Following the huge response to the last two articles regarding constipation and rectal pain, people have found it easier to talk about the more delicate issues in life.

I have had several intimate conversations with people in the vegetable section at the supermarket about a surprising range of problems!

I have decided to move on from that particular area, and for a complete change following a specific request from a reader; we are going to focus on panic attacks.

A panic attack is a severe episode of anxiety and fear that occurs suddenly and often for no apparent reason.

Panic attacks can occur anytime and anywhere. People experience them alone, when in crowds, or even wakening from a sound sleep.

They can occur with equal frequency in familiar or strange surroundings. Some individuals will experience a one off attack and some unfortunate individuals will experience many over lengthy periods of time.

They can occur in clusters where several five to ten minute attacks over a two-hour period are known.

During an attack, due to the sensations of anxiety that are experienced, specific parts of the nervous system are stimulated creating a host of dramatic symptoms that usually add to the stress experienced by the subject.

These include palpitations or an awareness of a fast heart-beat, sweating and shaking, a feeling of shortness of breath, feeling sick, dizzy or faint, pins and needles and a sense of detachment or isolation.

During a panic attack it is common to breath rapidly, resulting in hyperventilation leading to another set of symptoms including confusion, cramps as well as pins and needles and dizziness, all compounding the fear.

Who suffers from panic attacks? At least one in ten people will experience a panic attack in their lifetime.

The condition affects twice as many women as men.

These attacks can affect anyone but they also tend to run in families. Occasionally there is a trigger such as stress at work or bereavement but they can hit with no identifiable cause.

What should you do if you experience a panic attack? The most important aim is to slow down your breathing rate and attempt to breathe slower and deeper.

If you can breathe into a paper bag this will help to rebalance the carbon dioxide level and reduce the blood acid level that is affected by hyperventilation.

It is not uncommon for people to attend Emergency Departments convinced their chest pains and shortness of breath are due to a heart attack.

It is usually following a barrage of tests that patients are informed they were suffering from a panic attack. Treatment is not usually required if only occasional attacks are experienced.

It is often reassuring to understand the symptoms and to be confident that they are not indicative of a serious problem. For example, the palpitations and dizziness are not caused by a cardiac condition.

I know through some patients, that relaxation techniques using hypnotherapy or CDs can be helpful. Some patients use flower essences, as they are a gentle and natural way to relieve anxiety.

From a personal perspective, I have experienced only one panic attack. I was on a tube with my husband, pregnant with my first child.

It was hot and crowded as it usually is so there was nothing unusual or new about the situation.

I became aware of a gradually increasing sense of fear that proceeded to develop rapidly and resulted in me being convinced I was having difficulty breathing.

I was suddenly terrified we were going to crash and felt quite claustrophobic. I just wanted to get off.

I just sat with my eyes screwed tight gripping my husband's hand, wishing the trip would come to an end.

My heart was racing and my hands were clammy.

When it was finally possible to get off the tube, I rushed to the street level and drew in the fresh air.

As I calmed down, what struck me was how frightened I had been for no apparent reason, and also how quickly it passed.

I felt a bit daft to have reacted in that way but it felt right out of my control. I put it down to being thirsty and pregnant!

I can imagine having experienced one attack, that if they were a fairly regular occurrence, one could become anxious about the timing of the next attack and the possible consequences.

My advice would be to learn all about them. Read a self-help book or surf the net and perhaps try a relaxation tape or CD.

From patients who live with regular panic attacks, having all the information to hand reassures individuals so they can eventually reduce the severity or even stop an attack from becoming full blown.

If you would like to suggest a subject you would like me to cover in the Spinal Column, or if you have questions or comments on any subject please email me on ilkleychiro@tiscali.co.uk, or call Ilkley Chiropractic Clinic on 605060.