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Panic Attack Symptoms and Anxiety Attack Symptoms, Signs and Causes
The purpose of this material is to explain Panic Anxiety Disorder. If you've ever wondered, "What are anxiety attacks, exactly?" then this material is for you. Learning the symptoms of panic attacks may help you to decide if you are having panic attacks. If there is reason to suspect Panic Anxiety Disorder, the article suggests a reasonable approach to take so that a proper diagnosis can be made and, if necessary, treatment begun. This is intended for educational information only. Treatment for appendicitis is not a 'do it yourself' project. Neither is Treatment for
Anxiety. If you believe, after reading this, that you might have Panic Anxiety Disorder, you should see your physician who can either diagnose and treat you, or refer you to a specialist. You may have the symptoms of an anxiety attack, but a doctor will make a final determination.
A Case History
Ann was watching television after a typical workday. She suddenly developed a peculiar and very strong feeling of being lightheaded and a smothering sensation as if there were no oxygen in the air she was breathing. Then a surge of pounding rapid heartbeat began. It came on so quickly and was so severe that she became panicked that she might be dying of a heart attack! Then she felt very shaky, sweaty, and unsteady. This whole experience reached peak intensity within 60 seconds. This was the eighth such attack this month.
"Panic" was hardly the word
to describe how terrified she was feeling. It went beyond any feeling of fear
that she had ever experienced. Although she had gone to the emergency room
several times, nothing seemed to be found by the doctors to explain why she
kept having the attacks.
She frantically searched for
her car keys so that she could get to the hospital immediately. She thought
desperately, "What's wrong with me?"
What a panic attack feels like.
The main symptom of a Panic
Anxiety Disorder is the panic attack itself. Panic Anxiety Disorder is a medical disorder
characterized by severe and sudden episodes.
It is important to mention
that sudden episodes of the symptoms listed above caused by another reasonable
cause are not panic attacks. Two such reasonable causes would be (1) a certain
medical ailment that might mimic a panic attack, or (2) a life threatening
experience immediately preceding the attack. If these reasonable causes are
found not be the cause of the problem then there is the possibility of a Panic
Panic attacks reach maximum
intensity within a minute or two once they begin. They diminish slowly over the
next 30 minutes or the next several hours. It is common for the first attack to
cause a person to go to an emergency medical facility. Subsequent attacks occur
several times a month and are often as severe as the initial attack.
About three fourths of Panic
Disorder patients are women. Panic Anxiety Disorder begins most often when people are
20-30 years old. It begins less often in teenagers or persons in their forties.
It is uncommon for the disorder to appear in the elderly for the first time.
It is important to note that
although a few experts say it is more common in persons who experienced a
separation experience as a child, many of experts feel that Panic Anxiety Disorder
afflicts emotionally healthy people. Persons having Panic attacks are no more
likely than the average American to have suffered from emotional problems at
the time the disorder begins.
Symptoms of a Panic Attack
difficulty breathing, feeling as though you 'can't get enough air
terror that is almost paralyzing
nervous, shaking, stress
palpitation, feeling of dread
dizziness, lightheadedness or nausea
trembling, sweating, shaking
choking, chest pains, distress
fear, fright, afraid, anxious
flashes, or sudden chills
tingling in fingers or toes ('pins and needles')
fearful that you're going to go crazy or are about to die
Afraid of Something.
repetitive, severe panic attacks may simply have panic
attacks and that is all. Other persons may begin to
experience a progression of bothersome or distressing
panic attack "side effects". This progression commonly
occurs as follows:
A few weeks or months prior to the first
panic attack there are sometimes minor symptoms such as
rapid heart beat.
The first major panic attackoccurs. The person often seeks emergency medical
evaluation at this time. The initial examination is
Continued panic attacks
cause the person to seek further medical evaluations
which may be inconclusive. Many panic attack sufferers
go for months or years before receiving the proper
diagnosis and by that time may have seen over a dozen
physicians, psychologists and counselors. This
appearance of "doctor shopping" may cause others to
regard the sufferer as a hypochondriac.
An individual with Panic
Anxiety Disorder may begin to avoid a certain activity
because it occurs to them that it would be especially
embarrassing or dangerous to have a panic attack while
engaged in that activity. A typical sufferer of Panic
Anxiety Disorder might think, "It's bad enough to have a
panic attack at all, but it would be dangerous to have
one on Interstate 75 because I would be preoccupied with
the attack and would not be a safe driver. I might wreck
my car, injuring myself or someone else!" This avoidance
behavior may appear to be a fear of driving when it is
really a fear of having a panic attack while driving.
