Panic attacks are sudden, discrete periods of intense anxiety, mounting physiological arousal, fear, stomach problems (spastic colon) and discomfort that are associated with a variety of somatic and cognitive symptoms.^[1] The onset of these episodes is typically abrupt, and may have no obvious triggers. Although these episodes may appear random, they are a subset of an evolutionary response commonly referred to as fight or flight that occur out of context. This response floods the body with hormones, particularly epinephrine (adrenaline), that aid in defending itself from harm.^[2] Experiencing a panic attack is said to be one of the most intensely frightening, upsetting and uncomfortable experiences of a person's life.^[2] The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // F00-F99 - Mental and behavioural disorders (F00-F09) Organic, including symptomatic, mental disorders (F00) Dementia in Alzheimers disease (F01) Vascular dementia (F011) Multi-infarct dementia (F02) Dementia in other diseases classified elsewhere (F020) Dementia in Picks disease (F021) Dementia in Creutzfeldt-Jakob disease (F022) Dementia in Huntingtons... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... Medical Subject Headings (MeSH) is a huge controlled vocabulary (or metadata system) for the purpose of indexing journal articles and books in the life sciences. ... Physiology (in Greek physis = nature and logos = word) is the study of the mechanical, physical, and biochemical functions of living organisms. ... The term somatic refers to the body, as distinct from some other entity, such as the mind. ... Cognitive The scientific study of how people obtain, retrieve, store and manipulate information. ... The fight-or-flight response, also called hyperarousal or the acute stress response, was first described by Walter Cannon in 1915[1][2]. His theory states that animals react to threats with a general discharge of the sympathetic nervous system, priming the animal for fighting or fleeing. ... Hormone is also the NATO reporting name for the Soviet/Russian Kamov Ka-25 military helicopter. ... Adrenaline redirects here. ...

According to the American Psychological Association the symptoms of a panic attack commonly last approximately ten minutes. However, panic attacks can be as short as 1–5 minutes, while sometimes panic attacks may form a cyclic series of episodes, lasting for an extended period, sometimes hours. Often those afflicted will experience significant anticipatory anxiety and limited symptom attacks in between attacks, in situations where attacks have previously occurred, and in situations where they feel "trapped". That is, where escape would be obvious and/or embarrassing. The American Psychological Association (APA) is a professional organization representing psychology in the US. It has around 150,000 members and an annual budget of around $70m. ... Limited Symptom Attack (Limited Symptom Panic Attack or LPA/LSA) denotes a milder, less comprehensive panic attack with less than 4 panic related symptoms being experienced (APA 1994). ...

Panic attacks also affect people differently. Experienced sufferers may be able to completely "ride out" a panic attack with little to no obvious symptoms or external manifestations. Others, notably first-time sufferers, may even call for emergency services; many who experience a panic attack for the first time fear they are having a heart attack or a nervous breakdown.^[3] A myocardial infarction occurs when an atherosclerotic plaque slowly builds up in the inner lining of a coronary artery and then suddenly ruptures, totally occluding the artery and preventing blood flow downstream. ... This article or section does not cite its references or sources. ...

Descriptions

Many who suffer panic attacks state they are the most frightening experiences of their lives. Sufferers of panic attacks report a fear or sense of dying, "going crazy", or experiencing a heart attack, feeling faint, nauseous, "flashing vision", or losing control of themselves. These feelings may provoke a strong urge to escape or flee the place where the attack began (a consequence of the sympathetic "fight or flight" response). Heart attack redirects here. ... It has been suggested that Central Ischaemic Response be merged into this article or section. ... Heaving redirects here. ... This article or section should include material from Fight-or-flight The flight or fight response, also called the acute stress response, was first described by Walter Cannon in the 1920s as a theory that animals react to threats with a general discharge of the sympathetic nervous system. ...

A panic attack is a response of the sympathetic nervous system (SNS). The most common symptoms may include trembling, dyspnea (shortness of breath), heart palpitations, chest pain (or chest tightness), hot flashes, cold flashes, burning sensations (particularly in the facial or neck area), sweating, nausea, dizziness (or slight vertigo), light-headedness, hyperventilation, paresthesias (tingling sensations), sensations of choking or smothering or derealization, or the feeling that nothing is real. These physical symptoms are interpreted with alarm in people prone to panic attacks. This results in increased anxiety, and forms a positive feedback loop.^[4] The Sympathetic Nervous System (SNS) is a branch of the autonomic nervous system. ... Tremor is the rhythmic, oscillating shaking movement of the whole body or just a certain part of it, caused by problems of the neurons responsible from muscle action. ... Dyspnea (R06. ... Dyspnea (Latin dyspnoea, Greek dyspnoia from dyspnoos - short of breath) or shortness of breath (SOB) is perceived difficulty breathing or pain on breathing. ... A palpitation is an abnormal, rapid beating of the heart, brought on by overexertion, disease or drugs. ... In medicine, chest pain is a symptom of a number of conditions and is generally considered a medical emergency, unless the patient is a known angina pectoris sufferer and the symptoms are familiar (appearing at exertion and resolving at rest, known as stable angina). When the chest pain is not... This article or section does not cite its references or sources. ... Perspiration (also called sweating or sometimes transpiration) is the production and evaporation of a fluid, consisting primarily of water as well as a smaller amount of sodium chloride (the main constituent of table salt), that is excreted by the sweat glands in the skin of mammals. ... For other uses, see Nausea (disambiguation). ... Many different terms are often used to describe what is collectively known as dizziness. ... Vertigo, a specific type of dizziness, is a major symptom of a balance disorder. ... Light-headedness is a common ailment where individuals feel as though their head are weightless. ... In medicine, hyperventilation (or hyperpnea) is the state of breathing faster or deeper (hyper) than necessary, and thereby reducing the carbon dioxide concentration of the blood below normal. ... Paresthesia or paraesthesia (in British English) is a sensation of tingling, pricking, or numbness of a persons skin with no apparent long-term physical effect, more generally known as the feeling of pins and needles or of a limb being asleep (but not directly related to the phenomenon of... For choking meaning compression of the neck, see Strangling. ... A form of queening in which breath control may also be utilised. ... Derealization (DR) is an alteration in the perception or experience of the external world so that it seems strange or unreal. ... Positive feedback is a mechanism by which an output is enhanced. ...

