Panic attacks are sudden, intense surges of fear, panic, or anxiety. They are overwhelming, and they have physical as well as emotional symptoms.
Many people with panic attacks may have difficulty breathing, sweat profusely, tremble, and feel their hearts pounding.
Some people will also experience chest pain and a feeling of detachment from reality or themselves during a panic attack, so they make think they’re having a heart attack. Others have reported feeling like they are having a stroke.
Understanding Panic Attacks
What is a panic attack?
A panic attack is a sudden attack of exaggerated anxiety and fear. Often, attacks happen without warning and without any apparent reason. Some people may experience just one episode of panic attack, while others can have recurring episodes. Recurring episodes usually happen after a person is exposed to various events or situations that may “trigger” panic. While it is generally harmless, panic attacks can severely disable a person physically, emotionally and psychologically. In extreme cases, panic attacks can lead to panic disorder.
Who gets panic attacks?
The condition affects many people. It is believed that 10% of the total population is suffering from panic attacks, yet many are still not diagnosed or under-diagnosed. They tend to occur more on young adults. Female are twice as prone to have an attack as male. It is also said that the condition is genetically inherited so panic attacks may run in the family.
How do I know if I am having an attack?
A panic attack can be identified with different signs and symptoms. They include increased heartbeat or palpitation, chest pain, hyperventilation or shortness of breath, stomach churning, upset stomach, trembling and shaking, muscle tension, sweating, dizziness and light-headedness, hot or cold flashes, tingling sensation or numbness, fear of dying, going crazy or losing control and feeling detached from the surroundings.
The signs and symptoms of panic attacks are similar to a heart attack. The former is not dangerous, the latter can be deadly. It is best therefore to seek for emergency medical help, especially if the patient experiences it for the first time.
Panic Attack: Signs, Symptoms, Panic Disorder and Agoraphobia
A panic attack is a sudden surge of overwhelming fear and anxiety, usually without any clear reason and without warning. It can happen to anyone regardless of age, health and status. Many attacks are a one-time occurrence, but some people experience recurring episodes. Recurring episodes are often caused by a “trigger” – like speaking in front of a crowd or doing a presentation at work. Panic attacks may be a part of another disorder such as depression, panic disorder, or social phobia. These, however, are generally harmless, but sufferers still feel that their life is in danger. Either way, panic attacks are treatable.
Signs and Symptoms
A panic attack can happen anytime, but it usually happens when you are away from home. You may be at a store shopping, at work preparing for a presentation, in a class, driving, walking down the street or even during asleep.
The signs and symptoms develop quickly and usually arrive at its peak in 10 minutes. The majority of panic attacks do not last for more than 30 minutes and it rarely lasts for more than an hour.
A person during an attack shows these signs and symptoms:
• Increased heartbeat or palpitation
• Chest pain
• Hyperventilation or shortness of breath
• Stomach churning, upset stomach
• Trembling and shaking
• Muscle tension
• Dizziness and light-headedness
• Hot or cold flashes
• Tingling sensation or numbness
• Fear of dying, going crazy or losing control
• Feeling detached from the surroundings
A panic attack may happen just once without any problem or complication. And there is almost no reason to be concerned if you have one or two episodes. But those who have experienced several episodes usually develop panic disorder.
Recurring panic attacks along with persistent anxiety for future attacks and major changes in behavior can be considered as panic disorder. There are two symptoms of panic disorder: (1) phobic avoidance and (2) anticipatory anxiety.
Phobic avoidance – When you begin to avoid certain things or situations based on the belief that it would trigger another attack. It can also be avoiding situations that have caused the previous attack. You may also avoid places or situations where escape is difficult and help is unavailable, like riding an elevator or an airplane. Extreme case of phobic avoidance may lead to agoraphobia.
Anticipatory anxiety – The “fear of fear” or the fear of having future panic attacks. The person manifesting this symptom is usually tensed and anxious. When ignored, the condition can be disabling.
Panic disorder with agoraphobia
Agoraphobia is traditionally believed as fear of open places or public places, thus, it literally means “fear of the marketplace.” However, now it is believed that agoraphobia is fear of experiencing panic attack in a place where help is difficult or where escape would be difficult.
People with agoraphobia tend to avoid the following situations or activities:
• Being away from home
• Confined places where there is a possibility of being trapped (elevator, theaters, public transportation, stores)
• Going out with “unsafe” person or someone he or she is not comfortable being with.
• Places where it would be embarrassing to have a panic attack like parties and other social gatherings.
In severe cases, people with agoraphobia see their home as the only safe place.
What should I do during an attack?
Panic attacks peak from 5 to 10 minutes; it rarely lasts for more than half an hour. But during this time, you can experience discomfort such as those signs and symptoms mentioned above. Since the increased in heart rate is the main reason for experiencing other symptoms, it is important to take control of your breathing during an attack. Breathe slowly and deeply as you can. Breathe in slowly for 3 counts then hold your breath for the next 3 slow counts. Then, exhale for 3 slow counts.
Do this until you are calm. If you are able to stand, get up slowly and walk around. It is also helpful to breathe into a plastic or a paper bag. This allows you to re-breathe your carbon dioxide. Carbon dioxide helps correct the blood acid level that had been disturbed by excessive breathing.