Tendencies to avoid
circumstances in everyday life may increase and extend
to more activities. This extensive avoidance behavior is
referred to as agoraphobia.
Places, activities or
circumstances frequently avoided by persons with Panic
Anxiety Disorder include the following:
After months or years of
continuous panic attacks and the restricted lifestyle
caused by the typical avoidance behavior, the sufferer
of Panic Anxiety Disorder may become demoralized and
psychologically or physically depressed.
Some sufferers turn to
alcohol in an attempt to self medicate or to diminish
the symptoms of the disorder. This greatly complicates
the individual's life and ability to seek appropriate
Tragically, one out of
every five untreated sufferers attempts to end his or
her life, never realizing that there was hope and
Is There Damage?
A person will not die
from a panic attack. But, Panic Anxiety Disorder does
indeed cause damage. It is difficult to estimate the
misery and loss of overall productivity that this
There is personal pain
and humiliation and a restricted lifestyle. There are
missed days of work due to panic attacks. There may be
unemployment due to partial or complete disability.
There is increased risk of alcoholism, depression and
Add the unhappiness the
disorder causes in the loved ones of
Panic Anxiety Disorder and the consequential loss of
their productivity. You come to realize that the total
magnitude of the damage that the disorder causes
nationally is staggering. And we haven't even touched on
the tremendous cost that the waste of misdiagnosis and
unnecessary or inappropriate medical care adds to the
damage estimate. Drug and alcohol abuse are the number
one public concern of Americans. However, Anxiety
Disorders affect more Americans than the combined toll
of drug and alcohol abuse. And yet Anxiety Disorders are
not even in the top fifty of Americans' public concerns
The federal government has developed a plan to deal with
years ago Panic Anxiety Disorder was poorly understood
even by most experts. It was called Anxiety Neurosis and
was thought by some to stem from "deeply rooted"
psychological conflicts and subconscious upsetting
impulses of a sexual nature.
regard Panic Anxiety Disorder as more of a physical
problem with a metabolic core. It is not an emotional
problem, although after suffering from it, emotionally
healthy persons may develop depression or other
problems. There are different theories about where in
the nervous system the problem exists.
There is considerable evidence pointing toward an
abnormality in the function of the locus ceruleus and
its associated nerve pathways. The locus ceruleus is a
tiny nerve center in the brainstem(the part of the brain
that controls heartbeat, breathing and other vital
Few experts still cling to the notion that this is
not a physical disorder. Scientific evidence clearly
favors there being a physical cause of panic attacks. It
is regarded as a physical disorder much like Diabetes or
There is hope and help
there hope for persons with Panic Anxiety Disorder? Yes.
Panic Anxiety Disorder is very treatable. And nearly
everyone responds well to proper treatment. Treatment
consists of several steps:
person must be educated about this disorder. Simply
learning some of the things mentioned in this brochure
will improve matters somewhat by giving hope where there
perhaps was despair. Understanding and knowledge gives
confidence and a positive expectation so important to
the success of any medical treatment.
it is necessary to find a medication which can eliminate
the panic attacks completely, if at all possible.
Psychiatrists experienced in treating Panic Anxiety
Disorder have had success using any one of three kinds
Antidepressants. Tofranil (imipramine) and Paxil (paroxetine)
are examples of old and new antidepressants that are
useful in treating Panic Anxiety Disorder.
Though approved by the FDA for treating depression,
most antidepressants will block panic attacks. Physical
dependence does not occur on such medicine.
Successful treatment requires full strength dosage
and it usually takes four to eight weeks for the
medicine to begin to block the panic attacks. Perhaps
half of persons trying this type of medicine are made
initially worse to some degree. Certain properties of
the medicines tend to trigger more than the usual number
of attacks in the first couple of weeks or so. But this
discomfort may have to be considered a short term
investment in return for a long term gain of recovery.
As a rule, the less expensive antidepressants (Tofranil)
have more bothersome side effects than the newer more
expensive ones (Paxil) .
