As opposed to the more common milder panic attack that many people suffer from, severe panic attacks are more dangerous due to the inherent danger of the illness progressing to a more serious condition. Severe panic attacks need a different approach, and their management is often far from straightforward.

It's quite usual for severe panic attacks to appear in a series of waves that increase and decrease every few minutes, often lasting for several hours. It's also not surprising that this can lead to extreme physical exhaustion, which in turn can cause a chronic loss of sleep.

Severe panic attacks can involve temporary or short term dizziness during the period of distress, which can manifest itself suddenly, and disappear just as quickly. Attacks such as this can be extremely disconcerting for the sufferer, but it's worth remembering that these symptoms are the body's natural reaction, even though they are completely out of context.

Any prolonged case of severe panic attacks must be treated or at least checked by your doctor as soon as possible. This is primarily due to the danger of the panic attacks becoming self-sustaining - a condition whereby the person becomes afraid of the consequences of the panic attack itself, which in turn makes the condition worse, and so on, and so on.

If not checked, this kind of condition can cause an almost inescapable spiral of anxiety and panic, with the potential to lead the sufferer into serious states of depression. With depression on top of a panic attack there is a real danger that the sufferer will take irrational steps, possibly to the extent of harming themselves, which is why medical attention should be sought as a matter of urgency.

There are many treatments available for panic and anxiety, and medication is but one of them. When considering medication for panic attacks, the need for treatment has to be weighed up against the likelihood of possible side effects.

The worst of severe panic attack sufferers may not have much choice, in which case your doctor will prescribe the necessary medication. For less severe cases, a doctor may prescribe a low dose of anti-depressant, which in addition to suppressing the symptoms will also help any sufferer see things in a more reasonable way and prevent the runaway panic.

Although it's impossible to predict when a severe panic attack is imminent, there are things you can do and precautions you can take, some of them which work on changing the way you perceive things. One of the tricks is not to take yourself too seriously. This has it's own problems, but a more light-hearted view of yourself tends to produce a more light-hearted view of the world, and this leads to fewer situations in which you have the urge to feel anxiety and panic. Another method is to focus on a particular word, the more ridiculous or funny, the better, as soon as you begin to feel anxious. This has the effect of distracting you and diffusing your panic.

Analysis is another useful tool. As soon as you can after a panic attack, you write down what you were thinking about. Later, in the relative calmness, you consider what led you to feel such anxiety and fear. It's a good way to learn about how your mind works, and exactly what happens during your own panic attacks, how one fear can lead to another.

Once you have an idea of the process your own mind goes through, you are then in a position to anticipate things and you stand a much better chance of avoiding severe panic attacks. In addition to recognising the thoughts you may feel, there are also common physical symptoms of the onset of a panic attack. These include;

* an elevated pulse rate

* increased nervousness and restlessness

* your heart begins to pound for no apparent reason

* you start to perspire

* a feeling of nausea or dizziness

If you begin to feel any of these symptoms, immediately get up and go for walk. A quick change of scenery will give your mind something new to focus on and will help to distract you from whatever caused you to feel anxious.

By reducing panic as soon as it starts, you will most likely avoid a panic attack all together. This is because you interrupt the body's physical reaction to your emotional state, and you prevent the production of adrenalin which in turn increases your anxiety. Taking long, deep breaths and concentrating on controlling your breathing will help.

Longer term, you can try to get more exercise and make sure you are eating healthy. Try to avoid too many stimulants such as coffee and alcohol which affect your nervous system and emotional state. If your body is in good shape, there's a good chance your mind will be too.