While practicing deep breathing, try to focus your attention away from the cause of panic. Replace your anxious thoughts with happy ones. If available, do something that will occupy your mind such as solving puzzles and playing word games.
Experiencing a panic attack for the first time can be distressing not only because of the actual experience during the attack but also because you tend to develop fear of future attacks. Also known as anticipatory anxiety, fear of future attacks causes continuous fear and tension disabling you to relax. Often when the condition is not addressed, it will lead to phobic avoidance wherein you avoid places, situations, gatherings, and events where emergency help is not readily available or where having an attack can be embarrassing.
Take into extreme, this condition may lead to agoraphobia where you begin to avoid much of the activities you usually do. To avoid this, consider the following advices:
1. Use deep breathing
While hyperventilating is a symptom of panic attacks that can increase fear, deep breathing can reduce symptoms of panic during an attack.
If you’re able to control your breathing, you’re less likely to experience the hyperventilating that can make other symptoms — and the panic attack itself — worse.
Focus on taking deep breaths in and out through your mouth, feeling the air slowly fill your chest and belly and then slowly leave them again. Breathe in for a count of four, hold for a second, and then breathe out for a count of four:
2. Recognize that you’re having a panic attack
By recognizing that you’re having a panic attack instead of a heart attack, you can remind yourself that this is temporary, it will pass, and that you’re OK.
Take away the fear that you may be dying or that impending doom is looming, both symptoms of panic attacks. This can allow you to focus on other techniques to reduce your symptoms.
3. Close your eyes
Some panic attacks come from triggers that overwhelm you. If you’re in a fast-paced environment with a lot of stimuli, this can feed your panic attack.
To reduce the stimuli, close your eyes during your panic attack. This can block out any extra stimuli and make it easier to focus on your breathing.
4. Practice mindfulness
Mindfulness can help ground you in the reality of what’s around you. Since panic attacks can cause a feeling of detachment or separation from reality, this can combat your panic attack as it’s approaching or actually happening.
Focus on the physical sensations you are familiar with, like digging your feet into the ground, or feeling the texture of your jeans on your hands. These specific sensations ground you firmly in reality and give you something objective to focus on.
5. Find a focus object
Some people find it helpful to find a single object to focus all of their attention on during a panic attack. Pick one object in clear sight and consciously note everything about it possible.
For example, you may notice how the hand on the clock jerks when it ticks, and that it’s slightly lopsided. Describe the patterns, color, shapes, and size of the object to yourself. Focus all of your energy on this object, and your panic symptoms may subside.
6. Use muscle relaxation techniques
Much like deep breathing, muscle relaxation techniques can help stop your panic attack in its tracks by controlling your body’s response as much as possible.
Consciously relax one muscle at a time, starting with something simple like the fingers in your hand, and move your way up through your body.
Muscle relaxation techniques will be most effective when you’ve practiced them beforehand.
7. Picture your happy place
What’s the most relaxing place in the world that you can think of? A sunny beach with gently rolling waves? A cabin in the mountains?
Picture yourself there, and try to focus on the details as much as possible. Imagine digging your toes into the warm sand, or smelling the sharp scent of pine trees.
This place should be quiet, calm, and relaxing — no streets of New York or Hong Kong, no matter how much you love the cities in real life.
8. Engage in light exercise
Endorphins keep the blood pumping in exactly the right away. It can help flood our body with endorphins, which can improve our mood. Because you’re stressed, choose light exercise that’s gentle on the body, like walking or swimming.
The exception to this is if you’re hyperventilating or struggling to breathe. Do what you can to catch your breath first.
9. Keep lavender on hand
Lavender is known for being soothing and stress-relieving. It can help your body relax. If you know you’re prone to panic attacks, keep some lavender essential oil on hand and put some on your forearms when you experience a panic attack. Breathe in the scent.
You can also try drinking lavender or chamomile tea. Both are relaxing and soothing.
Lavender should not be combined with benzodiazepines. This combination can cause intense drowsiness.
10. Repeat a mantra internally
Repeating a mantra internally can be relaxing and reassuring, and it can give you something to grasp onto during a panic attack.
Whether it’s simply “This too shall pass,” or a mantra that speaks to you personally, repeat it on loop in your head until you feel the panic attack start to subside.
11. Take benzodiazepines
Benzodiazepines may help treat panic attacks if you take one as soon as you feel an attack coming on.
While other approaches to the treatment of panic may be preferential, the field of psychiatry has acknowledged that there is a handful of people who will neither respond fully (or at all in some cases) to the other approaches listed in above, and as such, will be dependent on pharmacological approaches to therapy.
These approaches often will include benzodiazepines, some of which carry FDA approval for the treatment of this condition, such as alprazolam (Xanax).
Because benzodiazepines are a prescription medication, you’ll likely need a panic disorder diagnosis in order to have the medication on hand.
This medication can be highly addictive, and the body can adjust to it over time. It should only be used sparingly and in cases of extreme need.
Help Someone Having a Panic Attack
Panic attacks often occur to anyone without warning. So whenever someone had an attack, it is important that you know what to do.
