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"Oh my God! My heartbeat is racing, I think I'm having a heart attack! I'm light headed, I'm going to faint. I'm going to die! " Wrong.

These are just some of the symptoms of panic attacks. The etiology of this condition is still unknown but it is believed that the symptoms are due to hyperactivity and overproduction of a hormone called adrenaline. This hormone is responsible for the "fight or flight" response.

Panic attacks are very sudden, discrete periods of intense anxiety or fear, in which, according to the DSM (Diagnostics & Statistical Manual) IV Criteria, 4 or more of 13 defined symptoms develop abruptly and peak rapidly less than 10 minutes from symptoms onset.

The DSM-IV delineates the following potential symptom manifestations of a panic attack:

Palpitations, pounding heart, or accelerated heart rate

Sweating

Trembling or shaking

Sense of shortness of breath or smothering

Feeling of choking

Chest pain or discomfort

Nausea or abdominal distress

Feeling dizzy, unsteady, lightheaded, or faint

Derealization or depersonalization (feeling detached from oneself)

Fear of losing control or going crazy

Fear of dying

Numbness or tingling sensations

Chills or hot flashes

Roger Tilton, Ph.D., a Psychologist who specializes in Cognitive Behavior Therapy,

defined a panic attack as "nothing more than bodily sensations of anxiety and a

catastrophic misinterpretation of those sensations as dangerous."

Thus, an accelerated heart rate may lead one to believe that he is having a heart attack, When in fact this is one of the body's natural mechanism in a fight or flight response.

Fainting or syncope, according to emedicine, is caused by a cessation of cerebral perfusion (flow of blood to the brain) lasting only 3 to 5 seconds. However, going back to the same principles stated above, adrenaline causes increased heart rate and blood pressure, making syncope, an impossibility.

The symptoms stated above such as palpitations, shortness of breath, or chest pains may mimic severe symptoms of a heart attack. A panic attack never cause death even in severe manifestations.

How to go about with the treatment?

Understanding is a stepping stone to overcome panic attacks. The more you learn about the condition, the closer you are to finding the solution.

Medications such as tranquilizers (the benzodiazepine group of drugs) and antidepressants (SNRI and SSRI) are both helpful in controlling the symptoms of panic attacks, however, they have the risk of dependency and other side effects.

Dr. Tilton gave two basic approaches: Identifying sensations and thoughts and coming up with an alternative explanation.

Identifying sensations and thoughts

The symptoms experience and the catastrophic thoughts that accompany these sensations are bodily functions. You must delineate the sensations from thoughts.

Come up with an alternative explanation

As soon as you recognize these sensations, you would be able to give an alternative explanation for the catastrophic thought which you first accepted.

It would be more helpful to write down these scenarios in a journal to better rationalize the events and be more objective in your analysis. An example is palpitations. "I have a fast heart rate!" (Sensation). "I'm having a heart attack!" (Catastrophic thought). "My heart beats fast because I am having a panic attack." (Alternative Explanation)

The next time you recognize a panic attack. Stop what you are doing. Focus. Get your pen and journal and be ready to write down your sensation and an alternative explanation.

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