People experiencing a panic attack for the first time often think they are going to die. I hear stories about highly functional people becoming completely overwhelmed with terror, rushing to the nearest emergency room and receiving complete medical workups for a heart attack.

At least one in every 20 people experiences a panic attack in any given year, making it one of the most common psychological problems. Sadly, many people with recurrent panic attacks put off getting help or never seek treatment at all.

Panic attacks are a sudden onset of intense fear and anxiety, accompanied by any number of physical symptoms such as pounding heartbeat, shortness of breath, dizziness, sweating and shakiness. Recurrent panic attacks are termed panic disorder.

People with panic disorder often rearrange major parts of their lives in order to avoid having another panic attack. It is common for people with panic disorder to spend much of each day in their house, stop driving, resist going to stores or avoid any situation from which they cannot readily escape.

For some people the triggers for a panic attack are quite evident. Crowds, closed-in spaces, fast-moving vehicles, heights or large stores are all common triggers for panic attacks. Sometimes, unpleasant events from your past become a trigger for a panic attack. The smell of alcohol on someone’s breath or a loud argument can lead to panic in some people.

For others, the causes of panic are more difficult to identify. One woman I treated began experiencing panic attacks after she was robbed at gunpoint. This made sense, although the pattern of places where she felt panic seemed random.

As we studied the problem, she realized that any place where she could be approached by strangers triggered a panic attack. Thus, closed-in spaces or traveling in a car did not make her anxious. However, a simple stop at a convenience store was overwhelming. With hard work and courage, this woman was able to gradually resume going places that previously had triggered overwhelming fear.

One of the saddest facts about panic attacks is that many people never get help or put off getting help for months or years. It can be embarrassing to admit that you are sometimes rendered helpless by fear. But 70 to 90 percent of people who receive treatment for panic disorder get better relatively quickly.

There are lots of ways to tackle this problem. Counseling or psychotherapy focuses on identifying triggering situations, learning to put yourself in a physically relaxed state and changing thinking patterns which intensify the panic.

Medications, such as a class of antidepressants called SSRIs -selective serotonin reuptake inhibitors – are also effective for many people with panic attacks.

Whatever type of help sounds best to you, it is important not to go it alone. Getting help really works. And, it is important to remember that you are not the only one who has panic attacks. It probably only feels that way.

For treatment providers in your area, contact 211.

Psychologist Dr. David Prescott is the director of psychology services and clinical research at The Acadia Hospital. He writes a monthly column as part of Acadia’s Because Your Mental Health Matters Campaign.