What is a panic attack? 
People experiencing a panic attack are suddenly overwhelmed with intense anxiety, shortness of breath, difficulty catching a breath, rapid heartbeat, or a pain in the chest  The attacks are normally brief, but they can occur several times a week.  The person may continue to feel anxiety between attacks.  When attacks are persistent then the problem is probably Panic Disorder.   It is common for people with Panic Disorder  to believe they are having a heart attack, about to die, or go insane.  Anticipatory anxiety occurs when the person worries about when or where the next attack will occur or whether they will survive. 

What treatment is available? 
A thorough physical exam, EKG & blood tests are needed to rule out "physical" illness. A complete psychiatric evaluation is needed to establish a final diagnosis. There are a variety of 
promising treatments and a psychiatrist can recommend the best approaches.   The tricyclic antidepressants, have  recently proved of value in some anxiety disorders.  Generally a tricyclic such as Tofranil (imipramine) is used to block spontaneous panic attacks. Anticipatory anxiety may be treated with minor tranquilizers such as valium (diazepam) or Xanax .  New or more specific drugs are regularly being tested.  Most behavioral techniques focus around "deconditioning" or unlearning inappropriate anxiety. 

What self-help is there? 
There are several things that you can do to help control panic attacks.  Below is a list of some tips to remember: 
The feelings are normal bodily reactions - exaggerated. 
They are not harmful - just unpleasant.  
Do not add frightening, negative,  or unpleasant  thoughts
Notice what IS not what you fear MIGHT.  
Wait for fear to pass - Do not fight or run away - accept it.  
When frightening thoughts stop, it fades by itself.  
Think about progress to date despite the difficulties
Think how pleased you'll be when you succeed this time.  
.When you begin to feel better, start to plan for next time 
When you are ready, start off in an easy, relaxed way. 
There is no need for effort or hurry.
Change "What If's" to "So What". 
Stay in the present. 
Don't judge your feelings. 
Thoughts and feeling are NOT actions. 
What am I telling myself that is scaring me? 
I am what I tell myself. 
The more I do, the more I can do. 
I've done it before, I CAN do it again! 
I am the same person, here or in my safe place. 
I can handle it, nothing terrible will happen. 
The feeling are distressing, NOT dangerous. 
In reality, there is nothing that can hurt me here. 
The anxiety can only go so high and then it comes down. 
SLOW DOWN.
Take slow, deep breaths.