Panic attacks are severe enough to derail normal life
DEAR DOCTOR: Could you explain panic attacks? I never knew what people were talking about until a few months ago, while sitting at the computer. I felt as if I had stopped breathing; I thought I was dying. I ended up in the ER, but no problems were found.
DEAR READER: Panic attacks are truly a scary experience, especially if you’ve never had them before. Many of the symptoms are similar to those of a heart attack, causing people to seek immediate attention in an urgent care department or emergency room. The symptoms, which develop suddenly, can include chest pain, heart palpitations, sweating, nausea, shortness of breath, lightheadedness and, for many, the feeling that they’re going to die.
Such attacks are surprisingly common. Onethird of people have at least one panic attack
during their lifetime. Those who experience recurrent panic attacks not related to generalized anxiety, depression, obsessive-compulsive disorder or post-traumatic stress disorder have what is termed panic disorder. People with panic disorder have a persistent worry about having another panic attack and the consequences of future attacks. Panic disorder affects nearly 3 percent of the population, ages 15 to 54.
People with panic disorder often report an increase in stressful life events over the past year and, even more often, within the past month. Genetic factors also play a role. A person who has a first-degree family member with panic disorder is three times more likely to develop
the disorder compared to people without such a tie. Further, an identical twin is five times more likely to have anxiety and panic if his or her twin has the disorder.
Panic attacks can also be precipitated by stimulants such as caffeine, cocaine and amphetamine as well as withdrawal from alcohol, opiates or benzodiazepines like Valium, Ativan and Xanax.
Cognitive behavioral therapy shows the greatest sustained benefit in stopping panic attacks, because it can alter the underlying brain responses. Selective serotonin reuptake inhibitor medications also can help.
Robert Ashley, M.D., is an internist and assistant professor of medicine at the University of California, Los Angeles.