By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

PANIC ATTACKS MAY HAVE NO APPARENT CAUSE, CAN MIMIC HEART ATTACK

Question: I have started having these spells where I get real nervous, my heart pounds, I break out in a sweat, and I get a headache. I am a 20-year-old college student. My mom says I am having panic attacks and I need medicine. Do you think these are panic attacks, and are there other things than medicine to treat them?

Answer: Everybody feels panic now and then. It could be as a result of an immediate threat to your health, like a fire or an accident. Or, you may feel panicked before speaking to a large group of people or while going through a job interview.

While this kind of panic is normal, some people experience true “panic attacks” that seem to come out of the blue for no obvious reason. These attacks have many of the symptoms you describe. The person may be walking down the street or sitting at home and suddenly tremors start, the heart starts racing, and he or she feels a great sense of fear. The person may also sweat profusely, experience chest pains, have shortness of breath, become weak and dizzy, feel like fainting, and have abdominal pain. Sometimes, the symptoms can feel like a heart attack. Each panic attack can last from a few minutes to a half hour.

People who experience these panic attacks are said to have panic disorder -- a relatively common problem that most often strikes young women between the ages of 20 and 25. About 2.4 million Americans of both genders have panic disorder. While we don’t know exactly what causes this disorder, it seems to run in families and can be related to stressful life events.

Panic disorder is defined medically as “sudden, and repeated episodes of intense fear associated with physical symptoms.” These attacks are spontaneous and often it is difficult to determine what triggers the attack. In some people the fear of having an attack becomes so great that they develop another problem called agoraphobia. This disorder -- which literally means “fear of the market” -- can be so severe that people won’t even leave their homes.

Medications, such as antidepressants can be used to treat panic disorder in many people. Another treatment, cognitive-behavioral therapy, which deals with a person’s attitudes and perceptions of the panic disorder, can be successful. Many people with panic disorder have other problems such as underlying depression or substance abuse issues. These must be dealt with if they are present. Many people have recurrences of their panic disorder after treatment, and they need medication and/or therapy for long periods of time.

The good news is, once you know what you have, you should be able to “get through” a panic attack by using one of several strategies. These may include sitting in a quite place, breathing into a brown paper bag, or just talking softly with a friend until the symptoms have passed. Once a person with panic disorder knows that they are not having a heart attack or other such life threatening medical problem, they can weather the storm of an attack. Also, some people are able to figure out what triggers their attacks. They can, then, avoid those stimuli and actually prevent the attacks from ever taking place.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.