A panic attack is a short episode, usually lasting less than one half hour, of intense fear. People experiencing such attacks feel as if they are gripped by terror for no reason. Sometimes they can’t breathe and believe they are on the verge of death. Other symptoms, which usually peak in the first ten minutes of an attack, are pounding or accelerated heart rate, trembling, trouble swallowing, headache, feeling of choking, chest pain, dizziness, feelings of detachment or depersonalization, numbness, nausea, feeling of going crazy, fears of dying, sweating, chills or hot flushes. These physical reactions can be the same ones you would endure if you were about to be run over by a big truck. Panic attacks often come without warning. There is probably a genetic factor in whether a person develops a panic attacks in that you have a higher risk of having them if you have biological relatives with histories of panic attacks or panic disorders. Other risk factors are the death or serious illness of a loved one, a childhood history of physical or sexual abuse, other extreme trauma, giving birth to a baby, and significant stress. Although most panic attacks go away on their own, there can be complications, such as avoiding social situations, depression, increased risk of suicide or suicidal thoughts, alcohol or substance abuse, problems at work or school, and/or financial problems. People who have panic attacks tell their doctors that one of the worst complications is their intense fear that the attacks will occur again. This fear interferes with their daily functioning, in that they start avoiding certain situations, become hypervigilant, and so forth. Anyone who experiences a panic attack for the first time should seek medical help, because these episodes can mimic serious and even life-threatening problems, including heart attacks.