Panic attacks are unmistakable. You're involved in some ordinary aspect of life when suddenly your heart begins to pound and you hyperventilate, sweat, and tremble. You fear you are having a heart attack, going crazy, or even dying. Then, 10 minutes or so later, it's gone. What just happened? You have had a panic attack.
Panic attacks are fairly common, usually beginning between ages 15 and 25. If you have recurrent panic attacks, a persistent fear of subsequent attacks occurring, or if you change your behavior significantly because of such attacks, you have panic disorder, which affects nearly 1 in 20 adults according to the National Institute of Mental Health. Between attacks, sufferers live in dread of the next one.
When Dorothea Lack was a little girl, she hid under a doctor's desk to avoid a vaccination. Undaunted, the doctor crawled under the desk and vaccinated her then and there. Lack said the incident provoked a fear of doctors that followed her into adulthood. "I didn't feel I could trust them," says Lack, PhD, now a psychologist who performs research on doctor-patient relations.
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Many people with panic disorder relate an attack to what they were doing when it occurred. They may assume that the restaurant, elevator, or classroom caused the attack, and decide to avoid that situation. In these cases, panic disorder may lead to agoraphobia -- the fear of leaving home or being in public places.
What Causes Panic Attacks?
The underlying cause of panic attacks and panic disorder is not clear. There is evidence of both a genetic and a biochemical basis. Some researchers believe that panic disorder may result from an oversensitivity in the brain to carbon dioxide and the triggering of a suffocation “false alarm” in the brain, leading to hyperventilation and panic. There is also an association between panic attacks and phobias, such as school phobia or agoraphobia, as well as with depression, alcohol abuse or cigarette smoking, suicide risk, and seasonal affective disorder -- a type of depression that occurs during winter months.
Panic disorder may begin after a serious illness or accident, the death of a close friend, separation from the family, or the birth of a baby. Attacks may also accompany the use of mind-altering drugs. Most often, however, a panic attack comes "out of the blue." It may even begin during sleep.
Some medical problems and medications can cause panic attacks, including some antidepressants. Panic disorder that begins after age 40 suggests depression or another underlying medical disorder.