Susan was relaxing like she did every Saturday morning at the nail salon. She had her feet in the tub, the massage chair activated and was getting a great pedicure. She was talking to the other ladies in the salon about the weather for the upcoming weekend, and the upcoming holidays.

Suddenly, her skin started to itch, it was on fire. She adjusted her feet, maybe the water was too hot. Sweat beads appeared on her forehead, she felt her back and underarms grow moist with sweat. Susan sat there paralyzed, her heart was racing so fast, the beating was so hard she felt like her chest was going to explode. She couldn´t breathe. Oh My God! She thought, I´m having a heart attack. The walls were closing in on her, everyone was looking at her, people must think she´s crazy.

She had to get out, get out, GET OUT NOW! Susan leapt from the pedicure chair and ran to the door. She burst out of the salon and into the parking lot in her bare wet feet. She breathes, she breathes, she can breathe again! Suddenly, she realizes she was in the parking lot in her bare feet. How could she go back in there? What would she say? This is mortifying? Does any of this sound familiar?

Panic attacks come quickly, often without warning and in places you would never imagine having them. What could be more relaxing than pedicure?

Understanding what triggers the attacks is the first step in preventing them. What actually set Susan off was talking about the holidays. Thinking about all the gifts she had to buy, meals to prepare, cards to spend and other preparations she had to do set her into panic mode.

Like most panic attack sufferers, she thought she was dying, having a heart attack or some other serious medical emergency. Her only impulse was to run, run away from the sensations, the experience, the fear. Her fight or flight response was triggered.

Indeed, most attacks come quickly and leave quickly. That´s what´s so frightening about them. They come on strong, often out of nowhere and severely interrupt a person´s life. Susan´s panic from start to finish was less than five minutes. Most attacks last only a couple of minutes but leave lingering fears and anxiety well after that.

Once Susan was able to breathe again, the realization that she had acted in an embarrassing manner hit hard. The mortification that sufferers experience after an episode often leaves long lasting effects. Explaining yourself and reassuring others is only the first part of the process. You then become obsessed with avoiding the situation that you connect to the panic attack.

Susan didn´t go to that nail salon or any other nail salon again for years. She lost touch with the ladies in the nail salon, she avoided those same ladies if she saw them around town, at the mall, in the supermarket. Ducking behind the donut display to avoid seeing someone you had known for years may seem extreme but for panic attack sufferers it’s not.

Susan also stopped going to the hair salon because she thought sitting in a chair in one of these places caused her attack and she didn´t want to look or act like a fool in the hair salon. She justified this by telling everyone she was growing her hair out. She told herself she was being economical and it was a good move for her family.

Susan´s condition worsened as the weeks and months passed after this first panic attack at the nail salon. Her life was unrecognizable and her priorities were completely out of whack.

Why did all of this happen? She was terrified of having another panic attack. Unchecked and untreated, anxiety can become crippling, ultimately leading to Generalized Anxiety Disorder or GAD or phobias, such as agoraphobia, a common companion condition to the attacks.

The good news is you can help yourself, you can manage and prevent your panic attacks. The key to preventing them is understanding the source of your anxiety and then managing your lifestyle and thought process.