Often when shortness of breath and chest pain are the predominant symptoms the sufferer incorrectly appraises this as a sign or symptom of a heart attack. This results in the person experiencing a panic attack to seek treatment in an emergency room. Dyspnea (Latin dyspnoea, Greek dyspnoia from dyspnoos - short of breath) or shortness of breath (SOB) is perceived difficulty breathing or pain on breathing. ... In medicine, chest pain is a symptom of a number of conditions and is generally considered a medical emergency, unless the patient is a known angina pectoris sufferer and the symptoms are familiar (appearing at exertion and resolving at rest, known as stable angina). When the chest pain is not... A symptom is a manifestation of a disease, indicating the nature of the disease, which is noticed by the patient. ... A myocardial infarction occurs when an atherosclerotic plaque slowly builds up in the inner lining of a coronary artery and then suddenly ruptures, totally occluding the artery and preventing blood flow downstream. ... The emergency room is the American English term for a room, or group of rooms, within a hospital that is designed for the treatment of urgent and medical emergencies. ...

The panic attack is distinguished from other forms of anxiety by its intensity and its sudden, episodic nature.^[2] Panic attacks are often experienced in conjunction with anxiety disorders and other psychological conditions, although panic attacks are not always indicative of a mental disorder, they are uncommon. Psychology (ancient Greek: psyche = soul and logos = word) is the study of mind, thought, and behaviour. ... Mental disorder or mental illness are terms used to refer psychological pattern that occurs in an individual and is usually associated with distress or disability that is not expected as part of normal development or culture. ...

Triggers and causes

• Long-Term, Predisposing Causes — Heredity. Panic disorder has been found to run in families, and this may mean that inheritance genes plays a strong role in determining who will get it. However, many people who have no family history of the disorder develop it. Various twin studies where one identical twin has an anxiety disorder have reported an incidence ranging from 31 to 88 percent of the other twin also having an anxiety disorder diagnosis. Environmental factors such as an overly cautious view of the world expressed by parents and cumulative stress over time have been found to be causes.^[2]

• Biological Causes — Generalized anxiety, obsessive compulsive disorder, post traumatic stress disorder, hypoglycemia, hyperthyroidism, Wilson's disease, mitral valve prolapse, pheochromocytoma and inner ear disturbances (labyrinthitis).^[2] Vitamin B deficiency from inadequate diet or caused by periodic depletion due to parasitic infection from tapeworm can be a trigger of anxiety attacks.

• Phobias — People will often experience panic attacks as a direct result of exposure to a phobic object or situation.

• Short-Term Triggering Causes — Significant personal loss, including an emotional attachment to a romantic partner, life transitions, significant life change, stimulants such as caffeine or nicotine, or the drugs marijuana or psilocybin, can act as triggers.^[2]

• Maintaining Causes — Avoidance of panic provoking situations or environments, anxious/negative self-talk ("what-if thinking"), mistaken beliefs ("these symptoms are harmful and/or dangerous"), withheld feelings, lack of assertiveness.^[2]

• Lack of Assertiveness — A growing body of evidence supports the idea that those that suffer from panic attacks engage in a passive style of communication or interactions with others. This communication style, while polite and respectful, is also characteristically un-assertive. This un-assertive way of communicating seems to contribute to panic attacks while being consistently present in those that are afflicted with panic attacks.^[2]

• Medications — Sometimes panic attacks may be a listed side effect of medications such as Ritalin (methylphenidate). These may be a temporary side effect, only occurring when a patient first starts a medication, or could continue occurring even after the patient is accustomed to the drug, which likely would warrant a medication change in either dosage, or type of drug. Nearly the entire SSRI class of antidepressants can cause increased anxiety in the beginning of use. It is not uncommon for inexperienced users to have panic attacks while weaning on or off the medication, especially ones prone to anxiety.

