Panic attacks are sudden and intense episodes of fear or anxiety that may last for several minutes or even hours. These attacks can occur unexpectedly, without any apparent trigger, or in response to a particular situation or stimulus. Panic attacks can be very distressing and can interfere with daily activities, leading to a condition known as panic disorder.

Panic disorder is a type of anxiety disorder characterized by recurrent and unexpected panic attacks, along with persistent fear and worry about experiencing another attack. People with panic disorder may also develop anticipatory anxiety, which is the fear of having another panic attack. This can lead to avoidance of certain situations or places where panic attacks have occurred in the past.

The symptoms of a panic attack include a rapid heartbeat, sweating, shaking, shortness of breath, chest pain, nausea, dizziness, and a feeling of impending doom or loss of control. These symptoms can be so severe that people may believe they are having a heart attack or are about to die.

The exact causes of panic attacks and panic disorder are not fully understood, but they are believed to be the result of a combination of genetic, environmental, and psychological factors. Treatment for panic disorder typically involves a combination of medication and therapy, including cognitive-behavioral therapy (CBT), which helps people learn new coping strategies and challenge negative thoughts and beliefs that contribute to anxiety.

With appropriate treatment, people with panic disorder can manage their symptoms and improve their quality of life. However, untreated panic disorder can lead to long-term complications, such as social isolation, depression, and substance abuse. If you experience symptoms of panic attacks or panic disorder, it's important to seek help from a mental health professional.

It's not known what causes panic attacks or panic disorder, but these factors may play a role:

• Genetics
• Major stress
• Temperament that is more sensitive to stress or prone to negative emotions
• Certain changes in the way parts of your brain function

Panic attacks may come on suddenly and without warning at first, but over time, they're usually triggered by certain situations.

Some research suggests that your body's natural fight-or-flight response to danger is involved in panic attacks. For example, if a grizzly bear came after you, your body would react instinctively. Your heart rate and breathing would speed up as your body prepared for a life-threatening situation. Many of the same reactions occur in a panic attack. But it's unknown why a panic attack occurs when there's no obvious danger present.

There's no sure way to prevent panic attacks or panic disorder. However, these recommendations may help.

• Get treatment for panic attacks as soon as possible to help stop them from getting worse or becoming more frequent.
• Stick with your treatment plan to help prevent relapses or worsening of panic attack symptoms.
• Get regular physical activity, which may play a role in protecting against anxiety.

Treatment can help reduce the intensity and frequency of your panic attacks and improve your function in daily life. The main treatment options are psychotherapy and medications. One or both types of treatment may be recommended, depending on your preference, your history, the severity of your panic disorder and whether you have access to therapists who have special training in treating panic disorders.

Psychotherapy

Psychotherapy, also called talk therapy, is considered an effective first choice treatment for panic attacks and panic disorder. Psychotherapy can help you understand panic attacks and panic disorder and learn how to cope with them.

A form of psychotherapy called cognitive behavioral therapy can help you learn, through your own experience, that panic symptoms are not dangerous. Your therapist will help you gradually re-create the symptoms of a panic attack in a safe, repetitive manner. Once the physical sensations of panic no longer feel threatening, the attacks begin to resolve. Successful treatment can also help you overcome fears of situations that you've avoided because of panic attacks.

Seeing results from treatment can take time and effort. You may start to see panic attack symptoms reduce within several weeks, and often symptoms decrease significantly or go away within several months. You may schedule occasional maintenance visits to help ensure that your panic attacks remain under control or to treat recurrences.

Medications

Medications can help reduce symptoms associated with panic attacks as well as depression if that's an issue for you. Several types of medication have been shown to be effective in managing symptoms of panic attacks, including:

• Selective serotonin reuptake inhibitors (SSRIs). Generally safe with a low risk of serious side effects, SSRI antidepressants are typically recommended as the first choice of medications to treat panic attacks. SSRIs approved by the Food and Drug Administration (FDA) for the treatment of panic disorder include fluoxetine (Prozac), paroxetine (Paxil, Pexeva) and sertraline (Zoloft).
• Serotonin and norepinephrine reuptake inhibitors (SNRIs). These medications are another class of antidepressants. The SNRI venlafaxine (Effexor XR) is FDA approved for the treatment of panic disorder.
• Benzodiazepines. These sedatives are central nervous system depressants. Benzodiazepines approved by the FDA for the treatment of panic disorder include alprazolam (Xanax) and clonazepam (Klonopin). Benzodiazepines are generally used only on a short-term basis because they can be habit-forming, causing mental or physical dependence. These medications are not a good choice if you've had problems with alcohol or drug use. They can also interact with other drugs, causing dangerous side effects.

If one medication doesn't work well for you, your doctor may recommend switching to another or combining certain medications to boost effectiveness. Keep in mind that it can take several weeks after first starting a medication to notice an improvement in symptoms.

All medications have a risk of side effects, and some may not be recommended in certain situations, such as pregnancy. Talk with your doctor about possible side effects and risks.