Panic attack is a severe psychological and physiological condition that is accompanied by a sudden feeling of fear, worry or imminent danger, without necessarily having a real threat in the environment. In such a situation, the affected person may experience this condition without any prior warning, even in seemingly safe environments such as at home or while resting. In this article, we have comprehensively and expertly examined the symptoms, causes and solutions to deal with panic attacks. What types of diseases are panic attacks? In terms of psychiatry, panic attacks are classified as anxiety disorders, but they can become chronic and manifest as panic disorder. Most people think they are having a heart attack in their first experience. The reason for this mistake is the high intensity of the physical symptoms that are related to the "fight or flight" reaction of the body. Panic attack symptoms that you should not ignore A panic attack includes a set of physiological and psychological symptoms at the same time. Many of these symptoms appear in such a way that a person thinks he is dying or having a heart attack. In the psychological dimension, a feeling of extreme restlessness, fear of losing control, separation from reality or the body (derealization and depersonalization) and fear of going crazy are the most common symptoms. These symptoms usually peak within a few minutes and then gradually subside. The important thing is that these reactions are real and should be evaluated with a specialized approach. Some of the physical symptoms of a panic attack include: - Strong heart palpitations - Body tremors - Cold sweat - shortness of breath - Feeling of suffocation - Dizziness and nausea Psychological and physiological causes of panic attacks The exact cause of panic attacks in each person may be different, but psychiatric research shows that this phenomenon is the result of the interaction between genetic, neurological, psychological and environmental factors. Studies have shown that people with a family history of anxiety or depression are more susceptible than others. At the physiological level, disturbances in the regulation of neurotransmitters such as serotonin, norepinephrine, and GABA in the brain are considered important factors. On the other hand, traumatic experiences such as bereavement, accidents, domestic violence or stressful life events can act as triggers. Sometimes, after an initial panic attack, people have a constant fear of repeating it, and this fear itself will become a factor for starting a new attack. This cycle of anxiety causes the person to gradually avoid situations in which they think an attack may occur. What are the most common conditions for a panic attack? Although a panic attack can happen at any time and place, certain situations make it more likely to occur. Closed places such as elevators, subways, airplanes or crowded shopping malls are among the environments that trigger attacks for many sufferers. Attending social gatherings, public speaking or even driving on the highway can also be the cause of this condition. Psychologically, these conditions are usually associated with a sense of lack of control or inescapability. In other words, the person is in a situation that he cannot get out of quickly or he does not feel mentally safe. In some people, even waking up with a racing heart and fear is a sign of a panic attack in sleep. This type of attack is more confusing and stressful for the patient due to the lack of an obvious external stimulus. The difference between a panic attack and a heart attack; How to recognize? One of the major challenges in experiencing a panic attack is the similarity of its symptoms to a heart attack. In both cases, a person may experience shortness of breath, chest pain, sweating, dizziness, and a feeling of death. However, there are differences that can help with the diagnosis. Chest pain in a panic attack is usually more superficial and does not decrease with a change in body position, while in a heart attack, the pain is deeper and may radiate to the left arm, neck, or jaw. On the other hand, a panic attack usually subsides within 10 to 20 minutes and can be controlled with breathing relaxation techniques, but a heart attack is usually more gradual and resistant to these methods. However, it is important to emphasize that in the face of the first experience of severe physical symptoms, you must go to the emergency room or doctor to completely rule out the possibility of a heart attack. The first reaction during a panic attack; What should be done in this situation? In the moment a panic attack begins, the most important thing to do is to remain alert to the fact that, although the symptoms are real, there is no immediate physical danger. Many sufferers experience severe panic when they first experience a panic attack, because their body goes into "emergency alert" mode. In this situation, the use of immediate relaxation techniques can reduce the intensity of the attack. The first suggested technique is to focus on breathing. Breathing slowly and deeply through the diaphragm for a few minutes helps calm the sympathetic nervous system. 4-4-8 breathing exercise (inhale for 4 seconds, hold for 4 seconds, exhale for 8 seconds) is one of the effective methods. The second method is the grounding exercise, which is done by focusing on the five senses. For example, a person identifies five examples of visible objects, four examples of tangible objects, three audible sounds, two smells and one taste. This technique helps to separate the mind from the fearful atmosphere and focus on the present. Panic attack treatment with scientific and practical solutions Panic attack treatment is based on three main approaches, which include psychological treatment, drug therapy and supportive interventions. Cognitive processing (CBT) is recommended as the most effective method of psychological treatment. This method helps patients identify distorted thoughts, exaggerated worries and unrealistic fears and gradually replace them with more rational ones. Techniques such as gradual exposure (Exposure Therapy) are also effective in reducing sensitivity to stimulating situations. On the other hand, the use of selective serotonin reuptake inhibitors (SSRIs) such as sertraline or fluoxetine is used to stabilize mood and control anxiety. In certain cases, benzodiazepines such as alprazolam are prescribed to control severe attacks, but these drugs should only be used for a short time and under the supervision of a doctor due to the risk of dependence. Panic attack and lifestyle; What changes are helpful? Lifestyle changes are an essential part of panic attack management. People who have a regular sleep pattern, healthy diet and regular physical activity usually show a higher ability to control anxiety. One of the important changes is regulating night sleep and avoiding frequent awakenings, because insomnia has a direct relationship with the increased likelihood of attacks. In terms of nutrition science, it is recommended to reduce the consumption of coffee, caffeinated drinks, dark chocolate and sugary foods, because these substances can increase nervous excitability. Some of the other most important recommendations in this regard are: - **Regular aerobic exercise:** Activities such as brisk walking, light running or cycling help to balance stress hormones and increase endorphins. - Mind and body relaxation exercises: Regular use of yoga, tai chi, meditation and mindfulness techniques improve the functioning of the nervous system and reduce anxiety. Can panic attacks be prevented? 100% prevention of panic attack is not possible in all people, but it is possible to reduce the probability of its occurrence with techniques. One proven method is to identify personal motivation patterns. Many psychologists recommend that sufferers keep an "anxiety notebook" and record the situations, thoughts or events they experienced before the attack. In addition, teaching calm breathing and relaxation techniques can help people react more quickly when an attack begins. Removing stressful factors from the work or family environment, strengthening problem solving skills and avoiding social isolation also play an effective role in preventing this disorder from becoming chronic. Living with a panic attack; Is it possible to manage it? Living with a panic attack is challenging, but by no means does it mean permanent disability or being forced to limit yourself. Many people living with this disorder have been able to live an active and successful life by using appropriate treatment, social support and strengthening mental resilience. The key to long-term management is accepting the reality of the disorder and taking responsibility for the treatment process. Successful sufferers do not ignore warning signs, seek professional help when needed, practice relaxation exercises regularly, and maintain a stable psychological environment. Sometimes it is necessary for family, friends and colleagues to understand this disorder in order to avoid labeling, judgment or neglect. Educating everyone about panic attacks can reduce a large part of the psychological burden of this disorder. Treatment of neurological and mental disorders at the Neural Brain Center At Neurali Brain and Neurology Center, we evaluate and treat neurological and mental disorders based on current knowledge, extensive clinical experience, and a scientific approach. Our team consists of neurologists, psychiatrists, clinical psychologists, and experienced therapists who develop a comprehensive and specific plan for each patient.