Panic attacks can be terrifying. Even if you have had them before.
If you have had one, then you know worrying about the next one can be debilitating. What if your at work, or need to drive the kids home, at home alone, etc.
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Panic Attack Symptoms
People with panic disorder have recurrent unexpected panic attacks, which are sudden periods of intense fear that may include palpitations, pounding heart, or accelerated heart rate; sweating; trembling or shaking; sensations of shortness of breath, smothering, or choking; and feeling of impending doom.
Panic disorder symptoms include:
- Sudden and repeated attacks of intense fear
- Feelings of being out of control during a panic attack
- Intense worries about when the next attack will happen
- Fear or avoidance of places where panic attacks have occurred in the past
- Abdominal distress (diarrhea, nausea)
- Chest pain or discomfort
- Chills or hot flashes
- Fear of dying
- Fear of losing control or going crazy
- Feeling faint, dizzy, lightheaded, unsteady
- Feeling of choking
- Feeling of unreality or of being detached from oneself
- Numbness or tingling sensations
- Palpitations, pounding heart, racing heartbeat
- Shortness of breath, feeling smothered
- Trembling or shaking
National Institute of Mental Health
Diagnostic and Statistical Manual of Psychiatric Disorders, 5th ed
Panic Attack Risk Factors
Researchers are finding that genetic and environmental factors, frequently in interaction with one another, are risk factors for anxiety disorders. Specific factors include:
- Shyness, or behavioral inhibition, in childhood
- Being female
- Having few economic resources
- Exposure to stressful life events in childhood and adulthood
- Anxiety disorders in close biological relatives
- Parental history of mental disorders
- Elevated afternoon cortisol levels in the saliva (specifically for social anxiety disorder)
- Major life stress, such as the death or serious illness of a loved one
- A traumatic event, such as sexual assault or a serious accident
- Major changes in your life, such as a divorce or the addition of a baby
- Smoking or excessive caffeine intake
- History of childhood physical or sexual abuse
National Institute of Mental Health
Causes of Panic Attacks (Disorder)
There are two types of theories about what causes panic disorder: biological and behavioral.
Biological theories are based on the idea that the brain has a natural alarm system that somehow malfunctions because of genetic or environmental circumstances, causing panic. All parts of the brain are intricately connected and are intricately interactive, so it is likely that, if the biological theories prove to be correct, more than one area would be affected in patients with panic disorder.
Currently, four areas of the brain are under investigation: the locus ceruleus, gamma-aminobutyric acid (GABA), septohippocampal interactions, and the ventrumedulla.
- The locus ceruleus is a cluster or nerves in the brain stem that produces and uses the neurotransmitter norepinephrine. The locus ceruleus nerves are activated during states of heightened vigilance and release norepinephrine into many areas of the brain.
- GABA neurons play important roles in the hypothalamus and the brain stem. Low levels of GABA may produce symptoms such as sweating, hypertension, tachycardia, and shortness of breath.
- Septohippocampal interactions involve neurons that connect the septal area of the brain to the hippocampus. There are many cells in the hippocampus that produce and use GABA. A substantial number of locus ceruleus cells that produce norepinephrine also connect to the hippocampus.
- Regulation of heart function is centered in the ventromedulla (part of the brain stem). When stress or exercise stimulates the hypothalamus, a signal is sent to the medulla to stimulate the cardiac nerves to increase the number of heartbeats per minute. Any dysfunction of the hypothalamus or medulla could produce some of the cardiac symptoms of a panic attack (e.g., rapid heart rate, palpitations).
Behavioral Theories focus on the nature of panic attack as an irrational response to a non-threatening stimulus. These theories hold that once the cause is identified and analyzed rationally, the person can learn to respond normally to the situation or trigger that causes panic.
- Mitral valve prolapse, a minor cardiac problem that occurs when one of the heart’s valves doesn’t close correctly
- Hyperthyroidism (overactive thyroid gland)
- Hypoglycemia (low blood sugar)
- Stimulant use (amphetamines, cocaine, caffeine)
- Medication withdrawal
Prescription Treatments for Panic Attacks (Disorders)
Medicines used most often to treat panic attacks include:
- Antidepressants, such as Paxil, Prozac, or Zoloft.
- Benzodiazepines, such as Ativan, Valium, or Xanax.
Medicines sometimes used to treat panic disorder include:
- Antidepressants, such as Anafranil, Norpramin, and Tofranil.
- Antidepressants with mixed neurotransmitter effects, such as Effexor.
- Monoamine oxidase inhibitors (MAOIs), such as Marplan, Nardil, or Parnate.
Get the program for the best self help. Why go through endless therapy and a trial and error method of finding the right prescription medication and still be no better. Or do a quick search of the internet will reveal all manner of techniques that range from somewhat effective to not helpful at all. If your here, it is likely you have tried all the home remedies and found them lacking. You need a technique that works and will keep you out of emergency rooms.
That is a lot of general information, when you go through withdrawal, your anxiety is going to go into overdrive. My withdrawal was just slightly less than a full blown panic attack. You will likely experience the same thing.
But your physical reactions will be real because your autonomic nervous system will be going full blast. The magic tricks won’t work. See my post on alcohol withdrawal and pay close attention to hyperarousal. Then you will also have to fight the emotional and intellectual anxiety tearing through your brain (it will help a little here). But not much. Your body is going to be run down, your electrolytes are going to be screwed up. Your neurotransmitters are going to be a mess because of all the booze. Expect the worst if you already have anxiety problems.
Anxiety was one of the main reasons I quit drinking. It just got to be too much. I would keep drinking because I did not want to deal with all the anxiety. Physical pain is easier, at least for me, to deal with than emotional pain. But I have all manner of mental health issues. Depression, anxiety, OCD, etc. That is what caused me to drink enough to become a drunk.
See the Addiction video to the left for more on this. If your trying to quit drinking this is the way to do it. This way works. See my Stop Drinking Alcohol post and watch the video.