does anyone here get severe panic attacks?

Fear of fainting or collapse

A common thought during a panic attack, especially if you feel dizzy or your legs feel weak, is that you will faint or collapse. These sensations are also a normal feature of anxiety or fear. They occur as a result of adrenaline being released into the bloodstream. You believe that you will faint or collapse only because you have misinterpreted those physical sensations. I will explain why it is impossible for you to faint during a panic attack.

When your heart beats fast during a panic, your blood pressure goes up. Fainting is a reflex reaction that only occurs if the blood pressure to your brain is too low. Very low blood pressure forces you to fall down so as to allow more blood to flow to your brain.

A common cause of fainting is standing for long periods on a hot day or in a stuffy place - a problem which can affect shop assistants or soldiers on parade, for example. Fainting is also a reflex action to the sight of a lot of blood. But people rarely faint in normal conditions if they are in good health.

Remember that in a panic attack your blood pressure is going up which will prevent you fainting. You may feel as if you are going to faint or collapse during a panic attack but it is just impossible. You can check this out by trying to reproduce the symptoms of dizziness you get in a panic attack by spinning round in a large room or open space. Then remain standing with your eyes shut. It may feel as if you are going to collapse but it does not happen because the balance mechanism in your ear prevents you from falling. And even if you did collapse in a panic, how much would it really matter? You are probably afraid of causing a scene, but even if you did faint, and I would dispute that it is possible, you would come round in a few seconds and then you could simply get up and walk off.

In summary, the fear that you will faint or collapse is only a symptom of a panic attack and makes the experience much worse. If you believe that you are about to collapse, you will feel more anxious and frightened and so get more sensations of dizziness. This feeds a vicious circle of further anxiety and creates more physical sensations.

So when you next start to get a panic attack, remind yourself that it is impossible to faint. Write down on a card why you are not going to faint or have a heart attack and read it when you start to get panicky. Remember that the sensations may be unpleasant but you will come to no harm. It will also help if you regularly provoke the symptoms of dizziness to get used to the sensations. You could do this, for example, by spinning yourself around.

http://www.cragface.co.uk/panic_attack.asp