THE PANIC CYCLE

The symptoms of a panic attack can be very frightening and distressing. Symptoms tend to occur very suddenly, without warning and often for no apparent reason.

As well as overwhelming feelings of anxiety, a panic attack can also cause the following symptoms:

• a sensation that your heart is beating irregularly (palpitations)
• sweating
• trembling
• hot flushes
• chills
• shortness of breath
• a choking sensation
• chest pain
• nausea
• dizziness
• feeling faint
• numbness, or pins and needles
• dry mouth
• a need to go to the toilet
• ringing in your ears 
• a feeling of dread, or a fear of dying
• a churning stomach
• a tingling sensation in fingers
• shivering
• shaking

The physical symptoms of a panic attack are unpleasant, and they can also be accompanied by thoughts of fear and terror. For this reason, people with panic disorder start to fear the next attack, which creates a cycle of living in ‘fear of fear’ and adds to the sense of panic.

Sometimes, the symptoms of a panic attack can be so intense they can make you feel like you are having a heart attack.

However, it is important to be aware that symptoms such as a racing heartbeat, or shortness of breath, will not result in you having a heart attack. Also, although a panic attack can often be frightening, it will not cause you any physical harm. People who have had panic disorder for some time usually learn to recognise this 'heart attack sensation', and become more aware of how to control their symptoms.

The symptoms of a panic attack usually peak within 10 minutes, with most attacks lasting for between 5 and 20 minutes. Some panic attacks have been reported to have lasted up to an hour. However, it is likely that the reason for this is due to one attack occurring straight after another, or high levels of anxiety being felt after the first attack.

Recurrent panic attacks

People with panic disorder have panic attacks on a recurring basis. Some people have panic attacks once or twice a month, while others have attacks several times a week.

People with panic disorder also tend to have ongoing and constant feelings of worry and anxiety. The panic attacks that are associated with panic disorder can be very unpredictable. If you have panic disorder, you may feel stressed and worried about when your next attack will be.

Depersonalisation

During a panic attack your symptoms can feel so intense and out of your control that you may feel detached from the situation, your body and your surroundings. It can almost feel as if you are an observer, making the situation seem very unreal.

This sense of detachment is known as depersonalisation. Being detached from the situation does not provide any relief, or make a panic attack less frightening. Instead, it often makes the experience more confusing and disorientating.