Panic (anxiety) attacks a few times in a lifetime, or even a few times a year, are normal. Sometimes your brain chemistry goes a little haywire and needs to be reset. A few times a month or more and you're looking at panic disorder. (I have this.) They're finding more and more evidence that panic disorder is genetic. My father, paternal grandmother, and paternal great-grandmother all had/have panic attacks, as does my younger sister. So I'd say that evidence is right, based on my own experience.
Panic attacks tend to manifest in one of two ways: chest pain or stomach distress, although feeling like your throat is closing certainly isn't unheard of. Many people think they're having a heart attack, but they aren't. I personally get extremely and violently sick to my stomach. For a while I thought I had stomach cancer. That's also pretty common. Luckily, you're not doing any serious damage to either your heart or your stomach (although you can get a sore throat from all the stomach acid). A lot of women, especially, also tend to get the "racing thoughts" feeling early in the morning or late at night when everyone's sleeping -- that's another form of panic attack.
Panic attacks happen when your brain chemistry gets off balance and signals a need for a fight-or-flight adrenalin response when there isn't any actual danger. That extra adrenalin is what makes you feel so sick.
There are a number of things that can contribute to your likelihood of having a panic attack if your brain chemistry is already off balance; these are called triggers. They're all things that physically affect your well-being and can change your brain chemistry. Everyone with panic disorder has their own personal list of triggers.
Some common ones are:
-stress
-lack of sleep
-poor diet
-caffeine (that's often a big one!)
-alcohol (which is also a depressant, and many people with panic disorder also have a tendency toward chronic depression)
What DOESN'T cause a panic attack: enclosed spaces, heights, etc. This is very important. A lot of people who get a panic attack while in a certain situation -- an elevator, or while out at a party -- connect those two and create a trigger for themselves by making that association. This can lead to agoraphobia, increased social anxiety, etc. But having panic disorder means you really are having those attacks at random times and it's important to disassociate your surroundings from the attack itself so that you don't create psychological triggers for yourself.
Treatment: I went to therapy twice a week for over a year. We talked about medications, which are certainly an option. We also talked about how I handle stress, my lifestyle, my diet, etc. For me, it came down to cutting out caffeine COMPLETELY for nearly a decade. No caffeinated coffee, soda, tea, iced tea, etc. Only very small amounts of milk chocolate, no dark chocolate. I realized I needed to give myself a more regular sleep pattern (I was in college when this started happening to me -- oy, the lack of sleep). I cut waaay down on alcohol -- maybe one or two beers or glasses of wine a week, or one hard drink. I also started eating more fresh food, less junk, and more regularly. I started taking tai chi classes, which helped me learn how to regulate my body's energy.
In the moment of a panic attack: breathe deeply and slowly, as if you were meditating. If you notice your thoughts circling around and around, recognize that and acknowledge to yourself that those aren't your true thoughts, it's just the panic attack creating that effect. If you're physically up to it, try to exercise to dump the excess adrenalin. Do tai chi, go for a walk, take a jog, get your heart rate up. It took me nearly five years, but I've gotten good enough at recognizing the signs that a panic attack is coming on that I can usually head it off at the pass by exercising until that feeling of an incipient attack goes away.
Medication would probably be easier, in a way, than the kind of lifestyle change I undertook, but this gave me the skills to really deal with it, no crutches involved. If I had needed medication to get over the hump and get to where I could learn those skills, though, I would have done it in a heartbeat. Just be wary of anyone telling you you'll need to be medicated for life -- that kind of defeatist attitude can be really damaging, you know? Good for you for being proactive and looking for help!
