Panic attacks and panic disorder

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Symptoms

By Mayo Clinic staff

Panic attacks typically begin suddenly, without warning. They can strike at almost any time — when you're driving the car, at the mall, sound asleep or in the middle of a business meeting. Panic attacks have many variations, but symptoms usually peak within 10 minutes. You may feel fatigued and worn out after a panic attack subsides.

Panic attacks typically include a few or many of these symptoms:

  • Sense of impending doom or danger
  • Fear of loss of control or death
  • Rapid heart rate
  • Sweating
  • Trembling
  • Shortness of breath
  • Hyperventilation
  • Chills
  • Hot flashes
  • Nausea
  • Abdominal cramping
  • Chest pain
  • Headache
  • Dizziness
  • Faintness
  • Tightness in your throat
  • Trouble swallowing

One of the worst things about panic attacks is the intense fear that you'll have another one. You may fear having a panic attack so much that you avoid situations where they may occur. You may even feel unable to leave your home (agoraphobia) because no place feels safe.

When to see a doctor
If you have any panic attack symptoms, seek medical help as soon as possible. Panic attacks are hard to manage on your own, and they may get worse without treatment. And because panic attack symptoms can also resemble other serious health problems, such as a heart attack, it's important to get evaluated by your health care provider if you aren't sure what's causing your symptoms.

References
  1. Panic attack. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed March 6, 2012.
  2. Hales RE, et al. The American Psychiatric Publishing Textbook of Psychiatry. 5th ed. Washington, D.C.: American Psychiatric Association; 2008. Accessed March 7, 2012.
  3. Panic disorder. National Institute of Mental Health. http://www.nimh.nih.gov/health/publications/anxiety-disorders/panic-disorder.shtml. Accessed March 6, 2012.
  4. Answers to your questions about panic disorder. American Psychological Association. http://www.apa.org/topics/anxiety/panic-disorder.aspx. Accessed March 6, 2012.
  5. Practice guideline for the treatment of panic disorder, Second edition. Arlington, Va.: American Psychiatric Association. http://psychiatryonline.org/content.aspx?bookid=28&sectionid=1680635. Accessed March 6, 2012.
  6. Inositol. National Medicines Comprehensive Database. http://naturaldatabase.com. Accessed Feb. 20, 2012.
  7. Smits JA, et al. The interplay between physical activity and anxiety sensitivity in fearful responding to carbon dioxide challenge. Psychosomatic Medicine. 2011;6:498.
  8. Saeed SA, et al. Exercise, yoga and meditation for depressive and anxiety disorders. American Family Physician. 2010;8:981.
  9. Panic disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed March 6, 2012.
  10. Katon W, et al. Panic disorder: Epidemiology, clinical manifestations, and diagnosis. http://www.uptodate.com/index. Accessed March 7, 2012.
  11. Roy-Byrne PP. Pharmacotherapy for panic disorder. http://www.uptodate.com/index. Accessed March 7, 2012.
  12. Whiteside SP (expert opinion). Mayo Clinic, Rochester, Minn. April 24, 2012.
  13. Moore KM (expert opinion). Mayo Clinic, Rochester, Minn. May 17, 2012.
  14. Fluoxetine (Prozac, Prozac Weekly), paroxetine (Paxil, Paxil CR, Pexeva) and sertraline (Zoloft), alprazolam (Xanax), clonazepam (Klonopin) and lorazepam (Ativan). Micromedex Healthcare Series. http://www.micromedex.com. Accessed March 8, 2012 and May 23, 2012.
DS00338 May 31, 2012

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