• Hyperventilation Syndrome — Breathing from your chest may cause overbreathing, exhaling excess carbon dioxide in relation to the amount of oxygen in one's bloodstream. Hyperventilation Syndrome can cause respiratory alkalosis and hypocapnia. This syndrome often involves prominent mouth breathing as well. This causes a cluster of symptoms including rapid heart beat, dizziness, and lightheadedness which can trigger panic attacks.^[2]

• Situationally Bound Panic Attacks — Associating certain situations with panic attacks, due to experiencing one in that particular situation, can create a cognitive or behaviorally predisposition to having panic attacks in certain situations (situationally bound panic attacks). It is a form of classical conditioning.^[2] See PTSD

• Pharmacological Triggers — Certain chemical substances, mainly stimulants but also certain depressants, can either contribute pharmacologically to a constellation of provocations, and thus trigger a panic attack or even a panic disorder, or directly induce one.^[5][6] This includes caffeine, amphetamine, alcohol and many more. Some sufferers of panic attacks also report phobias of specific drugs or chemicals, that thus have a merely psychosomatic effect, thereby functioning as drug-triggers by non-pharmacological means.^[7]

The ancients had a variety of ideas about heredity: Theophrastus proposed that male flowers caused female flowers to ripen; Hippocrates speculated that seeds were produced by various body parts and transmitted to offspring at the time of conception, and Aristotle thought that male and female semen mixed at conception. ... This stylistic schematic diagram shows a gene in relation to the double helix structure of DNA and to a chromosome (right). ... Twin study - Wikipedia /**/ @import /skins-1. ... For other things named OCD, see OCD (disambiguation). ... Posttraumatic stress disorder (PTSD), is a term for the psychological consequences of exposure to or confrontation with stressful experiences, which involve actual or threatened death, serious physical injury or a threat to physical integrity and which the person found highly traumatic. ... Hypoglycemia (hypoglycaemia in British English) is a medical term referring to a pathologic state produced by a lower than normal level of glucose (sugar) in the blood. ... Hyperthyroidism (or overactive thyroid gland) is the clinical syndrome caused by an excess of circulating free thyroxine (T4) or free triiodothyronine (T3), or both. ... Wilsons disease or hepatolenticular degeneration is an autosomal recessive hereditary disease, with an incidence of about 1 in 30,000 in most parts of the world and a male preponderance. ... Mitral valve prolapse (MVP) is a heart valve condition marked by the displacement of an abnormally thickened mitral valve leaflet into the left atrium during systole. ... A phaeochromocytoma (pheochromocytoma in the US) is a neuroendocrine tumor of the medulla of the adrenal glands originating in the chromaffin cells, which secretes excessive amounts of catecholamines, usually adrenaline and noradrenaline (epinephrine and norepinephrine in the US). ... Labyrinthitis is a balance disorder that usually follows an upper respiratory tract infection (URI). ... The B vitamins are eight water-soluble vitamins that play important roles in cell metabolism. ... Orders Subclass Cestodaria Amphilinidea Gyrocotylidea Subclass Eucestoda Aporidea Caryophyllidea Cyclophyllidea Diphyllidea Lecanicephalidea Litobothridea Nippotaeniidea Proteocephalidea Pseudophyllidea Spathebothriidea Tetraphyllidea Trypanorhyncha In biology, Cestoda is the class of parasitic flatworms, called cestodes or tapeworms, that live in the digestive tract of vertebrates as adults and often in the bodies of various animals... The term phobia, which comes from the Ancient Greek word for fear (φόβος, fobos), denotes a number of psychological and physiological conditions that can range from serious disabilities to common fears to minor quirks. ... A stimulant is a drug which increases the activity of the sympathetic nervous system and produces a sense of euphoria or awakeness. ... For other uses, see Caffeine (disambiguation). ... This article is about the chemical compound. ... A Cannabis sativa plant The drug cannabis, also called marijuana, is produced from parts of the cannabis plant, primarily the cured flowers and gathered trichomes of the female plant. ... Psilocybin (also known as psilocybine) is a psychedelic alkaloid of the tryptamine family, found in psilocybin mushrooms. ... This page meets Wikipedias criteria for speedy deletion. ... To meet Wikipedias quality standards, this article or section may require cleanup. ... This article does not cite any references or sources. ... Passive has several meanings: In grammar it describes a grammatical voice. ... Methylphenidate (C14H19NO2), or MPH, is an amphetamine-like prescription stimulant commonly used to treat Attention Deficit Hyperactivity Disorder (ADHD) in children and adults. ... Vitamin R redirects here. ... SSRI is an acronym that stands for several things: It is a class of antidepressants called selective serotonin reuptake inhibitor SSRI also is used as the stock symbol for Silver Standard Resources Inc. ... In medicine, hyperventilation (or hyperpnea) is the state of breathing faster or deeper (hyper) than necessary, and thereby reducing the carbon dioxide concentration of the blood below normal. ... Carbon dioxide (chemical formula: CO2) is a chemical compound composed of two oxygen atoms covalently bonded to a single carbon atom. ... This article is about the chemical element and its most stable form, or dioxygen. ... Red blood cells (erythrocytes) are present in the blood and help carry oxygen to the rest of the cells in the body Blood is a circulating tissue composed of fluid plasma and cells (red blood cells, white blood cells, platelets). ... Respiratory alkalosis results from increased alveolar respiration (hyperventilation) leading to decreased plasma carbon dioxide concentration. ... Hypocapnia, also sometimes known as acapnia, is a state in which the level of carbon dioxide in the blood is lower than normal. ... Heart rate is a term used to describe the frequency of the cardiac cycle. ... Many different terms are often used to describe what is collectively known as dizziness. ... Light-headedness is a common and often unpleasant sensation of dizziness and/or feeling that one may be about to faint, which may be transient, recurrent, or occasionally chronic. ... Posttraumatic stress disorder (PTSD), is a term for the psychological consequences of exposure to or confrontation with stressful experiences, which involve actual or threatened death, serious physical injury or a threat to physical integrity and which the person found highly traumatic. ... A psychosomatic illness is one with physical manifestations and supposed psychological cause, often diagnosed when any known or identifiable physical cause was excluded by medical examination. ...

