A person having a panic attack experiences a period of intense fear or discomfort while physically feeling some combination of these symptoms: heart palpitations, feelings of dizziness or lightheadedness, trembling or shaking, nausea or abdominal distress, chills or hot flushes, shortness of breath, or a tightness around the chest so extreme that it can feel like a heart attack. Persons suffering a panic attack can feel as if they’re about to die, to “lose control” or “go crazy.” They may feel as if the world seems unreal, or may feel detached from themselves. When panic attacks recur and are followed by significant fears of their reappearance and by changes in behavior- such as by avoiding circumstances that the person is afraid will trigger an attack- the person is diagnosed as having panic disorder.
A sufferer often feels that the panic attacks are coming out of nowhere, but in psychoanalytic consultation and treatment, triggers are discerned for the anxiety. Fears about imminent separation or loss, or about one’s aggression or sexuality, can cause anxiety, as can the fear of loss of personal control. Often panic attacks manifest themselves in the context of major life changes – graduation, a new job, a promotion – that have conflicted underlying meaning for the individual . The psychoanalyst helps the anxious person to regain a sense of emotional control by considering the meaning of the symptoms in the context of his life and relationships.