The Truth Behind Panic Attacks

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Why Some People Get Attacks

"Catastrophic personal or professional trauma or loss, especially when it's unexpected, is often behind panic attacks, and life is throwing these curveballs at a lot of people right now," says Eva Ritvo, MD, associate professor of psychiatry at the University of Miami Miller School of Medicine. That was true for Mary Lukens: She was returning to her Piermont, New York, home after visiting an aunt who'd recently had a stroke. "You may think you're having a heart attack or going crazy," says Dr. Ritvo. "It's important to recognize you're not -- you're having a panic attack.

Since everyone experiences stress and loss, why do some people fall prey to these attacks while others never experience one? Up to 40 percent of our susceptibility to panic disorder can be attributed to our genetic makeup. There may even be a brain difference. The evidence comes from research on general anxiety disorder, a related problem. When people with GAD were asked to anticipate a non-frightening event, their brain's fear centers still fired, says lead study author Jack B. Nitschke, PhD, assistant professor of psychiatry and psychology at the University of Wisconsin-Madison. Non-anxious people, however, didn't have the same fear reaction.

The problem is, unless these attacks run in your family, there's no way to know if you might be predisposed. "It doesn't matter how healthy and strong you think you are," Dr. Ritvo says. She would know: Last fall she herself had a half dozen panic attacks when she was going through a divorce and the shutdown of her hospital department. "It's important to know they can be successfully treated," she says.

The symptoms of a panic attack mimic those of some serious illnesses, so you need to rule out other causes, including heart attack, especially if it's your first episode, says Dr. Kiriakos. Call 911 or go to the ER or your doctor's office for immediate evaluation of the first attack and any later one. Other possible causes? A hyperactive thyroid, high blood pressure, or medication reaction.

Melissa Wurst of St. Louis only realized she'd had a panic attack, not a heart attack, during the EKG she got in a doctor's office. The 46-year-old had had a dozen panic attacks in the years since her late 30s. "It honestly didn't dawn on me," she says. "It felt like a train was sitting on my chest, and I was overwhelmed by the fear I was going to die." Her physician gave her Xanax, an anti-anxiety drug, to take if she felt an attack coming on again. So far she hasn't needed it.

Studies have connected attacks with too much coffee and too little sleep, so if you've had a single panic attack and your health checked out fine, you may want to watch your caffeine intake and make sure you're getting enough rest. If you've had more than one attack, ask your doctor whether you should carry a fast-acting anti-anxiety medication, such as alprazolam (Xanax) or lorazepam (Ativan). These benzodiazepines are thought to slow down central nervous system activity. You can become dependent on them, so use them only under a doctor's care.

Continued on page 3:  What Can Help


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