Physiological considerations

While the various symptoms of a panic attack may feel that the body is failing, it is in fact protecting itself from harm. The various symptoms of a panic attack can be understood as follows. First, there is frequently (but not always) the sudden onset of fear with little provoking stimulus. This leads to a release of adrenaline (epinephrine) which brings about the so-called fight-or-flight response wherein the person's body prepares for strenuous physical activity. This leads to an increased heart rate (tachycardia), rapid breathing (hyperventilation) which may be perceived as shortness of breath (dyspnea), and sweating (which increases grip and aids heat loss). Because strenuous activity rarely ensues, the hyperventilation leads to a drop in carbon dioxide levels in the lungs and then in the blood. This leads to shifts in blood pH (respiratory alkalosis or hypocapnia), which in turn can lead to many other symptoms, such as tingling or numbness, dizziness, burning and lightheadedness. Moreover, the release of adrenaline during a panic attack causes vasoconstriction resulting in slightly less blood flow to the head which causes dizziness and lightheadedness. A panic attack can cause blood sugar to be drawn away from the brain and towards the major muscles. It is also possible for the person experiencing such an attack to feel as though they are unable to catch their breath, and they begin to take deeper breaths, which also acts to decrease carbon dioxide levels in the blood. Epinephrine (INN) or adrenaline (BAN) is a hormone and a neurotransmitter. ... The fight-or-flight response, also called hyperarousal or the acute stress response, was first described by Walter Cannon in 1915[1][2]. His theory states that animals react to threats with a general discharge of the sympathetic nervous system, priming the animal for fighting or fleeing. ... This article or section does not cite any references or sources. ... In medicine, hyperventilation (or hyperpnea) is the state of breathing faster or deeper (hyper) than necessary, and thereby reducing the carbon dioxide concentration of the blood below normal. ... Dyspnea (R06. ... Carbon dioxide (chemical formula: CO2) is a chemical compound composed of two oxygen atoms covalently bonded to a single carbon atom. ... For the village in Tibet, see Lung, Tibet. ... For other uses, see Blood (disambiguation). ... For other uses, see PH (disambiguation). ... Respiratory alkalosis results from increased alveolar respiration (hyperventilation) leading to decreased plasma carbon dioxide concentration. ... Hypocapnia, also sometimes known as acapnia, is a state in which the level of carbon dioxide in the blood is lower than normal. ... Paresthesia or paraesthesia (in British English) is a sensation of tingling, pricking, or numbness of a persons skin with no apparent long-term physical effect, more generally known as the feeling of pins and needles or of a limb being asleep (but not directly related to the phenomenon of... Many different terms are often used to describe what is collectively known as dizziness. ... Burning may refer to any of the following: Combustion The use of a CD burner The Burning Man festival Burning-in of Photographic paper Immolation An insult (slang term) This is a disambiguation page — a navigational aid which lists other pages that might otherwise share the same title. ... Light-headedness is a common and often unpleasant sensation of dizziness and/or feeling that one may be about to faint, which may be transient, recurrent, or occasionally chronic. ... Epinephrine (INN) or adrenaline (BAN) is a hormone and a neurotransmitter. ... Vasoconstriction is a narrowing of the blood vessels resulting from contracting of the muscular wall of the vessels. ... Blood flow is the flow of blood in the cardiovascular system. ... Many different terms are often used to describe what is collectively known as dizziness. ... Light-headedness is a common and often unpleasant sensation of dizziness and/or feeling that one may be about to faint, which may be transient, recurrent, or occasionally chronic. ... In medicine, blood sugar is a term used to refer to levels of glucose in the blood. ... For other uses, see Brain (disambiguation). ...

The "panic trick" (Carbonell 2004)

Dr. David Carbonell describes panic attacks and Panic Disorder as a "trick". First, it tricks the sufferer into believing what they are experiencing is dangerous, for example having a heart attack, fainting, insanity, and/or "doing something crazy", when a panic attack presents no danger. Second, it tricks those afflicted into doing anything they believe will help them, which can make the panic attacks worse. These activities would include avoidance behaviors, trying to control panic attacks (for example, by taking deep breaths), fighting panic attacks, superstitions and rituals to avoid panic attacks and excessive self-protection. (Carbonell 2004) Panic Disorder is a psychiatric condition characterized by recurring panic attacks in combination with significant behavioral change or at least a month of ongoing worry about the implications or concern about having other attacks. ... Look up dangerous in Wiktionary, the free dictionary. ... A myocardial infarction occurs when an atherosclerotic plaque slowly builds up in the inner lining of a coronary artery and then suddenly ruptures, totally occluding the artery and preventing blood flow downstream. ... It has been suggested that Central Ischaemic Response be merged into this article or section. ... ‹ The template below (Expand) is being considered for deletion. ... Superstition is a set of behaviors that may be faith based, or related to magical thinking, whereby the practitioner believes that the future, or the outcome of certain events, can be influenced by certain of his or her behaviors. ... For other senses of this word, see ritual (disambiguation). ...

