Ask the Doctor: Panic Attacks

Question: “What is a panic attack”?
Panic attacks are basically sudden attacks of fear.  They may last from 10 to 15 minutes or so. Symptoms associated with fear can be physical, such as shortness of breath, rapid and pounding heartbeats, sweating, trembling and/or having hot or cold flashes.  They can also be psychological, such as thinking you will lose control or are about to die.

Carmen McIntyre
Dr. Carmen McIntyre

Panic disorder is when the panic attacks are creating difficulty in functioning in your day-to-day life. What sets panic attacks apart from other fear reactions is that they come on suddenly, often for no reason, and are limited in duration.
If you are afraid during an earthquake or when being robbed, this makes sense.  Anyone would understand why you might be afraid, and the fear may go away once the situation is over.   If you have an unreasonable amount of fear only in specific circumstances, such as being around spiders, you have a phobia.   Panic attacks, however, can be very disabling because they seem uncontrollable.
What causes panic attacks?  For many people, it is likely that there is an imbalance in the nervous system that makes people more prone to set off physical symptoms associated with fear, such as the rapid heart rate or temperature flashes.   Some people may also have chemical imbalances that trigger the fear reactions.  For example, improper breathing can lead to poor oxygen exchange, which makes it easier to have a panic attack.  There is also a psychological aspect to panic disorder.   Many people have these physical symptoms, but not everyone is bothered by them.
Some people worry about the physical sensations that they have. When they worry, they are afraid, and that may trigger more attacks. Panic attacks may be treated with therapy, medications, or a combination of the two.  In therapy, the patient learns relaxation techniques such as proper breathing, as well as controlling the distorted thoughts that he or she may have when the panic attack is occurring.  For example, having a panic attack does not mean you are having a heart attack or dying.
Medications used to treat the underlying causes of panic attacks are often the same used for depression, such as Prozac (fluoxetine) or Zoloft (sertraline).  Abruptly stopping these medications, or abruptly increasing the dosage, can cause a temporary imbalance which may trigger panic attacks.   Occasionally, medications that prevent or mask symptoms of anxiety are used to treat panic attacks. These medications, however, can lead to addiction and other side effects, so they are best used only for a short time.
Dr. Carmen McIntyre is the chief medical officer at the Detroit Wayne Mental Health Authority. She is committed to ensuring that the Authority meets the mental health needs of those with substance use disorders, children with serious emo- tional disturbance, mental illness, and persons with intellectual and/ or developmental disorders in Wayne County. 

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