What is panic attacks?

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.

Symptoms of a panic attack may include:

• A feeling of intense fear, terror, or anxiety.
• Trouble breathing or very fast breathing.
• Chest pain or tightness.
• A heartbeat that races or isn't regular.
• Sweating.
• Nausea or an upset stomach.
• Dizziness and shaking.
• Numbness or tingling.
• Fear that you are going to die, lose control, or "go crazy."

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:

• Counseling. An example is cognitive-behavioral therapy.
• Medicines. This may be an antidepressant or a benzodiazepine.
• Home treatment. This includes relaxation exercises.

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.

• Take your medicine exactly as directed. Call your doctor if you think you are having a problem with your medicine.
• Go to your counseling sessions and follow-up appointments.
• Recognize and accept your anxiety. Then, when you are in a situation that makes you anxious, say to yourself, "This is not an emergency. I feel uncomfortable, but I am not in danger. I can keep going even if I feel anxious."
• Be kind to your body:
  • Relieve tension with exercise or a massage.
  • Get enough rest.
  • Avoid alcohol, caffeine, nicotine, and illegal drugs. They can increase your anxiety level, cause sleep problems, or trigger a panic attack.
  • Learn and do relaxation techniques. See below for more about these techniques.
• Engage your mind. Get out and do something you enjoy. Go to a funny movie, or take a walk or hike. Plan your day. Having too much or too little to do can make you anxious.
• Keep a record of your symptoms. Discuss your fears with a good friend or family member, or join a support group for people with similar problems. Talking to others sometimes relieves stress.
• Get involved in social groups, or volunteer to help others. Being alone sometimes makes things seem worse than they are.
• Get at least 30 minutes of exercise on most days of the week to relieve stress. Walking is a good choice. You also may want to do other activities, such as running, swimming, cycling, or playing tennis or team sports.

Relaxation techniques

Do relaxation exercises for 10 to 20 minutes a day. You can play soothing, relaxing music while you do them, if you wish.

• Tell others in your house that you are going to do your relaxation exercises. Ask them not to disturb you.
• Find a comfortable place, away from all distractions and noise.
• Lie down on your back, or sit with your back straight.
• Focus on your breathing. Make it slow and steady.
• Breathe in through your nose. Breathe out through either your nose or mouth.
• Breathe deeply, filling up the area between your navel and your rib cage. Breathe so that your belly goes up and down.
• Do not hold your breath.
• Breathe like this for 5 to 10 minutes. Notice the feeling of calmness throughout your whole body.

As you continue to breathe slowly and deeply, relax by doing the following for another 5 to 10 minutes:

• Tighten and relax each muscle group in your body. You can begin at your toes and work your way up to your head.
• Imagine your muscle groups relaxing and becoming heavy.
• Empty your mind of all thoughts.
• Let yourself relax more and more deeply.
• Become aware of the state of calmness that surrounds you.
• When your relaxation time is over, you can bring yourself back to alertness by moving your fingers and toes and then your hands and feet and then stretching and moving your entire body. Sometimes people fall asleep during relaxation, but they usually wake up shortly afterward.
• Always give yourself time to return to full alertness before you drive a car or do anything that might cause an accident if you are not fully alert. Never play a relaxation tape while driving a car.