Understand what a panic attack is. A panic attack is a sudden surge of overwhelming fear or anxiety. It is manifested by several signs and symptoms. During an attack, a person experiences increased heartbeat or palpitation, chest pain, hyperventilation or shortness of breath, stomach churning, upset stomach, trembling and shaking, muscle tension, sweating, dizziness and light-headedness, hot or cold flashes, tingling sensation or numbness, fear of dying, going crazy or losing control and feeling detached from the surroundings.
Seek for emergency medical help. It is important to call for a health professional especially if a person experiences an attack for the first time.
Identify the cause of the symptoms. The signs and symptoms of panic attack are similar to medical conditions. Hyperventilation or shortness of breath can be a sign of asthma. Chest pain, increased heartbeat or palpitation and sweating can be a heart attack. Talk to the person and determine if the symptoms are caused by other medical conditions. When in doubt, a health professional will be a great help.
While waiting for help, find the cause of attack. Once it is established that the cause of the symptoms is really a panic attack, find the source of the panic and take the person away from it. Do not make an assumption about what the person needs. A person who is suffering from the attack may know exactly what to do or has medications which will get him through the attack, so it is best to ask.
Don’t surprise the patient. Be predictable with your movements. Do not grab, hold or restrain. Keep him calm and stay calm yourself. Reassure the person that everything is going to be fine but do not dismiss his fear by saying “it’s all in your mind” or “don’t worry about it” or “you are overreacting.” Take note that the fear is very real to the victim so it dismissing the fear has no effect or can even make the matter worse.
Help the patient to control his breathing. Many patients breathe heavily during an attack; others hold their breath. Using deep breathing technique is a very effective way to purge the symptoms of a panic attack as well as calm the patient down. Guide the person and tell him to breathe in for 3 slow counts. Then ask him to hold his breath for 3 slow counts and breathe out for another 3 slow counts. Do this several times until the person is calm. You can also advice him to breathe into a paper bag. This way, he will re-breathe his carbon dioxide. Carbon dioxide helps correct the blood acid level that had been disturbed by excessive breathing. But be careful when using paper bags since they may trigger another fear.
Stay with the person throughout his ordeal. Never leave a person especially if he is having difficulty in breathing. Be patient. They may act rude or unfriendly but remember that it is temporary and will go back to normal as soon as the attack is over.
Do not forget that for the patient, the thoughts are real. Reassure him the help is on the way. Never allow the patient to do things that will put his life at risk.
Panic Attacks – Out With the Myths
Misinformation does not only create vague pictures of a condition but will also likely cause people to believe things that do not actually exist. Among those conditions that typically receive serious amounts of myths are psychological and behavioral disorders, partly because psychological conditions are often hard to understand and seem mysterious. In this article, we would try to debug the myths of one of the more common behavioral conditions—panic attacks.
People with panic attacks are crazy. Crazy is never a good term for people with psychological conditions and people with panic attacks are hardly crazy. They may seem deranged and a bit psychotic for some people when they experience attacks of panic and terror but this does not suggest that they are.
As if to add to the insult, people with panic attacks are sometimes perceived to have schizophrenia, the most advanced form of psychosis which is marked by severe auditory and visual hallucination as well as aggravated delusions and dysfunctional thoughts. Clearly, there is no relationship between people who feel like they are “going crazy” when undergoing attacks and people who have advanced (and even minor) psychological conditions.
People with panic attacks lose control. Wrong. Panic attacks do not rob a person his sense of control. While a person’s thoughts may seem distorted for a while during attacks due to physical symptoms that lend themselves towards this possibility such as shortness of breath and heart attack-like symptoms, this does not mean that the person is losing grip of the reality. Anxiety which normally accompanies panic attacks is a body’s way to tell you that something is going wrong. Since this is a defense mechanism, it is not dangerous to anyone, not even the person undergoing the panic attack.
It is good to remember that panic attack happens only in the mind, it may, in fact, be unnoticeable for people surrounding the person during the attack. What exacerbates the attack is the person’s conscious thought that it could cause embarrassment or harm to other people. It is the sense of losing control of one’s self that makes the condition worse, a thought that is manufactured in the brain, never the total lack of sense of control.
People with panic attacks have chronic heart disorders. While this may be partly true due to the link between mitral valve prolapse and panic attacks, this does not make the assertion entirely valid. People have good reasons to believe that they are having heart attacks or heart failures when they experience episodes of panic attacks since some of the symptoms of both conditions are similar. But such symptoms are perfectly rational when seen from the viewpoint of elevated fear.
For example, people subjected under conditions that stimulate fear experience tightening of the chest, faster heart beat, profuse perspiration, shortness of breath and increased respiration. All these signs are also symptoms of heart attacks which make it easy for most people to believe that instead of having a disorder of the mind, they are having dysfunctional hearts. But then again, similarity in symptoms does not make two completely different conditions alike.
Myths often offer a semblance of the reality that is not hard to believe in. But do not be fooled. Knowing what is the exact truth and not the half lies may serve you well when dealing with conditions that root from and are aggravated by thoughts.