Panic Attacks

Health News
Sanjiv is a 35-yr. old male a computer engineer. Few days back he had sudden onset of palpitations, choking sensation, chest pain & sweating. He became very anxious & now worries that he has a heart problem (his 60 years old uncle also has similar problem). He has gone to many cardiologists since then. His E.C.G (Electrocardiogram) has been done & the cardiologist says that every thing is Normal, and, "come again if you have similar attack."

Sanjiv’s life has changed since then. He’s not the same dynamic computer engineer. He is not going on out station projects because he fears that if he has similar attack again in other place what will he do. He has stopped going for picnic & badminton because he feels his heart cannot take the load.

The worst thing is that he cannot detect & pinpoint his problem. What is he suffering from?

Sanjiv is not suffering from A heart attack but a Panic attack -

What is a Panic attack?
Panic attack is a sudden onset of apprehensions (anxiety) which can present with,
• chest pain/ discomfort
• sweating
• tremors
• choking sensation/ breathlessness
• nausea/ vomiting
• fainting / syncope/ feeling dizzy
• Feeling of impending doom, as if something is going to happen.


But doctor, I am not anxious at all, I have no problems, my life is going very smooth, what is the cause?

The cause of a Panic Attack is a sudden release of chemicals known as Adrenaline and Noradrenaline in our blood stream, because of more active Sympathetic Nervous System. The Sympathetic Nervous system has a lot of nerves going to the heart as well, so a sudden overactivity of this system leads to excitation of the Heart and manifests as palpitations & chest pain.

Genetic predisposition could also be a cause.

Psychological factors may not be very obvious but can be covert cause of anxiety.

How can I differentiate between a Heart Attack and a Panic Attack?
• In a Panic Attack the Chest Pain is generalized (not localized to left side of the chest) as in a heart attack.
• It does not get relieved with anti Angina drugs.
• A lot of other symptoms e.g. nauseating sensation & feeling of impending doom, as if something is going to happen, are present in a Panic Attack.
• A Normal E.C.G in the presence of an attack.

What should I do? Should I forget about it thinking that was just a panic attack?
No, you need treatment for this. A tendency for Panic Attacks cannot be wished away. You need to consult a psychiatrist for proper evaluation and treatment.

A Psychiatrist? I am not mad!! Why a Psychiatrist?

It’s a big myth that Psychiatrists are only for mad people. Psychiatrists are for sad people, for anxious people and a lot of other problems, which may not present with a psychiatric or mental symptom but have a psychiatric basis.

Self-medication, like taking Sleeping Pills or Anti Anxiety drugs can in fact be harmful. Ignoring the symptoms can also lead to difficult situations.

What is the treatment of Panic Attack? Just antianxiety Drugs?

No, Antianxiety drugs are one of the treatments. To decrease the levels of Adrenaline, Noradrenaline & hyper stimulation of nerves of the Heart other drug are also available.

Antidepressants also have an important role to play but they have to be taken under supervision of a psychiatrist

Are these drugs Sedative and/or Addictive? If a Start them once do I have to take them Always?

No, They are not sedatives; they are not addictive and need not be taken always. Normally it’s a course of 8 months to 12 months, after which the chemicals are brought back to the balance. Once there is improvement they have to be gradually tapered by your Doctor (but a full course of 8 –12 months is necessary).

Any other methods of treatment?
• Yes, Relaxation exercises.
• Breathing exercises.
• Counseling &,
• Psychotherapy