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"Out of the blue, I was overcome by a suffocating sense of dread that started to gradually build. I started hyperventilating and my heart began pounding so hard that it felt like it would explode out of my chest. The world around me started spinning out of control. My hands were clutching the steering wheel so tightly, my fingers became numb. I thought, ‘Oh my God, I need to get out of here. This isn't safe!’ There was a sense of unreality and impending doom. It felt like the end of the world."
That's how Robert, a 63-year-old college professor in San Francisco (who asks that his last name not be included), describes the terror that suddenly hit when he was driving across the Oakland Bay Bridge one day. He had driven over the bridge countless times to and from work in Berkeley, but on this particular day — during rush hour on a foggy Thursday afternoon — he lost control. It was a panic attack.
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The National Institute of Mental Health estimates that about 5 percent of adults in the U.S. will experience a panic disorder at least once in their lives. Sometimes they include panic attacks: full-on surges of anxiety that start abruptly, often without warning. And though they're short-lived — they usually reach their peak within 10 minutes, then fade within a half-hour — they can pack one heck of a punch. Among the symptoms: a racing heart, sweating, shaking, shortness of breath, chest pain, a sensation of choking, nausea, dizziness, numbness or chills, and hot or cold flashes.
In extreme cases, sufferers may report an out-of-body experience or an intense, inexplicable feeling of dread. Some go rushing to the ER, convinced they're having a heart attack, losing their mind, or even dying.
"The most eloquent description I've ever heard was from a patient,” says Philip Muskin, M.D., a professor of psychiatry at the Columbia University Irving Medical Center in New York City. “'Imagine that you're sitting all alone at home. It's dusk and the room is starting to get dark. Suddenly, you feel a hand slide around your throat. That's a panic attack.'”
What triggers an attack
One of the most frightening aspects of these episodes is their unpredictability: They can happen anywhere, at any time, even rousing you from a deep sleep. You can be overcome when you're perfectly calm or when you're stressed out — say, by the pressures of caring for a parent or a heavy workload at the office. Change, perhaps a big move, can also prime you for an overanxious fight-or-flight response.
A tendency toward panic attacks seems to run in families, and a person's temperament can make them more prone. Women are almost twice as likely to have panic attacks as men. (Menopause, and the hormonal imbalance that comes with it, can make some women especially vulnerable.)
Asthmatics are also at risk. “If someone has difficulty catching his or her breath, that can trigger a panic attack,” says Ken Yeager, director of the Stress, Trauma and Resilience (STAR) Program at The Ohio State University.