Panic Attacks represent an abrupt surge of intense fear, discomfort or anxiety peaking in intensity within minutes and manifest by physical symptoms. Primary manifestations of Panic Attacks include a racing heart beat or palpitations, trembling or shaking and nausea or a feeling of abdominal distress. Other common symptoms are lightheadedness, feeling faint and chills or a hot sensation sometimes associated with tingling of the extremities. Feelings of unreality or being detached from oneself and fear of losing control and dying round out the list of major complaints associated with Panic Attacks.
The frequency of Panic Attacks can vary from several times daily to only a few attacks during the year. Panic Attacks generally begin without warning but more careful probing finds some autonomic system arousal up to an hour before symptoms begin.
Nearly 1-3% of the general population may experience Panic Attacks with the number growing to 3-8% among patients in a general practice setting. Peak age of onset is bimodal with adolescents and young adults primarily targeted with another spike among individuals in their mid-30s.
Panic Attacks generally last between 20-30 minutes but at times may persist for several hours. They may also occur during sleep. Diagnosis of Panic Attacks may be delayed for years as patients and doctors futility search for an underlying physical cause for the symptoms.
Panic Disorder requires recurrent Panic Attacks followed by at least a month of persistent concern that another one will occur. Additionally the individual changes their behavior to avoid situations they believe precipitated the previous attacks. Similar symptoms may involve fear of heights, spiders and snakes. Posttraumatic Stress Disorder may display overlapping complaints.
Many individuals experiencing Panic Attack also fulfill the diagnostic criteria for depression, anxiety or bipolar disorder. They may abuse illicit drugs or suffer a personality disorder. Anxiety Attacks are not a specific disease but refer to symptoms much less intense than associated with Panic Attacks.
Treatment may include psychotherapy or antidepressants in the SSRI family including Celexa, Prozac, Zoloft. Although much maligned, benzodiazepines including Klonopin, Alprazolam and Lorazepam may be additionally required.