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Panic Attacks can occur at random and without any advance warning. They are very distressing to the sufferer and can be difficult to cope with. One minute the sufferer can be at ease and the next minute they are in the throes of blind terror. Many sufferers describe such intense feelings that they feared that they were going to die.

A key element in the genesis of a panic attack is the thought: 'what if I lose control here'? It has been described as a first fear followed by a second fear. The first fear is a collection of symptoms of which the person suddenly becomes aware. The symptoms are listed in a later paragraph. The second fear is a reaction to the first fear.

There are several reasons offered for the triggering of the second fear. It may be fear of suffocation or imminent death. The second fear escalates rapidly and feeds back into increasing the level of the initial symptoms. The symptoms increase like a snowball rolling down a hill resulting in the avalanche of full-blown panic

What are the symptoms?

The essential feature of a panic attack is an intense fear or discomfort accompanied by a variety of physical or psychological symptoms. The attack is sudden in onset and usually peaks within ten minutes. Sufferers describe feelings of imminent danger or impending doom and feel an urgent need to escape.

The accompanying symptoms include palpitations, sweating, trembling, discomfort, nausea, dizziness or light-headedness, fear of dying, pins and needles, and hot flushes and chills. The majority of sufferers describe an intense fear of losing control.

Why does it happen?

Panic disorder is a broad umbrella label applied to a wide variety of conditions having very different origins, outcomes and treatment strategies. Distinct causes of PD include:

  • Prolonged stress

  • Obsessive thought patterns.

  • Phobias.

  • Poor breathing habits of physical or psychological origin.

  • Emotional turmoil.

  • Separation anxiety.

There are a number of conditions associated with panic attacks, which may be instrumental in causing the attacks, or they may simply co-exist.  They include the following:

  • Alcohol abuse.

  • Depression.

  • Sexual dysfunction.

  • Oesophageal reflux.

  • Irritable bowel syndrome.

  • Chronic fatigue syndrome.

  • Fibromyalgia.

  • Endocrine disorders, especially of the thyroid gland.

  • Disturbances of circadian rhythm (e.g. shift workers).

  • Allergic reactions.

The hormonal changes associated with the menopause can produce such a degree of symptom overload that some women experience panic attacks for the first time during this phase of change. In some cases it is the panic attack itself that generates the need for a medical consultation.

Researchers are also focussing on the possible role of excessive caffeine consumption in the triggering of panic attacks.

There is no "one size fits all" treatment for panic attacks. Each case is treated on its own individual merit.

** With thanks to

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