Symptoms

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Image File history File links Question_book-new. ...

Physical

• A sensation of adrenaline going through your entire body
• Sweating
• Shortness of breath (dyspnea)
• Stomach problems (spastic colon)
• Racing or pounding heartbeat or palpitations
• Chest pain
• Dizziness or vertigo
• Headache
• Lightheadedness
• Nausea / stomach pains
• Hyperventilation
• Choking or smothering sensations
• Hot flashes
• Cold flashes
• Tingling or numbness in the hands, face, feet or mouth (paresthesia)
• Feelings of "crawly," "itchy," or "cringy" skin sensations.
• Burning sensations
• Trembling or shaking
• Feeling of claustrophobia
• Feeling like the body is shutting down/ dying
• Tremors in the legs/shaking legs/thighs
• Tingling spine
• Feeling like one is experiencing a heart attack
• Exhaustion
• Muscle spasms
• Feeling of physical weakness or limpness of the body
• Grinding teeth or tensing other muscles repeatedly or for prolonged periods of time
• Temporary blindness
• Sizzling/ringing in ears/head

Epinephrine (INN) or adrenaline (BAN) is a hormone and a neurotransmitter. ... Perspiration (also called sweating or sometimes transpiration) is the production and evaporation of a fluid, consisting primarily of water as well as a smaller amount of sodium chloride (the main constituent of table salt), that is excreted by the sweat glands in the skin of mammals. ... Dyspnea (R06. ... In medicine (gastroenterology), irritable bowel syndrome (IBS) or spastic colon is a group of functional bowel disorders which are fairly common and make up 20–50% of visits to gastroenterologists. ... Heart rate is the frequency of the cardiac cycle. ... A palpitation is an abnormal, rapid beating of the heart, brought on by overexertion, disease or drugs. ... In medicine, chest pain is a symptom of a number of conditions and is generally considered a medical emergency, unless the patient is a known angina pectoris sufferer and the symptoms are familiar (appearing at exertion and resolving at rest, known as stable angina). When the chest pain is not... Many different terms are often used to describe what is collectively known as dizziness. ... Vertigo, a specific type of dizziness, is a major symptom of a balance disorder. ... A headache (cephalgia in medical terminology) is a condition of pain in the head; sometimes neck or upper back pain may also be interpreted as a headache. ... Light-headedness is a common and often unpleasant sensation of dizziness and/or feeling that one may be about to faint, which may be transient, recurrent, or occasionally chronic. ... For other uses, see Nausea (disambiguation). ... In medicine, hyperventilation (or hyperpnea) is the state of breathing faster or deeper (hyper) than necessary, and thereby reducing the carbon dioxide concentration of the blood below normal. ... Paresthesia or paraesthesia (in British English) is a sensation of tingling, pricking, or numbness of a persons skin with no apparent long-term physical effect, more generally known as the feeling of pins and needles or of a limb being asleep (but not directly related to the phenomenon of... Look up tremble in Wiktionary, the free dictionary. ... Claustrophobia is an anxiety disorder that involves the fear of enclosed or confined spaces. ... Fatigue is a feeling of excessive tiredness or lethargy, with a desire to rest, perhaps to sleep. ...

Mental

• Intense and/or frightening realizations of reality
• Loss of the ability to react logically to stimuli
• Loss of cognitive ability in general
• Racing thoughts (often based on fear)
• Irrational thoughts
• Loud internal dialogue
• Feeling like nothing is real
• Feeling of impending doom
• Feeling of "going crazy"
• Feeling out of control
• Feeling like no one understands what is happening
• Vision is somewhat impaired (eyes may feel like they are shaking.)
• Feeling like you are going to die any second
• Avoidance behavior
• Agoraphobia

Emotional

• Terror, or a sense that something unimaginably horrible is about to occur and one is powerless to prevent it
• Fear that the panic is a symptom of a serious illness
• Fear that the panic will not subside
• Fear of losing control
• Fear of death
• Fear of living
• Fear of going crazy
• Flashbacks to earlier panic trigger^{[citation needed]}
• Intense "scared" feeling
• Fear of failure

A true medical diagnosis, this fear is characterized by an abnormal or irrational fear of death. ...

Perceptual

• Tunnel vision
• Heightened senses
• The apparent slowing down or speeding up of time
• Dream-like sensation or perceptual distortion (derealization)
• Dissociation, or the perception that one is not connected to the body or is disconnected from space and time (depersonalization)
• Feeling of loss of free will, as if acting entirely automatically without control

This article refers to the medical condition. ... Senses Senses are a UK based alternative rock band from Coventry. ... Derealization (DR) is an alteration in the perception or experience of the external world so that it seems strange or unreal. ... Dissociation is a state of acute mental decompensation in which certain thoughts, emotions, sensations, and/or memories are compartmentalized because they are too overwhelming for the conscious mind to integrate. ... Depersonalization is an alteration in the perception or experience of the self so that one feels detached from, and as if one is an outside observer of, ones mental processes or body. ... Free-Will is a Japanese independent record label founded in 1986. ...

