Carol Brown is 54 now, healthy and happy. But until her early 40s, her life was one panic attack after another.
The first occurred when she was 16, in an elevator. Out of the blue, said Brown, "my heart started racing, my hands were sweating, my breathing was shallow. I thought I was going to die. I didn't tell anybody. I thought I was losing my mind. It lasted maybe a minute, maybe a minute and a half, but it was enough to begin the pattern of events."
That pattern is horribly familiar to the 2.4 million Americans who get panic attacks.
In a panic attack, a person feels a rush of fear or distress with no sense of its cause. This is often accompanied by heart palpitations, shortness of breath or "air hunger," numbness or tingling, lightheadedness, fear of going crazy, depersonalization (feeling like you are not really there), flushes, chills, nausea, sweating, trembling or shaking.
Many people rush to the hospital emergency room, fearful they are having a heart attack. And the first attack often makes a person so afraid of another one that she -- women get panic attacks more often than men -- soon avoids anything associated with it.
For Brown, who is now director of program development at the Cole Mental Health Consumer Resource Center at McLean Hospital in Belmont, Mass., that meant avoiding elevators. Then, after an attack on the highway, driving. Then the supermarket. Then agoraphobia, the fear of being trapped in any situation or place where a panic attack might happen, even situations where no attack has occurred before.
Years ago, doctors might have attributed panic attacks like Brown's to some deep psychological problem. Now they suspect biology.
"The biological hypotheses for panic disorders are based on several observations," said Dr. Srini Pillay, director of the panic disorders research program at McLean.
"Pharmacologic medications can stop panic attacks, and panic attacks can be induced by various compounds," he said. Panic attacks also occur "out of the blue, suggesting some sudden alteration in chemistry." They can also occur when a person is not anxious, and even occur during sleep, "suggesting panic attacks may be tied to biological rhythms."
Family history plays a role, Pillay noted. If you have a parent or sibling with panic attacks, you have four to eight times the normal risk of getting them, too.
