How to Tell if You're Having a Panic Attack -- and What to Do

Lillian Mondaro was a college student at Seton Hall University in New Jersey when one day "an overwhelming feeling of fear" suddenly washed through her entire body. Her face flushed bright red. Her hands began to tremble. She felt dizzy and lightheaded. And her blood pressure shot through the roof.

"I didn't know what was going on," says Mondaro, 36, who's now a proofreader for a printing company and lives in Parsippany, New Jersey. It took a few more of these episodes -- and a trip to the campus health center -- for her to realize she wasn't ill. She was having a panic attack.

Mondaro's experience, while scary, isn't unique. Anyone can experience a panic attack, anxiety specialists say, although people who suffer from these sometimes don't recognize the source of their discomfort. Panic attacks are easily explainable -- and with the guidance of a physician or therapist, they're also treatable.

What is a Panic Attack?

Experts say panic attacks are sudden rushes of intense dread or distress, accompanied by a number of painful physical symptoms. Dizziness, sweating, a racing heart, chest pain and disorientation are common, as are labored breathing, shaking and numbness.

And what's going on inside the brain isn't much better: Typical thoughts racing through one's mind during a panic attack -- which usually lasts between five to 10 minutes -- include "a fear of going crazy; of doing something uncontrollable; of dying," says Todd Farchione, research assistant professor at the Boston University Center for Anxiety & Related Disorders.

Sufferers aren't actually dying, nor are they having a nervous breakdown. In reality, their blood is coursing with epinephrine, more commonly known as adrenaline. "The body is responding as though a threat is immediately present, " Farchione says. "So all the symptoms people experience [during a panic attack] -- increased heart rate, increased breathing -- are tied to an evolutionarily sound response to protect the individual. It's really designed to get that person to either fight or flight; it's primarily to escape."

Of course, an immediate threat isn't always actually present -- which the mind realizes, but the body ignores. "Your body doesn't know what to do, so you stay in one spot," Mondaro says. "Half your brain is telling you to run, and the other half is telling you to stay. You're in kind of a deadlock."

[Read: Dealing With a Psychiatric Illness in College .]

What Causes a Panic Attack?

There's no one direct trigger of panic attacks, nor is there a typical person who experiences them -- although researchers do note that individuals tend to have their first panic attacks in adolescence, and that women experience them more than men. There's also a "decently high genetic contribution," says Debra Kissen, clinical director of the Light on Anxiety Treatment Center of Chicago. "You do see within families with high anxiety that there might be a greater likelihood that children will develop panic."

Although panic attacks can sneak up out of the blue, they can be triggered by chemical and hormonal imbalances, a lack of sleep and drugs, alcohol or caffeine. They're also often tied to traumatic or taxing life situations. "The cause is very often stress that's occurred over the past six to eight months," says Reid Wilson, an associate clinical professor of psychiatry at the University of North Carolina School of Medicine who's authored several self-help books about panic attacks. "Often the stress might have to do with loss -- a sense that there's a task or challenge in front of me that I perceive as large, and I perceive my skills as small."

True to form, Mondaro's first panic attack occurred shortly after the death of her best friend. But she can't always predict when they'll strike. "Sometimes they happen when I'm under extreme stress; sometimes they're random," she says. "Weird things sometimes trigger them."

[See: How to Find the Best Mental Health Professional for You .]

How Do You Treat a Panic Attack?

Since a panic attack can closely mirror a medical emergency -- say, a heart attack -- people who experience them for the first time often end up in the emergency room. After a full body examination, Wilson says, they're usually referred to their primary care doctor for an additional check-up. "We want people to rule out any physical conditions that might be causing the symptoms," he says.

If someone's official diagnosis turns out to be a panic attack, they don't have to, well, panic. Simple lifestyle adjustments, such as getting enough sleep and exercise, can reduce symptoms. And although doctors don't recommend the frequent use of habit-forming anti-anxiety medicines such as Klonopin and Xanax, they can be useful on occasion (say, if you only have panic attacks when you fly on an airplane).

But if the panic attacks become frequent, there's a chance the person experiencing them might have panic disorder -- a debilitating anxiety condition that affects about 6 million American adults, according to the National Institute of Mental Health.

With panic disorder, Farchione says, patients often become so worried about having a panic attack that their anxiety begets more anxiety. To avoid having another attack, they'll stray away from situations, people or places that trigger their symptoms. And when they feel panic, they'll try to fight the fear overcoming their bodies -- which, paradoxically, can make it even worse.

Panic disorder can be alleviated with antidepressants. But many anxiety specialists also recommend cognitive behavioral therapy. Cognitive behavioral therapy is a treatment that helps patients tap into the thoughts and feelings that influence their behaviors. This allows them to reevaluate the deep-set fears that trigger their anxiety.

"Step one [of cognitive behavioral therapy] is psychoeducation -- understanding what's going on by understanding the brain, the body and the interconnections," Kissen says. "The goal is to break the cycle of panicking about panic. When we understand it, we don't have as strong as a reaction."

By identifying the thoughts and behaviors that fuel panic, Kissen says, individuals can challenge their negative mindset and adopt coping skills.

Another step of cognitive behavioral therapy involves being exposed to what one fears the most -- i.e., "going to a movie and sitting in the middle seat even if you feel trapped," Kissen says. This allows someone to decrease their dread of situations or places that they associate with panic.

But at the end of the day, some people deal with panic in their own way. Mondaro doesn't take medicine for her panic attacks, and she doesn't see a therapist about them. They're infrequent enough, she says, that they're an annoyance, not a hindrance. Over the years, however, she's developed a personal method to ride out the fear. "Sit in a place where you feel comfortable," Mondaro says. "Don't be afraid to cry. Don't be afraid to be loud if you need to be. Let it out; holding it in is not going to stop [the panic attack] from happening ... Breathe. It'll pass."

[See: Coping With Depression at Work .]