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Most of us are familiar with our fears. We may be afraid of heights, spiders or flying in airplanes. When faced with the situation, there are a few things that happen. First our brain fires and sends warning messages throughout our body that prepares it for “fight or flight,” releasing cortisol and adrenaline. Our heart starts pumping, mouth gets dry, and we may feel butterflies.  I am sure that we have all had that experience. Those feelings most could also be described as anxiety or a general sense of apprehension. Some people may develop excessive fears or a phobia. Phobias are very common in men and women.

Less commonly known about, but still a situation that occurs in almost six percent of the United States population are panic attacks. Panic attacks may lead to panic disorder. Women are two to three times more likely then men to develop panic disorder. Panic Disorder is defined as recurrent, unexpected panic attacks, persistent worrying about having additional attacks, and concern about the panic attacks or the imagined consequences that could occur (heart attack, losing control, or “going crazy”). Panic Disorder is more serious than panic attacks and should be diagnosed and treated by a health care provider.

Back to panic attacks. A sudden intense feeling of discomfort and fear that is accompanied by four or more of the following symptoms can be classified as a panic attack. Examine this list and check off any symptoms that you may have:Feeling of intense fear and discomfort with four or more of the following symptoms:

  1. Palpitations, pounding heart or accelerated heart rate
  2. Sweating
  3. Trembling or shaking
  4. Sensations of shortness of breath or smothering
  5. Feeling of choking
  6. Chest pain or discomfort
  7. Nausea or abdominal distress
  8. Feeling dizzy, unsteady, lightheaded or faint
  9. Feeling like you’re losing a sense of reality (briefly)
  10. Fear of losing control or going crazy
  11. Fear of dying
  12. Numbness or tingling sensation
  13. Chills or hot flashes

It is important to understand that most panic attacks do not have triggers. A panic attack can be an expected or unexpected, sudden feeling of fear, or “gloom and doom”.  In response to your physical symptoms, you may end up in your local emergency room being worked up for complaints of chest pain or feeling stressed.  A complete medical work-up is necessary, including a blood count, thyroid and liver functions, a drug screen and electrocardiogram. Medical conditions that are important to be aware of that may cause symptoms of anxiety are anemia, angina, asthma, migraine, diabetes, systemic infections, and a Vitamin B-12 deficiency. There are also associations with the development of panic attacks in people who smoke and have alcohol or drug dependence.

Panic attacks may or may not be associated with current stressful life events. However, there are some life factors that have been associated with the development of panic attacks, those may involve a chronic sense of feeling trapped, triggered by situations of increased work responsibilities, difficulty tolerating anger, and issues of separation from significant persons in childhood and in adult life.

After a medical condition has been ruled out, if you have a panic attack, you should feel secure in your ability to manage it. Some symptoms of panic may be managed by the use of medications like antidepressants and or anti-anxiety medication.  Identifying underlying sources of conflict or anxiety and behavioral modification treatments through cognitive behavioral therapy is also an option.

Self-management of your panic attacks is possible. It starts with a plan. Here is your panic plan:

PrepareBe aware of your symptoms. Take a look at the checklist. If you feel that you may suffer from panic-attacks, understand that you can take steps to make it through them. Identify your sources of support.

RelaxLearn to relax if you are having a panic attack. Practice deep breathing. Take ten deep breaths through your nose with your mouth closed. On inspiration, think calm relaxing thoughts, and as you exhale, push out any stress and anxiety that you feel.

Keep a small memo pad handy that you can record what you experienced, notice the sensations in your body, how long they lasted and how they resolved. It can serve as a tool to assist you in identifying triggers or enhance communication with your doctor about your symptoms.

HelpSeek medical and, or psychological assistance if your symptoms persist.

Panic attacks can be treated. Be aware of how much caffeine that you ingest, and try to get proper amounts of sleep. Cut down on your cigarettes or try and stop smoking. Watch your alcohol intake. Don’t be afraid to talk to a doctor or healthcare provider about your symptoms as well as how you have tried to manage them. Panic attacks are not just in your head, have a plan.