Imagine a sense of terror overtaking you with extraordinary intensity. For no apparent reason your heart pounds and you cannot catch your breath. As perspiration rolls across your brow, your mind flashes to an image of a heart attack. Do I need to get to a hospital? Am I losing my mind?

People who struggle with panic disorder know experiences such as this all too well. In the next six months, more than 1.5 million Americans will qualify for a diagnosis of panic disorder.

Often, panic disorder is not diagnosed immediately, since people believe they are experiencing a physical problem – or they are too embarrassed to discuss a panic attack with friends or family members.

While not all people have the same symptoms during a panic attack, there are some symptoms which commonly occur. Shortness of breath, trembling or faintness, rapid heartbeat, sweating, and chest discomfort are usually present. People often feel that they are about to lose control, or they have an intense fear of dying. Once the attack begins it typically peaks within 10-15 minutes.

People with panic disorder commonly report that they spend lots of time and energy trying not to have another panic attack. Worrying that you may have another attack is actually one of the diagnostic criteria for panic disorder.

It is understandable that people who have a panic attack try to avoid situations where it is difficult to escape – for example, a crowded concert or shopping mall. However, our initial attempts to cope may unintentionally feed into the disorder.

Structuring your life so that you avoid most situations that lead to anxiety may make you feel more isolated and alone. In almost half the cases of panic disorder, problems with depression are also present.

As with many mental health problems, treatment can proceed along a number of different lines. Many people use more than one approach.

Learning systematic relaxation techniques can help people tolerate situations that induce anxiety. Current psychotherapy and counseling approaches focus on identifying triggers for anxiety or panic, and finding ways to cope other than avoidance.

Often, our assumptions and beliefs feed anxiety, and examining our thinking patterns can be the key to getting relief.

A variety of medications can be used to treat panic disorder. Certain medications are specifically targeted to assist with physical relaxation and more immediate reduction of anxiety symptoms. Others may take a few weeks to help, but can be effective in reducing both anxiety and depression.

In either case, your family doctor or a licensed mental health professional is a good place to start.

David Prescott is a psychologist at Acadia Hospital in Bangor. To request a free information sheet on panic disorder, call The Acadia Hospital at 973-6166.