Defintion

Discrete periods of intense fear or discomfort in which at least four of the symptoms below develop abruptly and reach a crescendo within ten minutes. Typically ten minutes, these attacks may recur repeately, rapidly and may leave severe anxiety in its wake lasting for hours.
Must occur unexpectedly or spontaneously in the absence of specific or environmental triggers (e.g. elevators). Four attacks over a four week period or one attack followed by one month of fearful anticipation of more. Subtypes include with or without agoraphobia (phobic avoidance).

Symptoms

shortness of breath - smothering sensation

dizziness, faintness or unsteady feeling

accelerated heart rate

trembling or shaking

sweating

choking

nausea

depersonalization or derealization

tingling

hot flashes or chills

chest pain

fear of dying

fear of going crazy or being out of control

Causes

Etiology is largely unknown at present. Medical or biochemical disturbances are suspected. Empirical clinical evidence suggests trumatic experiences and anger management problems may have a relationship. There is a significant correlation of people who have difficulty identifying, expressing or releasing anger and panic attacks.
Physicals ruling out thyroid, heart or other medical problems is routinely recommended.

Treatment

Behavioral Therapy - graduated exposure aimed at reducing avoidance and anticipatory anxiety

Cognitve Therapy - cognitive restructuring of maladaptive thought processes

Relaxation Therapy - biofeedback or breathing retraining

Pharmacologic - medications