A panic attack is a sudden, intense fear or anxiety. It may make you short of breath or dizzy or make your heart pound. You may feel out of control. Some people believe that they're having a heart attack or are about to die. An attack usually lasts from 5 to 20 minutes. But it may last longer, up to a few hours. 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. Attacks occur when you feel stressed or sense danger even though there is none. They may be more likely if you have a family history of panic disorder. They may be triggered by things such as depression, high stress levels, and heavy alcohol use.
A panic attack may cause a feeling of intense fear, terror, or anxiety. Other symptoms include trouble breathing, chest pain or tightness, and a fast or irregular heartbeat.
When you have panic disorder, you have repeated, unexpected panic attacks. And you may worry that you'll have another attack. Because of this fear, you may change your daily activities to avoid situations that may trigger it.
Your doctor will ask about your health and symptoms and do a physical exam. You may get blood tests to rule out other causes of your symptoms. You may have panic disorder if you have at least two unexpected panic attacks, worry about having another attack, and avoid situations that may trigger it.
Treatment for panic attacks and panic disorder includes counseling, such as cognitive-behavioral therapy (CBT). Medicines, such as antidepressants, 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.
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Experts aren't sure what causes panic attacks and panic disorder. The body has a natural response when you're stressed or in danger. It's called the fight-or-flight response. It speeds up your heart, makes you breathe faster, and gives you a burst of energy. It gets you ready to deal with or run away from danger. If this response happens when there's no danger, it's called a panic attack.
Panic attacks and panic disorder may be more likely if you have a family history of panic disorder. They sometimes have no clear cause.
Panic attacks may also be brought on by:
Symptoms of a panic attack may include:
Symptoms of panic disorder may include:
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.
People who have panic disorder often have depression at the same time.
A first panic attack often starts without warning during an everyday activity such as shopping or walking down the street.
For many people, the first panic attack may occur at a stressful time. It may happen during a serious 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's also possible for a first panic attack to be caused by a drug reaction or a reaction to nicotine or caffeine.
If panic attacks happen often, they are called a panic disorder. People with panic disorder may:
Panic attacks may continue for years, especially if you also have agoraphobia (avoiding places where you fear another attack will occur). These attacks can be mild to severe. You may have long periods of time without panic attacks. And you may have other periods of time when attacks occur often.
Panic disorder may last a lifetime. Most people who have panic disorder get better with treatment. But the attacks can come back, especially if treatment is stopped too soon.
Call 911, or other emergency services immediately if you have symptoms of a heart attack. These may include:
After you call 911, the operator may tell you to chew 1 adult-strength or 2 to 4 low-dose aspirin. Wait for an ambulance. Do not try to drive yourself.
Call your doctor if you have:
It can be hard to tell the difference between the symptoms of a panic attack (such as shortness of breath and chest pain) and 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.
Your doctor will ask about your past health and symptoms. He or she will do a physical exam. The doctor will listen to your heart and check your blood pressure. You may get blood tests to check for other causes of your symptoms. The doctor may need to rule out other health conditions that have symptoms that are similar to panic disorder, such as a heart attack or hyperthyroidism.
You may be diagnosed with panic disorder if you have at least two unexpected panic attacks and worry about having another attack. This includes avoiding situations that may trigger an attack.
Treatment may include:
Treatment can help most people control or even stop attacks. It can help lower the anxiety you feel because of the fear of future attacks. But symptoms can come back, especially if you stop treatment too soon.
Unfortunately, many people don't seek treatment. 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. It can prevent other problems related to panic disorder. These problems include depression, anxiety disorders, and substance use disorder.
If your panic attacks get too severe or happen too often, you may need to be treated in the hospital until they are under control.
Here are steps you can take to decrease the number of panic attacks you have. These steps can also reduce the severity of your symptoms when an attack does occur.
Do tension-reducing activities, and lower the amount of stress in your life.
These involve 10 to 20 minutes of deep breathing and muscle relaxation each day.
Changing how you think can change how you feel—and that can reduce your anxiety. Noticing negative thoughts and replacing them with helpful ones is one way to do this.
Get your breathing and heart rate up several times a week.
One option is a group organized by the Anxiety Disorders Association of America (ADAA).
This means eating fresh, healthy foods and limiting your intake of foods that are high in sugar and fat.
Medicines for panic disorder are used to:
Your symptoms should start to improve within a few weeks after you start to take medicines. If they don't improve within 6 to 8 weeks, you may need a higher dose. Or you may need another medicine.
Medicines used most often to treat panic attacks and panic disorder include:
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