Bill was walking down the street near his home when his heart started pounding, it was hard to breathe, his chest tightened, and he had pain in it. He was terrified and thought he was going to die of a heart attack. He went immediately to an urgent treatment center only ten minutes away, but by then he felt much better. Tests there showed no sign of a heart attack or any other physical problem.
He had served in two countries where there were many reasons to be afraid, but he had never felt this kind of fear. How could it be that he had it here back in his peaceful passport country after serving for three years in a job he loved at headquarters? What caused it? Will it happen again? What can he do about it?
What is a panic attack?
A panic attacks occur when, without warning, individuals experience intense fear that occurs suddenly and for no apparent reason. It is one of the most unpleasant, terrifying, and upsetting experiences individuals can have. Although the attack is usually over in a few minutes, it may take people days to fully get over it, and those individuals may fear having another one.
The American Psychological Association notes that “Many people experience occasional panic attacks, and if you have had one or two such attacks, there probably isn’t any reason to worry” (http://www. apa. org/topics/anxiety/panic-disorder. aspx#).
However, people who continue to have them are diagnosed with panic disorder, about 1 in every 75 people. To get some indication of whether you have cause for concern you may want to take the Panic Disorder Severity Scale. A self-report form of that scale is at http://serene. me. uk/tests/pdss. pdf. This is just a screening test, but if you score above ten, it is a good idea to look for professional help.
For some unknown reason, during a panic attack the sympathetic branch of the autonomic nervous system arouses the whole body. Its neurons are interconnected so it arouses glands and smooth muscles all over, including the adrenal glands. Adrenalin (epinephrine) from those glands flows throughout the body through the blood stream. The heart pounds, breathing increases, sweat glands secrete, pupils dilate, etc. All of this unexpected arousal is terrifying. It can occur even while asleep.