PANIC ATTACKS A classic Panic attack is unpredictable, short-lived and recurrent episode of intense anxiety accompanied by marked symptoms. Agoraphobia may be present. Distressing symptoms and signs such as breathlessness, tachycardia, palpitations, headaches, dizziness, choking, smothering feelings, nausea, and bloating are associated with feelings of impending doom (alarm response). Recurrent sleep panic attacks (not nightmares) occur in about 30% of panic disorders. Anticipatory anxiety develops in most of these patients further constricting their daily lives. Panic disorders tend to run in families, with onset usually under the 25; and the female-to-male ratio is 2:1. The premenstrual period is one of heightened vulnerability. Most patients are frequently evaluated for "heart attacks" or "hypo-glycemia" before the correct diagnosis is made. Patients with recurrent panic disorder often become demoralized, hypochondriacal, agoraphobic and depressed. These patients are at increased risk for major depression and associated suicide attempts. Alcohol abuse (about 20%) results from self-treatment and is not in frequently combined with dependence on sedatives.
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