In some cases, various physical conditions such as the Chronic Obstructive Pulmonary Disease (COPD), Dyspnea (difficult or painful breathing), Mitral Valve Prolapse (MVP), the irregular heart, low blood sugar, etc., may be accompanied by panic attacks.

In saying this let me clarify that although physical conditions such as these may be accompanied by panic attacks, panic attacks do not necessarily indicate that you have an underlying physical illness.   Most people with panic attacks have a strong heart and healthy lungs.  However, in some physical illnesses, especially ailments involving the heart and the breathing system, panic attacks can be present, and furthermore there may be a physical explanation for it.

Spontaneous panic attacks," as they are called, come out of the blue.  A patient is not thinking of any anxious or worrying thoughts to cause a panic attack.  In fact, the patient may be resting and thinking about a harmless, everyday event, and then a panic attack may "spontaneously" appear.  His heart races, the breathing goes haywire, the body shakes, the person sweats like his body is on fire, legs feel weak and crumbling, and other menacing symptoms ravage the body.  All  these things happen when there is no valid cause for such a terror.

After the attack, one asks oneself, "I was not in a life an death situation, why did I panic as if I really was?"  Often, a person undergoing a panic attack suspects a heart attack or some other horrible illness and checks in at the emergency room or at the doctor's office.  Medical tests usually don't show any signs of a real heart attack.

Many panic patients tell me, "Doctors told me there was nothing wrong with my heart.  My panic attacks were still going out of control.  I began to think I was going crazy."  I assure them that there may be a good cause as to why their body and mind has a "life-and-death emergency" type o panic response.  Their body and mind may be acting on a "false alarm," sending a misleading signal that they are suffocating or about to choke to death.

Mother Nature has built in us a "suffocation alarm system" so that we don't go on suffocating to the point of death.  This suffocation alarm is important for our survival.  Consider the case of babies who die in their sleep, perhaps without a scream or a cry.  Perhaps their suffocation alarm system failed or had never developed.  Without such an alarm system, we may not feel the need to get away from a toxic environment even when the pollution reaches a dangerous level.

If the alarm system is messed up, it can go off even when there is no real danger.  Imagine your house alarm that goes off by a slight smoke when you are cooking.  The house is not on fire, but the alarm has gone off, and people who do not know that it was a false alarm are in a panic, trying to put out the fire or running in a frenzy to save their lives.  Likewise, the body and brain may act on a false alarm.

To continue with the analogy, some patients with heart or lung problems may receive false alarm because of the presence of "smoke," that is, the heart or breathing problem.  The two major symptoms found in almost all panic attacks are heart palpitation (heart goes "thump, thump") and the dyspnea (shortness of breath).

In some cases, just a moderate change in heartbeat and breathing can set off a false suffocation alarm. Shortness of breath, painful breathing can set off a false suffocation alarm.  Shortness of breath, painful breathing or difficulty in breathing perhaps, induces the fear of suffocation.  During a panic attack, patients rush to a window and throw it open in an attempt to fill their lungs with air.

To take an example of one physical illness, COPD is associated with smothering sensations.  Panic disorder is the most common psychiatric disorder in COPD.  Note that not all COPD patients have panic attacks and not all panic attack patients have heart or lung problems.  People who are highly anxious or tense can also have changes in their heart rate and breathing.  Some of the times, the suffocation alarm may be falsely activated by even moderate changes in the breathing and in the heart rate.  Proper education, the psychological training and medication such as Imipramine can provide considerable relief for panic attacks with or without a physical illness.
 

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