Agoraphobia

Main article: Agoraphobia

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Agoraphobia is an anxiety disorder which primarily consists of the fear of experiencing a difficult or embarrassing situation from which the sufferer cannot escape. As a result, severe sufferers of agoraphobia may become confined to their homes, experiencing difficulty traveling from this "safe place". The word "agoraphobia" is an English adoption of the Greek words agora (αγορά) and phobos (φόβος), literally translated as "a fear of the marketplace" usually applies to any or all public places; however the essence of agoraphobia is a fear of panic attacks especially if they occur in public as the victim may feel like he or she has no escape and be very embarrassed of having one publicly in the first place. This translation is the reason for the common misconception that agoraphobia is a fear of open spaces, and is not clinically accurate. Agoraphobia is an anxiety disorder precipitated by the fear of having a symptom attack or panic attack in a setting from which there is no easy means of escape. ... Image File history File links Question_book-new. ... Anxiety disorder is a blanket term covering several different forms of abnormal, pathological anxiety, fears, phobias. ... Stoa of the ancient agora de Thessaloniki An agora (αγορά), translatable as marketplace, was a public space and an essential part of an ancient Greek polis or city-state. ... In Greek mythology, Phobos is one of the sons of Ares (Mars) and Aphrodite (Venus). ...

People who have had a panic attack in certain situations may develop irrational fears, called phobias, of these situations and begin to avoid them. Eventually, the pattern of avoidance and level of anxiety about another attack may reach the point where individuals with panic disorder are unable to drive or even step out of the house. At this stage, the person is said to have panic disorder with agoraphobia. This can be one of the most harmful side-effects of panic disorder as it can prevent sufferers from seeking treatment in the first place. It should be noted that upwards of 90% of agoraphobics achieve a full recovery. Agoraphobia is actually not a fear of certain places but a fear of having panic attacks in certain places. Agoraphobia is an anxiety disorder precipitated by the fear of having a symptom attack or panic attack in a setting from which there is no easy means of escape. ...

In its extreme form, agoraphobia and panic attacks can lead to a situation where people become housebound for numerous years (Barry 2006). In Japan this condition is coined and down-played as Hikikomori, as it is rather commonly perceived by the Japanese psychiatrists as a state of mere laziness and indulgent behaviour forgiven by the mercy of the sufferer's family. General perception amongst the Japanese are that Hikikomori sufferers are lazy freeloaders of the society. That means Japanese sufferers may not actually seek out treatment due to the negative connotation of the disorder and become more dependent on their families, thus resulting in a self-fulfilling prophecy of sorts. Hikikomori , lit. ... A self-fulfilling prophecy is a prediction that directly or indirectly causes itself to become true. ...

It is important to note that agoraphobia is by no means a hopeless situation. Sufferers often do not realize that they have experienced these same situations before and nothing terrible occurred. Successful treatment is possible with the right combination of therapy and medication.

Panic disorder

Main article: Panic Disorder

People who have repeated, persistent attacks or feel severe anxiety about having another attack are said to have Panic Disorder. Panic Disorder is strikingly different from other types of anxiety disorders in that panic attacks are often sudden and unprovoked.^[8] Panic Disorder is a psychiatric condition characterized by recurring panic attacks in combination with significant behavioral change or at least a month of ongoing worry about the implications or concern about having other attacks. ... Anxiety disorder is a blanket term covering several different forms of abnormal, pathological anxiety, fears, phobias. ... Panic is the primal urge to run and hide in the face of imminent danger. ...

In 1993 Jacob Markusson developed a technique he coined the POEM system, or Point Of Exit Methodology, whereby a patient focuses a pattern of thinking during the exit of the panic attack. The theory being that the sufferer can break the cycle of panic attacks and resume a panic-free life. The POEM system has been used effectively to give patients relief without the use of medication such as Paxil.

Treatment

People with Panic disorder often can be successfully treated with therapy, particularly Cognitive Behavioral Therapy and/or anti-anxiety medication or antidepressants.^[2] Panic Disorder is a psychiatric condition characterized by recurring panic attacks in combination with significant behavioral change or at least a month of ongoing worry about the implications or concern about having other attacks. ... A Cognitive Behavioral Therapy (CBT) is a psychotherapy based on modifying cognitions, assumptions, beliefs and behaviors, with the aim of influencing disturbed emotions. ...

Paper bag rebreathing

Some panic attack sufferers and even some doctors recommend breathing into a paper bag as an effective short-term treatment of an acute panic attack.^[9] This balances the ratio of oxygen and carbon dioxide in the blood. Too much oxygen and too little carbon dioxide, caused by breathing too fast or too deeply through the mouth, contributes to the chain reaction of symptoms that occur in a panic attack.

