A panic attack is a sudden onset of acute anxiety that is often mistaken for a life-threatening illness, and for those who suffer from recurrent attacks it can often be debilitating. Physical symptoms of an attack can include rapid heart rate, dizziness, shaking, nausea, abdominal cramping, numbness of the hands and feet, chest pain and shortness of breath. Many people report feeling like they were going to die during these episodes, which can last for several minutes.
About 23% of Americans report having experienced a panic attack while up to 4.7% of Americans  with recurrent attacks have been diagnosed with panic disorder. Women are twice as likely as men to develop the condition.
Panic disorder is complex involving psychological, neuro-biological and environmental factors. Neuroimaging studies  have highlighted the role of the amygdala in panic disorder but also implicate the “thalamus, hypothalamus, and brain stem regions including the periaqueductal gray, parabrachial nucleus, and locus ceruleus."
Environmental and psychological components engaging the sympathetic nervous system and a fight-flight response in the disorder include chronic or acute stress, trauma, excess caffeine or alcohol intake. Stress-induced dysfunction of the HPA axis can affect the balance of steroid hormones, adrenaline and cortisol, and may contribute to the condition.
Left unaddressed, recurrent panic attacks may lead to phobias, depression, substance misuse and abuse.
Panic attacks can be aborted using sedative drugs, but there is no effective drug treatment for the underlying disorder. In one long-term study on the use of psychodynamic psychotherapy and cognitive behavioural therapy for panic attacks over 2 years, the condition improved in 70% of patients.  Acupuncture has also been shown to be effective in reducing anxiety.