Panic attacks can be terrifying and leave you isolated and affect your quality of life. The feeling that a panic attack stirs up, overwhelming fears and emotions, can spring up without warning and leave you feeling disorientated and helpless. It’s a frequent, terrifying, staggering wave of emotions that can truly disorientate your life and have you living in a state of fear. Thankfully, this disorder is manageable as well as treatable.
“During a panic attack, the individual usually thinks something like “I am having a heart attack” or “I am going insane”, but may not be aware of how those thoughts affect, or even exacerbate, the attack’s symptoms”, says Clinical Psychologist and CBT Expert, Dr. Colinda Linde.
It’s vital to educate yourself about the disorder, especially when so many people would rather choose to ignore the problem, and leaving it could potentially jeopardize their life.
What are panic attacks?
According to Mayo Clinic, a panic attack can be defined as a sudden episode of intense fear that triggers severe physical reactions when there is no real danger or apparent cause (1). It is believed that panic attacks are essentially the brain’s fight or flight response being inappropriately aroused.
Recurrent, unexpected panic attacks, as well as one spending long periods in constant fear of another attack, may mean that the person is battling a panic disorder. Approximately 2.4 million Americans have panic disorders in a given year and women are twice as likely as men to develop panic disorders.
Symptoms of panic attacks
As mentioned, when one experiences their first panic attack, it typically arises unexpectedly. The person could be engaging in some ordinary activity, and they may even be sharing a laugh with friends. Before they know it, they are suddenly struck with uncomfortable symptoms.
- Sense of being overwhelmed by fright and terror, with accompanying physical distress for between four and six minutes.
- Racing and pounding heartbeat
- Chest pains
- Dizziness and Light-headedness
- Difficulty breathing
- Tingling or numbness in the hands
- Flushes and chills
- Sense of unreality
- Fear of losing control, going “crazy,” or doing something embarrassing
- Fear of dying
What causes a panic attack?
Initial panic attacks often occur in individuals who are battling considerably higher stress levels or significant life changes. This can be due to financial strain, excessive work obligations, the death of a loved one, hospitalization, a serious accident, or childbirth. Excessive use of stimulants such as caffeine and drug abuse can also trigger panic attacks.
Furthermore, according to a study published in the Depression and Anxiety journal, genetic factors may also influence a person’s risk of developing a panic disorder.
While studies are still ongoing in terms of why panic disorders develop, it’s important to remember that the unpredictability associated with panic attacks is what makes them so devastating and dangerous.
What are the effects of panic attacks?
Anticipatory anxiety is associated with panic disorders. Basically, they begin to experience an intense apprehension of having another attack. In addition to seriously inhibiting their daily life, this fear may soon lead the person to develop phobias about situations where the panic attack has occurred. For example, if they had a panic attack in the supermarket or at work, they may be afraid to return to these areas.
Individuals battling panic disorders may develop agoraphobia. This is a condition whereby the person is apprehensive and afraid of being in a place or situation whereby it would be difficult to be assisted in the event of a panic attack. Such places include public transportation, big crowds, queues, and shopping malls. As a result of this fear, these individuals will restrict themselves to safe zones that are often their homes. They will find it incredibly difficult to go beyond these safe zones without being accompanied by a particular family member or friend.
According to the National Institute on Alcohol Abuse and Alcoholism, one can expect at least 20% of all individuals diagnosed with panic disorder to also have a co-occurring substance use disorder (2). There is also a strong link between individuals living with panic disorders and alcohol abuse (3).
According to a study published in the Clinical Psychology Review, panic disorders and symptoms are statistically significant, yet weak, risk factors for future suicide ideation and attempts. If you, or anyone you know, are battling suicidal thoughts, it’s important to reach out to a family member, friend, or your local mental health clinic.
Treating panic attacks
Some treatments use a combination of medication and some form of psychotherapy as they believe that it produces the best treatment response rates.
A form of psychotherapy, cognitive-behavioral therapy is a combination of cognitive and behavioral therapy. Cognitive therapy aims to modify or eliminate thought patterns contributing to the patient’s symptoms and behavioral therapy serves to help the patient to change his or her behavior.
Throughout the treatment, the therapist conducts a careful search for the thoughts and feelings that accompany the panic attacks. The therapist might use the “cognitive model” of panic attacks. This states that individuals with panic disorders often have distortions in their thinking, of which they may be unaware, and these may give rise to a cycle of fear. The behavioral aspect may appear when the therapist involves systematic training in relaxation techniques. Relaxation techniques used include breathing exercises that will teach the patient how to control their breathing and avoid hyperventilation.
The therapist helps determine whether the patient has been avoiding particular places and situations. If so, the patient and the therapist both agree to work on avoidance behaviors that are most seriously interfering with the patient’s life. The therapist might even take their patients on excursions to places the patients have been avoiding.
Prescription medications are prescribed to help prevent panic attacks or reduce their frequency and severity. They are also used to decrease the associated anticipatory anxiety.
Common medications are Selective Reuptake Inhibitors (SSRIs), Tricyclic Antidepressants, High-Potency Benzodiazepines, and Monoamine Oxidase Inhibitors (MAOIs). Doctors select which medication to use based on considerations of safety and efficacy as well as the personal needs and preferences of the patient.
Selective Reuptake Inhibitors (SSRIs)
These anti-depressants are generally associated with fewer side effects.
These side effects include dry mouth, constipation, and blurred vision.
Benzodiazepines are quite effective, well-tolerated, and have few side effects. Unfortunately, patients, especially those who have had problems with alcohol or drug dependency, may become dependent on benzodiazepines.
Monoamine Oxidase Inhibitors (MAOIs)
The use of MAOIs requires the patient to observe exacting dietary restrictions. This is because certain foods can interact with the MAOI and affect a patient’s blood pressure. That said, individuals who are taking MAOIs need to be conscious of their doctor’s guidance concerning dietary restrictions.
Easy “on the spot” Tips to get Though a Panic Attack
- Take a “time out” and slow down. Slow your rate of breathing and slow your racing thoughts. Then slow your entire body, head to toe. Then slowly resume your previous activities.
- Picture a relaxing scene using all your senses. Go further by putting yourself on the scene.
- If there are places available, take a stroll. If there are people available, talk to one of them.
- Picture a person you trust or someone who believes in you supports you and cares about your well-being. Now imagine the person is with you, offering you encouragement.
- Recall a time when you handled a similar situation well. You can also try to bring to mind a past success and the good feelings you experienced at the time.
- Focus on the present such as concrete objects around you. Make a game of noticing details or inventing questions about every object you identify with.
- Count backward from twenty and with every number. Picture a different image of someone you love, something that pleases you or something that calms you. These might be images you recall from the past or those you only imagine.
- Occupy your mind with an absorbing task such as planning a splendid meal.
- Bring to mind the image of a person you admire and imagine yourself to be that person.
- Remind yourself that attacks always end.
- Take a giant yawn and stretch your body, head to toe.
- Get mad and vow not to let panic win out. You deserve better.
- If all else fails, take as deep a breath as you can and hold it for as long as you can. Use one of the other strategies to occupy your mind. You will notice that your physical symptoms should come down and stay down. (Courtesy of “Master Your Panic” – Beckfield)
You are more likely to experience another panic attack after a time of feeling better. When that happens, it’s important not to give up on your treatment and progress. Remember that your treatment is essential and that in time, the attacks will be less severe, and you will go on to live a healthy and fully-functional life.