Medication

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The benzodiazepine class of drugs includes diazepam, lorazepam, alprazolam, and clonazepam. These drugs are highly effective and very fast acting in stopping panic. Image File history File links Question_book-new. ... Alprazolam 2 mg tablets The benzodiazepines (pronounced , often abbreviated to benzos) are a class of sedative hypnotic psychoactive drugs with varying hypnotic, sedative, anxiolytic, anticonvulsant, muscle relaxant and amnesic properties, which are mediated by slowing down the central nervous system. ... Diazepam (IPA: ), first marketed as Valium by Hoffmann-La Roche) is a benzodiazepine derivative drug. ... Lorazepam is a benzodiazepine tranquilizer with short to medium duration of action. ... Alprazolam, also known under the trade names Xanax and Niravam, is a short-acting drug in the benzodiazepine class used to treat severe anxiety disorders and as an adjunctive treatment for anxiety associated with clinical depression. ... Clonazepam (marketed by Roche under the trade-names Klonopin in the United States and Rivotril or Rivatril in Europe, South America, Canada, India, and Australia) is a drug which is a benzodiazepine derivative. ...

Some doctors may prefer to prescribe an antidepressant, particularly an SSRI (such as paroxetine, sertraline, fluvoxamine, escitalopram or fluoxetine), which after an initial titration period may be effective at reducing anxiety.^{[citation needed]} SNRIs such as Venlafaxine can also be prescribed. Studies^[specify] have proven they may be more effective than the SSRIs for anxiety.^{[citation needed]} NaSSAs such as Mirtazapine have also been found effective, particularly with individuals whose anxiety and panic causes insomnia.^{[citation needed]} SSRI is an acronym that stands for several things: It is a class of antidepressants called selective serotonin reuptake inhibitor SSRI also is used as the stock symbol for Silver Standard Resources Inc. ... Paroxetine (Paxil, Seroxat, Pexeva) is a selective serotonin reuptake inhibitor (SSRI) antidepressant. ... Zoloft bottles, with blue and green tablets Sertraline hydrochloride (also sold under brand names Zoloft, Lustral, Apo-Sertral, Asentra, Gladem, Serlift, Stimuloton, Xydep, Serlain, Concorz) is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. ... Fluvoxamine (brand name as Luvox®, Faverin®, Fevarin® and Dumyrox®) is an antidepressant which functions pharmacologically as a selective serotonin reuptake inhibitor. ... Escitalopram (trade names Lexapro, Cipralex) is the pure (S) enantiomer of citalopram and is a selective serotonin reuptake inhibitor (SSRI). ... Prozac redirects here. ... This article is about volumetric titration. ... Serotonin-norepinephrine reuptake inhibitors (SNRIs) are a class of antidepressant used in the treatment of clinical depression and other affective disorders. ... Venlafaxine (Effexor, Efexor) is an antidepressant of the serotonin-norepinephrine reuptake inhibitor (SNRI) class first introduced by Wyeth in 1993. ... Selective serotonin reuptake inhibitors (SSRIs) are a class of antidepressants for treating depression, anxiety disorders and some personality disorders. ... Noradrenergic and specific serotonergic antidepressants (abbreviated: NaSSAs) are a relatively new class of antidepressants. ... Mirtazapine is an antidepressant introduced by Organon International in 1994 used for the treatment of moderate to severe depression. ... This article is about the sleeping disorder. ...

Herbs

Some sufferers report that ingestion of Passion Flower (whether made into a tea or smoked) significantly relieves not only the symptoms of immediate attacks (abortive), but also acts as a prophylactic treatment as well (preventing an attack in the first place).^{[citation needed]} Species Passiflora amalocarpa Passiflora amethystina Passiflora aurantia Passiflora caerulea Passiflora capsularis Passiflora edulis Passiflora foetida Passiflora helleri Passiflora holosericea Passiflora incarnata Passiflora karwinskii Passiflora mucronata Passiflora murucuja Passiflora tenuifila Passiflora tulae Passiflora vitifolia Passiflora yucatanensis Passion flower refers to vines in the genus Passiflora—flowering plants known for their showy...

Treatment

All persons experiencing persistent and frequent panic attacks should consult their physicians. However, many experienced sufferers treat panic attacks with some the following methods and techniques: The word physician should not be confused with physicist, which means a scientist in the area of physics. ...

• Diaphragmatic Breathing or Abdominal Breathing — Breathing slowly through the nose using the diaphragm and abdomen. Do not breathe through the mouth. Focus on exhaling very slowly. This will correct or prevent an imbalance of oxygen to carbon dioxide in the blood stream.^[2]

• Taking anti-anxiety medication — to be used under the guidance and direction of a physician.

• Staying in the Present — rather than having "what if" thoughts that are future oriented asking yourself, "what is happening now" and "how do I wish to respond to it". (Carbonell 2004)

• Acceptance and Acknowledgement- accepting and acknowledging the panic attack. (Carbonell 2004)

• Floating with the symptoms — allowing time to pass and floating with the symptoms rather than trying to make them better or fighting them. (Carbonell 2004)

• Coping Statements — repeated as part of an internal monologue
  • "No one has ever died from an anxiety attack."
  • "I will let my body do its thing. This will pass."
  • "I can be anxious and still deal with this situation."
  • "This does not feel great, but I can deal with it".^[2]

• Talking with a supportive person — someone who has experienced true panic attacks personally; someone who is highly trained in treating panic attacks; loved ones who can offer support and comfort.

• One particularly helpful and effective form of therapy is Cognitive Behavioral Therapy (CBT). This is the most generally accepted method of treatment^{[citation needed]}.

