Panic attacks are sudden periods of intense fear and discomfort that may include palpitations, otherwise defined as a rapid, irregular heartbeat, sweating, chest pain or discomfort, shortness of breath, trembling, dizziness, numbness, confusion, or a sense of impending doom or loss of control.

[2] When people experience a panic attack, it usually comes on very suddenly and unexpectedly with a wide range of symptoms that tend to last, on average, a few minutes.

Individuals who are naturally anxious, need a lot of reassurance, worry excessively about their health, have an overcautious view of the world, and have cumulative stress are more likely to experience panic attacks.

Eventually, the pattern of avoidance and level of anxiety about another attack may reach the point where individuals with panic disorder are unable to drive or even step out of the house, preferring the comfort of remaining in a safe and known place.

[34] In Japan, people who exhibit extreme agoraphobia to the point of becoming unwilling or unable to leave their homes are referred to as Hikikomori.

After first being defined by the Japanese Ministry of Health, Labor, and Welfare, a national research task force refined the definition as "the state of avoiding social engagement (e.g., education, employment, and friendships) with generally persistent withdrawal into one’s residence for at least six months as a result of various factors.

"[36] When panic attacks occur, people experience the sudden onset of fear and anxiety in the setting of no actual perceived threat (ex.

[41] It is thought that dysfunction of the area responsible for controlling fear could be due to stress experienced in childhood, along with a genetic component as well.

[38] This information has allowed scientists to suggest that panic attacks could be caused by our brain's inability to stop alarm signals that make us feel like we're suffocating.

This theory suggests that problems in any of these brain areas or the connections between them could lead to excessive fear responses, like panic attacks.

Studies have shown that in both animal and human subjects with a history of panic attacks, the amygdala is hyperactive with decreased volume when compared to the control.

In fact, medications that increase GABA activity in the brain, such as benzodiazepines and barbiturates, help with reducing anxiety almost immediately.

[43] Because glutamate is the primary excitatory neurotransmitter involved in the central nervous system (CNS), it can be found in almost every neural pathway in the body.

During a panic attack, the body's stress response is triggered which can cause the small vessels of the heart to tighten, leading to chest pain.

The body's nervous system and rapid breathing during a panic attack can cause spasming of the arteries of the heart (also known as vasospasm).

[45] In individuals with a history of coronary artery disease, panic attacks and stress can make chest pain worse by increasing the heart's need for oxygen.

[49] Panic disorder is usually effectively managed with a variety of interventions, including psychological therapies and pharmacological treatment with medication.

[citation needed] However, benzodiazepines, specifically alprazolam and clonazepam, are frequently prescribed for panic disorder due to their quick onset of action and good tolerability and can thus be used as a way to end a current, on-going attack.

[52] Additionally, deep breathing techniques and relaxation can be used and are found to be helpful while the person is experiencing a panic attack or immediately after as a way to calm oneself.

Cognitive behavioral therapy (CBT) has the most complete and longest duration of effect, followed by specific selective serotonin reuptake inhibitors (SSRIs).

[54] Growing research suggests that along with standardized medical treatments, lifestyle changes can help alleviate some of the most common mental health conditions.

There is evidence that suggests that this effect is correlated to the release of exercise-induced endorphins and the subsequent reduction of the stress hormone, cortisol.

[63] Hyperventilation syndrome occurs when an individual experiences deep, quick-paced breathing, eventually affecting blood flow to the brain and altering conscious awareness.

[69][70] According to the American Psychological Association, "most specialists agree that a combination of cognitive and behavioral therapies are the best treatment for panic disorder.

"[71] The first part of therapy is largely informational; many people are greatly helped by simply understanding exactly what panic disorder is and how many others experience it.

[72] Avoidant behavior, such as what is seen in patients with agoraphobia, is one of the key aspects that prevent people with frequent panic attacks from functioning healthily.

[27] Exposure therapy,[73] which includes repeated and prolonged confrontation with feared situations and body sensations, helps weaken anxiety responses to panic-inducing external and internal stimuli.

In deeper-level psychoanalytic approaches, in particular object relations theory, panic attacks are frequently associated with splitting (psychology), paranoid-schizoid and depressive positions, and paranoid anxiety.

[74] There was a meta-analysis of the comorbidity of panic disorders and agoraphobia that used exposure therapy to treat hundreds of patients over a period of time.

[27] While drug treatment seems promising for children and adolescents, they are at an increased risk of suicide while taking these medications and their well-being should be monitored closely.