Almost everyone feels anxious at times. But a panic attack involves such a high level of that it can feel as if you are having a heart attack, going insane, or losing control of yourself. During a panic attack, you may have physical symptoms such as shortness of breath, tingling sensations, ringing in your ears, a sense of impending doom, trembling, a feeling of choking, chest pain, sweating, and heart pounding. You should see your physician in order to rule out medical causes for these symptoms, such as hyperthyroidism, caffeine addiction, mitral valve prolapse, or other causes. A panic attack, however, can produce the same physical symptoms as these medical conditions. When a person has recurring, unexpected panic attacks, is afraid of having more or worried about their meaning, and makes changes in his or.. her behavior as a result, the person is said to have “panic disorder.” Many patients who have panic disorder also experience “agoraphobia.” Agoraphobia is fear of places or situations where a panic attack may occur or from which escape might be difficult. For example, people with agoraphobia avoid being out alone, going to supermarkets, traveling in trains or airplanes, crossing bridges, being at heights, going through tunnels, crossing open fields, and riding in elevators. Many patients even experience panic when they are asleep, possibly because the large decrease in pulse rate during sleep elicits a compensating increase in pulse rate, resulting in feeling jolted out of sleep.
Some patients with agoraphobia experience anxiety in sunlight; others become anxious in dimming light. Heat is a major factor in panic disorder-there is a dramatic increase in panic disorder and agoraphobia during the summer, primarily because heat increases pulse rate, dizziness, and dehydration, and there are more opportunities to be outside (where an individual feels more vulnerable). The individual fears that in these situations, he or she will have a panic attack.