:

muscles tense up
breathing becomes faster to take in more oxygen, which muscles need to help them transform sugar into energy
the heart pumps harder to get blood to where it’s needed
blood is diverted to the muscles, away from areas that don't need it, so you become pale
digestion slows down and salivary glands dry up, causing a dry mouth
your senses become more alert; the slightest sound or touch provokes a reaction
sweating increases.
These reactions occur in a matter of seconds, and can happen in moments of pleasurable excitement, as well as in fear-provoking and threatening situations.

When adrenalin floods your body, it can cause a number of different physical and emotional sensations that may affect you during a panic attack.

These may include:

very rapid breathing or feeling unable to breathe
very rapid heartbeat
pains in your chest
feeling faint or dizzy
sweating
ringing in your ears
tingling or numbness in your hands and feet
hot or cold flushes
feeling nauseous
wanting to go to the toilet
feelings of absolute terror
feelings of unreality, called depersonalisation and derealisation.
(During depersonalisation, people feel detached from their body and surroundings, strange and unreal. During derealisation, they feel grounded in themselves, but the world seems distant or strange, and they may feel unsteady on their feet.)

Panic attacks come on very quickly, symptoms usually peaking within 10 minutes. Most panic attacks last for between five and 20 minutes. Some people report attacks lasting for up to an hour, but they are likely to be experiencing one attack after another, or a high level of anxiety after the initial attack. You may have one or two panic attacks and never experience another. Or you may have attacks once a month or several times each week.

Panic attacks can come in the night when you are asleep. These night-time attacks occur as your body is on 'high alert' and can detect small, normal changes in your body which it then takes as a sign of danger. (The fact that you can be monitoring your bodily sensations while asleep is perfectly normal and automatic – just think about the times you have woken up and needed to go to the toilet.) Night-time attack may be particularly frightening, as you may feel confused and helpless to do anything to spot it coming.

This is one of the most distressing aspects of suffering from panic attacks – they may seem completely unpredictable, and therefore uncontrollable.

During an attack, you may fear that the world is going to come to an end, or that you are about to die or go mad. The most important thing to remember is that, however dreadful you may feel during an attack, this is not going to happen. The bodily effects of panic attacks, such as breathlessness, are just part of the panic. If you would like further reassurance, see your GP, so he or she can rule out any physical cause for your symptoms.