Panic attack

Definition

Panic attacks, the hallmark of panic disorder, are discrete episodes of intense anxiety. Panic attacks can also be experienced by people with specific phobia, social phobia, or by people who have used or consumed certain substances, such as cocaine.

Description

Panic attacks are intense anxiety experiences that are usually accompanied by symptoms in the affected person's body and thinking. The panic attack can occur unexpectedly during early stages of panic disorder illness. As panic disorder progresses, panic attacks may become associated with certain situations that trigger attacks. Panic attacks triggered by a specific experience are called situational panic attacks, since a certain situation initiates the intense anxiety.

Persons affected with panic attacks usually exhibit a broad range of clinical signs and symptoms that include:

• heart palpitations (accelerated heart rate)
• shaking or trembling
• sweating
• shortness of breath or sensation of feeling smothered or choked
• feeling of tingling
• chest discomfort or pain
• nausea or abdominal distress
• feeling dizzy, light headed, unsteady or faint
• perceptions of being detached from oneself (depersonalization), or a feeling out of touch with reality (derealization)
• chills or hot flashes
• fear of dying
• fear of going crazy or losing control

A person meets the criteria for a panic attack if the symptoms start abruptly, reach a quick peak (usually within 10 minutes), and if the affected individual has at least four symptoms as listed above. In persons who have less than four symptoms during an attack, the disorder is called a limited symptom attack.

It is typical that affected persons who seek treatment usually have one to two attacks a week and in worse periods may have one daily attacks or several within a week.

As stated, panic attacks can be experienced as a result of stimulant chemical usage, such as cocaine usage. There is evidence to suggest that persons with panic attacks are sensitive to certain chemicals such as caffeine, carbon dioxide, antihistamines, and, in women, progesterone replacement. Exposure to these substances may precipitate an attack.

BOOKS

Rakel, Robert E. Conn's Current Therapy.54th ed. Philadelphia: W. B. Saunders Company, 2002.

Tasman, Allan. Psychiatry.1st ed. Philadelphia: W. B. Saunders Company, 1997.

Laith Farid Gulli, M.D. Jean Suvan, B.S., RDH