Most people experience a panic attack at some point in their lives. It is usually triggered by an event that causes fear and tension, such as a death in the family, a thief entering the house, an accident, financial stress or the loss of a job.

It may cause the heart to beat rapidly, with sweating or diarrhoea. It may also make us feel faint, especially when we think of the problem. Sometimes, these symptoms can also occur without a precipitating cause.

Suddenly, a person feels that he or she cannot breathe. The heart beats rapidly, and he or she thinks he or she is going to die. This is an exaggerated flight-or-fight reaction, which occurs in response to a triggering event.

When we are frightened or tense, the body releases the chemicals adrenaline and noradrenaline, which causes these flight-or-fight responses. Sometimes the release of adrenaline occurs for no reason; these attacks occur frequently and unexpectedly, affecting the person’s life. They may be unable to leave the house, enter an elevator or sleep. If they lie down, they will wake up in a panic. If they are sleep-deprived, they may not be able to function or work effectively.

The real reason for panic attacks is not known. They are commoner in women, leading to speculation that hormones play a role. The person may be genetically predisposed when parents, grandparents or other members of the family have similar attacks. The reason may be genetic or caused by significant continuing financial or emotional stress in the family that cannot be cured and will not go away. The cause is not clear.

If you are prone to panic attacks, you must have specific investigations done. A hyperfunctioning thyroid can produce a rapid heartbeat, sweating and tremors, but it will be present all the time. If you are diabetic and your blood sugar suddenly dips, you may also have similar symptoms. You may also have a problem with your heart, where there is an uncontrolled, sudden, rapid beating of the heart due to abnormal signals or atrial fibrillation. Blood tests and ECGs can diagnose these conditions.

You are lucky if there is a treatable cause for your panic attack. Treating thyroid problems, regulating the heartbeat with medication or a pacemaker, or controlling the blood sugar levels may then prevent the attacks.

If the panic attack is because of a lifestyle situation or has no known precipitating cause, psychotherapy can be tried. This means consulting a counsellor or a psychiatrist so that you can talk about your fears and anxieties.

Deep breathing helps. This technique involves breathing in for a count of 20, holding your breath for a count of 20 and breathing out for a count of 20. This regulates the heart rate and calms the mind. You can do this 20 times twice a day, morning and evening. Many people can sense a panic attack coming on, so you can do it at that time too and prevent an attack.

Meditation and yoga are a great help. They control the brain chemicals that cause panic attacks and help regulate them.

Regular exercise has a similar effect. It also regulates the heart rate, which helps to control and prevent panic attacks.

If none of this works, you may need to be put on medication. Usually, a combination of antidepressants and antianxiety agents is tried. A low dose is started first and then gradually increased.

Do not try to treat yourself with medication purchased over the counter. Remember that some of these — especially the group of compounds like diazepam and alprazolam — can be addictive, so eventually higher doses need to be taken to achieve the same effect.

Anxiety and panic attacks are very treatable conditions. Remember, it takes time for the body to respond, so be patient. Exercise regularly and do yoga even if medication has been prescribed and live a healthy life.

The writer has a family practice at Vellore and is the author of Staying Healthy in Modern India. If you have any questions on health issues please write to yourhealthgm@yahoo.co.in