Panic attacks

If we were to face an unfamiliar situation, or something that makes us feel uncomfortable, we may feel nervous and frightened. This is because our brains are hardwired to respond to a real or perceived threat and prepares us for flight or fight. A panic attack is an exaggeration of this normal reaction, resulting in a sudden surge of overwhelming anxiety and fear. Panic attacks often happen out of the blue with no warning and reason to explain it. They can occur at any time of the day, sometimes even when you are sleeping. A panic attack can be a one off incident but many people have several episodes and it can also be a repetitive feature. Recurrent attacks are usually triggered by specific situations like using public transport, crowded situations or enclosed spaces, situations that are not easy to escape from. Panic attacks sometimes occurs as a part of another disorder, like depression, panic disorder or agoraphobia.


The signs and symptoms come on suddenly and reach a peak within 10 minutes and usually last for about half an hour or so before fading away.

The common symptoms are

  • Pounding of the heart
  • Difficulty in breathing
  • Chest pain or discomfort
  • Shaking
  • Light-headedness
  • Sweating
  • Nausea
  • Numbness and tingling
  • Feeling unreal and detached from surroundings
  • A fear of losing control, of having a heart attack, of dying or going mad

Some people who have panic attacks develop panic disorder, characterised by recurrent episodes of panic attacks, worrying about having panic attacks called anticipatory anxiety, and avoiding situations which have triggered panic attacks in the past.

Who is at risk

People with anxiety, depression and those who have had panic attacks in the past are more likely to get them. They can occur, when people go through stress or major life events. Panic attacks can also be related to physical conditions like overactive thyroid glands, low blood sugar, and alcohol and drug misuse and withdrawal from medication.


Panic attacks are treatable conditions. Self help strategies, psychological treatment, and medication are all helpful and when used in combination are very effective. It is very important to understand the fight flight response to real and perceived threat. The physical symptoms are a part of this response, but they are frightening because they make you feel out of control, and this fear produces more anxiety and you get into a vicious cycle. It is important to break this cycle. General measures like physical exercise, distracting yourself, listening to music, talking to someone you trust, and breathing exercises can be helpful. Reducing your alcohol and caffeine intake is also beneficial.

What type of treatment you require depends on how often you get the attacks, how bad they are and how it affects your life. Therefore, it is important to have an assessment to decide what treatment is best for you.

Cognitive Behaviour Therapy is proven to be helpful, it involves talking through your problems, to understand how your thoughts can have an impact on your feelings and behaviour.

By working together with an expert, you can learn to alter these negative thought patterns which would have a positive impact on your feelings. Medication can also be helpful. These help to restore the imbalance of chemicals in your brain which are responsible for your symptoms. Different types of medication are used for anxiety, some give short term relief, others give sustained relief, the expert will discuss the options with you and help you to decide what is best for you. A combination of these treatments is often the best way forward.

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