The phone rings early in the morning and you hear the voice of your friend on the other end. “Oh my gosh,” you think, “Dinner!” Your friend asks where you were last night. She waited at the restaurant for almost two hours, but you never showed up; you were not home either because she called your house. “Where were you?” your friend demands. “In the emergency room with chest pain,” you reply. Suddenly, her tone changes to one of concern. She wants to know what is going on.

How do you tell your friend that last night you were sure you were having a heart attack? Twelve hours ago, you were convinced that you were living your last night on earth. However, after hours of tests and monitors, the doctors found nothing. “You have panic disorder. There is nothing physically wrong with you,” the doctor said. He then gave you the phone number for a mental-health referral center.

You read the pamphlet you were given at the hospital and it sounded all too familiar. You have panic disorder, a psychiatric illness that comes out of nowhere and occasionally makes you afraid of your own shadow. How can you explain this to your friends?

You and your friends need to know that panic disorder is fairly common, affecting anywhere between 1.5 percent to 3.5 percent of the population at sometime during their life. It is a treatable illness. With medication or psychotherapy-or a combination of both-people who suffer from panic attacks can lead normal and fulfilling lives.

Understand how to read the symptoms

Living with panic disorder is like having a home with an automatic-security system. The first time the burglar alarm goes off, you react as if there is a real threat. You imagine that someone is breaking into your home. You get nervous and dial the police-a completely appropriate reaction. Then, you learn it was a false alarm-a problem with the system or its overly sensitive detectors. The next time the alarm goes off, you react again, imagining this time that it is not a false alarm but a real intruder. You never completely get used to it going off, although you begin to appreciate that it probably is a false alarm. At least you are not so quick to summon the police.

The symptoms of a panic attack are real and measurable-like the bells, sirens and whistles of the burglar alarm-but in both cases they are misleading. You must learn to adjust to the meaning of the symptoms. A racing heartbeat and hyperventilation do not mean that you are having a heart attack. Racing thoughts and feeling as if you are disconnected from your body do not mean that you are going crazy. They are signs that something is amiss, and knowing that can be the first step in getting control of the situation.

Help your friends know the symptoms

Tell your friends about the symptoms, so that if they are with you when you have an attack, they can recognize what is going on and offer you help. Symptoms of a panic attack, as described in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Volume Four (DSM-IV), include:

  • chest pounding or increased heart rate
  • sweating
  • tremors or the shakes
  • feeling short of breath or as if you are being smothered
  • choking sensation
  • chest pain or discomfort
  • nausea or abdominal discomfort
  • feeling dizzy, light-headed or faint
  • feeling as if you or the world is unreal
  • fear of going crazy or losing control of yourself
  • fear of dying
  • tingling feeling in extremities
  • chills or hot flashes

Guide your friends in appropriate action

By being aware of these symptoms, your friends can be educated about what a panic attack is. Tell them not to rush you to the hospital unless you describe symptoms that are different from your typical panic attack. Tell them that being reassuring during the experience generally is enough.

Here are some other pointers you might want to give:

  • Don’t assume what I need, ask me.
  • Let me pace my recovery, but encourage me to get help.
  • Find something good in my achievements. When I overcome an obstacle (such as driving on the highway), make a big deal of it.
  • Don’t let me avoid life. Help me take the baby steps to live life to its fullest.
  • Don’t give up your own life to protect me. We only will grow to resent each other.
  • Don’t panic when I panic. I need you to be confident that I will get through this.
  • Don’t tell me to “Calm down” or “Get a grip on yourself.” If I could do that, don’t you think I would?

Panic disorder is a difficult problem for everyone involved. But, with care, patience and some help from your friends, you can overcome it.