As I leaned in, thirty-year-old Jim related his recent striking experience: “I’m sitting at my desk at work, when all of a sudden my heart starts pounding out of my chest for no good reason. I’m thinking I’m having a heart attack. My chest starts hurting and I get short of breath and lightheaded. Then my fingers and around my mouth start tingling. By this time, I’m so scared my co-workers dialed 911. The frustrating thing is, at the hospital all the tests are normal. They say my heart and lungs seem fine… that I must have had a panic attack. Ever since then I keep getting anxious off and on at work. I’m afraid it’s all going to happen again, or I’m just going to lose my mind next time.”
Jim’s description pulls together some of the symptoms and feelings one might experience while having a panic attack. Panic disorder is one of the dozen or so recognized anxiety disorders. With over 40 million Americans suffering from them, anxiety disorders are considered the most common mental health maladies.
Panic disorder is a type of anxiety disorder in which a person has repeated attacks of intense fear that something bad is about to happen. The cause is unknown but it is a bit more common if it runs in your family. Panic disorder is also twice as common in women as in men. Usually symptoms begin before age 25, but sometimes not until one’s mid-30s. At times, even children can have panic disorder.
Panic attacks tend to strike rather suddenly and symptoms usually reach a peak in about 10 minutes and then may last up to an hour or so. To fit the criteria, a panic attack will include at least 4 of the following symptoms:
- trembling or shaking
- shortness of breath
- feeling of choking
- chest pain or discomfort
- nausea or abdominal distress
- dizziness or lightheadedness
- feelings of detachment or unreality
- fear of losing control or going crazy
- fear of dying
- numbness or tingling
- chills or hot flashes
Not a pleasant list of symptoms to experience. Also at least one of the attacks is followed by one month or more of either persistent concern about having additional attacks or worry about the consequences of another attack (like going crazy or really having a heart attack), or a significant change of behavior related to the attacks.
These unpredictable, frightening, and embarrassing episodes sometimes cause folks to more and more pull back from their normal activities. Some sufferers end up barely able to leave the house.
So what can you do about them? While there is no quick cure for panic attacks, there is much that can help. See your doctor about them and they can first make sure your symptoms aren’t from something else like heart disease, thyroid disease or one of a few other mimickers. If your symptoms really do point to panic disorder, there are several treatment choices, including appropriate counseling and possibly, meds – options include both those that treat you at the moment of the attack and those that, when taken regularly, can help prevent the attacks altogether, or at least reduce them.
All this often takes some patience as one approach doesn’t fit everybody. But it’s worth the effort to keep this frightening but non-deadly specter from haunting your thoughts and shrinking the boundaries of your life.
Andrew Smith, MD is board-certified in Family Medicine and practices at 1503 East Lamar Alexander Parkway, Maryville. He is contracted with some commercial insurance carriers and sees Direct Primary Care patients who do not have insurance, who belong to a cost sharing ministry, or who are on Medicare. He is accepting new patients. You may contact him at 982-0835