Here are some examples of antidepressants known by
clinicians to be helpful for Panic Anxiety Disorder:
Benzodiazepine Tranquilizers. Some examples are Xanax (alprazolam),
Ativan (lorazepam) and Klonopin (clonazepam). Xanax (alprazolam)
is the most thoroughly studied of this group. Xanax (alprazolam)
was already used for a decade to treat Panic Anxiety
Disorder when it was approved for use in Panic Anxiety
Disorder by the FDA in 1990. These medicines are quite
effective and usually have few side effects at proper
doses. They block panic attacks almost immediately in
the first day or two of treatment.
Several dosage increases over a
period of several weeks are customary. Ultimately no
further increases are required.
Public concern about such
medicines being dangerously addictive is unduly
exaggerated in the case of persons with
Panic Anxiety Disorder.
Scientific evidence shows
surprisingly low rates of abuse of this and other
medicines in persons with Panic Anxiety Disorder.
Physical dependence does develop with such medicines at
larger dosages. The person who chooses such medicine for
this disorder should accept the fact that they may
require higher doses and may therefore be physically
dependent on the medicine. They must not abruptly cease
taking their medicine. Doing so would result in
withdrawal symptoms. One does not abruptly stop such
medicine. When it comes time to go off medicine it is
decreased gradually by tiny reductions every one to
three weeks). More information about this benzodiazepine
kind of medication is linked (click benzodiazepine).
Nardil (phenelzine). This
unique medicine, though more effective than any other
medicine for this disorder, is rather complicated to
use. It may be best to reserve it for cases where
simpler medications have failed or cannot be used for
some reason. Nardil is a safe medicine when used by an
experienced physician in a patient who complies with the
necessary diet and medication restrictions. Unsafe
elevations of blood pressure for several hours can occur
if one does not adhere to these restrictions while
the panic attacks have been successfully blocked
completely for about three months Panic Anxiety Disorder
patients usually get back to normal life without any
additional assistance. However, many do not
automatically overcome their tendencies to avoid the
situations that they have been evading. Success in such
patients is achieved by organizing a systematic approach
of doing the very things that have been avoided. They
begin going into the least difficult of avoided places
first. This exposure to the feared situations is
practiced repeatedly until they are reasonably
comfortable. Then they proceed to the next more
difficult avoided activity.
This highly successful approach is a common sense
method based on the old adage "If you fall off the
horse, get right back on." This cognitive behavior
therapy approach may be helpful in resolving such fears.
The person discovers that they can indeed perform the
avoided activities and the medication prevents the
attacks from occurring. Confidence is restored and
normal life resumes with security, peace of mind and a
sense that one is in control once again.
Some professionals believe that Panic Anxiety
Disorder can be treated solely with talk therapy such as
cognitive behavioral therapy or expensive cassette
tapes. This area is controversial. The National Anxiety
Foundation urges professionals and patients to employ
the combination of both methods (medication and
cognitive-behavioral therapy) until convincing research
clarifies, once and for all, this controversy.
What kind of doctor should I
see to get help?
The first step should be to have a
medical evaluation to determine the proper diagnosis.
Your family physician is the good place to start. Tell
him or her what has been happening to you and that you
wonder if you might be having Panic Attacks. Show the
doctor this brochure. After the evaluation perhaps the
doctor will tell you that you do have Panic Anxiety
Disorder. Then what? You may wish to see a psychiatrist.
Psychiatrists are physicians (MD's).
A psychiatrist who is experienced in treating Panic
Anxiety Disorder is the most qualified single
professional to deal with the problem. There is a
national shortage of psychiatrists. There may not be one
in your area, or your HMO may not allow you to be seen
by one of their psychiatrists. In these instances,
seeing your regular doctor for medication to stop the
attacks and consulting a psychologist, if necessary, for
behavior therapy is second best. Psychologists are not
physicians (instead of M.D., they may have other
abbreviations after their name such as Ph.D. or Ed.D. or
Psy.D.). If a psychologist isn't available for behavior
therapy, a social worker who is familiar with this
therapy might be helpful.
Remember, Panic Anxiety Disorder is a
serious but highly treatable medical illness. Almost
everyone responds well to treatment and can return to
normal functioning in weeks or months.
Adding natural alternative treatments for anxiety, panic attacks,
OCD, depression, ADHD, Eating Disorders, and phobias can make a big
difference in your life. We have spent years researching these programs
to help these disorders before they become disabling disorders.
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