For other uses, see Doctor. ... A Cognitive Behavioral Therapy (CBT) is a psychotherapy based on modifying cognitions, assumptions, beliefs and behaviors, with the aim of influencing disturbed emotions. ...

Interoceptive desensitization/symptom inductions

Another form of treatment is 'Interoceptive Desensitization which intends to desensitize the afflicted from the symptoms of panic attacks. In a study by Barlow & Craske (1989), 87% of the individuals that participated in the two of four treatments that involved Interoceptive Desensitization were free of panic at the end of treatment and these results were maintained at a 2-year follow up. In controlled studies of Interoceptive Desensitization treatments compared to other treatments, those treatments that included Interoceptive Desensitization were found to be significantly superior to other treatments such as muscle relaxation alone, or education or insight-oriented treatments. Interoceptive Desensitization often leads to a dramatic reduction in the frequency and intensity of panic attacks and as such should be implemented immediately under the guidance of a mental health professional. It is important the patient is given medical clearance and permission from a medical doctor before attempting these exercises. The key to the induction is that the exercises should mimic the most frightening symptoms of a panic attack. Symptom Inductions should be repeated 3-5 times per day until the patient has little to no anxiety in relation to the symptoms that were induced. Often it will take a period of weeks for the afflicted to feel no anxiety in relation to the induced symptoms. With repeated trials, a person learns through experience that these internal sensations do not need to be feared – the individual becomes less sensitized or desensitized to the internal sensation. After repeated trials, when nothing catastrophic happens, the brain learns (hippocampus & amygdala) to not fear the sensations, and the sympathetic nervous system activation fades. Many people overcome Panic Disorder and sudden Panic Attacks on their own. It takes time, but in a sense, they ride out the panic attacks and eventually learn that nothing is going to happen during one. Often, they 'taper off' until they are not noticeable any longer. It is for this reason that some psychologists helping people with panic disorders induce them into an attack, so they can see for themselves that indeed, nothing will happen. See: Sensitivity (electronics) Sensitivity (human) Sensitivity (tests) For sensitivity in finance, see beta coefficient This is a disambiguation page — a navigational aid which lists other pages that might otherwise share the same title. ... A mental health professional is a person who offers services for the purpose of improving an individuals mental health and/or researches in the field of mental health. ... The word physician should not be confused with physicist, which means a scientist in the area of physics. ... For other uses, see Hippocampus (disambiguation). ... This article is about part of the human brain. ... The Sympathetic Nervous System (SNS) is a branch of the autonomic nervous system. ...

Increased risk of heart attack and stroke

A recent study suggests that menopausal women with panic disorder and many occurrences of panic attacks have a threefold higher risk of suffering heart attack or stroke over the next five years. The researchers believe that panic attacks or more accurately their associated symptoms (chest pain, dyspnea) can be manifestations of undiagnosed cardiovascular disease, or result in heart damage due to cardiovascular stress in patients with panic disorder and many panic attacks over periods of years.^[10] The study did not find that isolated cases of panic attacks in patients without panic disorder or agoraphobia lead to immediate heart damage, nor did it prove that the correlation between panic disorder and strokes was causal, or that it couldn't be attributed to the cardiovascular effects of medication that many panic disorder patients receive, such as SSRIs and benzodiazepines. Menopause (also known as the Change of life or climacteric) is a stage of the human female reproductive cycle that occurs as the ovaries stop producing estrogen, causing the reproductive system to gradually shut down. ... Image of a woman on the Pioneer plaque sent to outer space. ... A myocardial infarction occurs when an atherosclerotic plaque slowly builds up in the inner lining of a coronary artery and then suddenly ruptures, totally occluding the artery and preventing blood flow downstream. ... For other uses, see Stroke (disambiguation). ... In medicine, chest pain is a symptom of a number of conditions and is generally considered a medical emergency, unless the patient is a known angina pectoris sufferer and the symptoms are familiar (appearing at exertion and resolving at rest, known as stable angina). When the chest pain is not... Dyspnea (R06. ... Panic Disorder is a psychiatric condition characterized by recurring panic attacks in combination with significant behavioral change or at least a month of ongoing worry about the implications or concern about having other attacks. ... Agoraphobia is an anxiety disorder precipitated by the fear of having a symptom attack or panic attack in a setting from which there is no easy means of escape. ... SSRI is an acronym that stands for several things: It is a class of antidepressants called selective serotonin reuptake inhibitor SSRI also is used as the stock symbol for Silver Standard Resources Inc. ... Benzodiazepine tablets The benzodiazepines are a class of drugs with hypnotic, anxiolytic, anticonvulsant, amnestic and muscle relaxant properties. ...

Limited symptom attack

Many people being treated for panic attacks begin to experience limited symptom attacks. These panic attacks are less comprehensive with fewer than 4 bodily symptoms being experienced.^[2] Limited Symptom Attack (Limited Symptom Panic Attack or LPA/LSA) denotes a milder, less comprehensive panic attack with less than 4 panic related symptoms being experienced (APA 1994). ...

References

External links

• No More Panic UK based website for sufferers of panic attacks
• Anxiety Disorders Association of America Information for families, clinicians and researchers
• American Psychological Association: Answers to Your Questions About Panic Disorder
• US Surgeon General
• Quiz: Did I Have a Panic Attack?
• http://www.nopanic.org.uk/