[sramsay]

An actual panic attack is completely and totally devastating. The entire fight/flight system goes haywire, and people think they're about to die. It's even possible to start hallucinating. Lots of sufferers wind up in the ER absolutely convinced they're having a heart attack.

What's worse, this can lead to a whole range of phobias (I'm in the middle of this theater. What if I have an attack? Then you start having one. Now you're afraid of theaters and theater-like spaces).

It can take many, many years for people to learn how to "talk themselves down" out of this (or, more accurately, to endure the onset of one without letting it get full blown). It's not life threatening, but it's a very serious illness indeed.

[raelshark]

I think it's people usually don't get that these are often just random and not always tied to an event, but vice-versa. Certain situations and interactions can lead up to or trigger attacks, but when it's a real disorder with the fight or flight mechanism, there's often no rational meaning to the sense of panic.

In my case my attacks turned out to be related to a disorder of the autonomic nervous system, which (among lots of other things) results in my response system overreacting to stimuli. It took me a long time to get diagnosed and I've learned to cope by rationalizing my panicky feelings as nothing more than flawed biology. I know that there's nothing really wrong, and I can calm myself down, telling myself it's just my screwed up vagus nerve, before an attack becomes full-blown. Thanks to that I was eventually able to taper off taking Xanax regularly.

But while going through that process I had days where I couldn't even work, and even had a boss drive me to an urgent care place once in a full-blown attack. The work at the time was definitely stressful, but I think the panic attacks exacerbated the work more than the other way around.

[tvm]

Yes, the main deal is that the fight/flight system gets triggered too often, even in inappropriate situations. The result is devastating.

[stephendedalus]

I feel for you so much. I've gone through this for the last 14 years. On and off. Mostly off since I've been on medication, but it's debilitating. When you don't go places or do things because you're afraid of simply being there for a panic attack. Always sitting on aisles (when you finally get to the point where you can go to a movie) so you have an easy escape.

And yeah, often you don't look at people, wear headphones or do other things like that. That's when you're doing "well" and not having panic attacks. When you've learned how to manage it.