What is a panic attack?
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 may think they’re having a heart attack. Others have reported feeling like they are having a stroke.
Some people may develop panic disorders
For many people, the feelings of panic occur only occasionally during periods of stress or illness. A person who experiences recurring panic attacks is said to have panic disorder, which is a type of anxiety disorder. They generally have recurring and unexpected panic attacks and persistent fears of repeated attacks.
Symptoms
Symptoms of a panic attack can include:
Heightened vigilance for danger and physical symptoms
Anxious and irrational thinking
A strong feeling of dread, danger or foreboding
Fear of going mad, losing control, or dying
Feeling lightheaded and dizzy
Tingling and chills, particularly in the arms and hands
Trembling or shaking, sweating
Hot flushes
Accelerated heart rate
A feeling of constriction in the chest
Breathing difficulties, including shortness of breath
Nausea or abdominal distress
Tense muscles
Dry mouth
Feelings of unreality and detachment from the environment.
The ‘flight-or-fight’ response
When the body is faced with immediate danger, the brain orders the autonomic nervous system to activate the ‘flight-or-fight’ response. The body is flooded with a range of chemicals, including adrenaline, that trigger physiological changes. For example, heart rate and breathing are accelerated and blood is shifted to the muscles to prepare for physical combat or running away. A panic attack is said to occur when the ‘flight-or-fight’ response is triggered but there is no danger about to happen. A person may experience the symptoms of a panic attack in harmless and apparently stress-free situations, such as watching television or while asleep. Some of the factors that can prime the body to inappropriately activate the ‘flight-or-fight’ response include:
Chronic (ongoing) stress – this causes the body to produce higher than usual levels of stress chemicals such as adrenaline.
Acute stress (such as experiencing a traumatic event) – can suddenly flood the body with large amounts of stress chemicals.
Habitual hyperventilation – disturbs the balance of blood gases because there is not enough carbon dioxide in the blood.
Intense physical exercise – for some people, this may cause extreme reactions.
Excessive caffeine intake – the caffeine in coffee, tea and other beverages is a strong stimulant.
Illness – may cause physical changes.
A sudden change of environment – such as walking into an overcrowded, hot or stuffy environment.
Causes other than anxiety
Some symptoms that are common to panic attacks may also occur in some physical conditions. Some medications and drugs – such as tranquillisers, alcohol and caffeine – may also induce panic-like symptoms.
Always seek professional advice
Always seek medical advice if you are not sure whether your symptoms, or another person’s symptoms, indicate a panic attack. In an emergency, dial triple zero (000) for an ambulance. It’s important to see your doctor for a check-up to make sure that any recurring physical panic-like symptoms are not due to illnesses, including:
Diabetes
Asthma
Inner ear complaints
Hyperthyroidism (overactive thyroid gland)
Cardiac (heart) complaints
Post-partum (after childbirth) hyperthyroidism.
Self-help suggestions
Suggestions on how to cope with a panic attack include:
Avoid ‘self-talk’ that focuses your attention on your symptoms – don’t tell yourself ‘Stop panicking!’ or ‘Relax!’
Remind yourself that the symptoms of a panic attack are uncomfortable, but not life threatening. Reassure yourself that you’ve felt these feelings before and nothing bad happened to you.
Focus your attention on something outside your own body and symptoms. For example, distract yourself by counting backwards in threes from 100, recall the words from a favourite song or concentrate on the sights and sounds around you.
Fleeing from the situation will only reinforce the perception that your panic attacks are unbearable. If you sit and allow the symptoms to pass, you gain confidence in your ability to cope.
Medical treatment options
If the physical anxiety symptoms are caused by physical illnesses, such as diabetes or hyperthyroidism, proper treatment for these illnesses should stop the panic-like symptoms from recurring. If the panic attacks are due to anxiety, treatment options can include:
Medications
Psychotherapy, including cognitive behaviour therapy
Biofeedback therapy
Stress management techniques
Proper breathing techniques
Relaxation techniques
Learning problem-solving skills
Lifestyle adjustments, such as attention to diet, exercise and sleep.
5 Ways to Interrupt a Panic Attack:
1. Distraction!
If you are sitting on the couch watching tv and you start to feel the beginnings of a panic attack don't continue to sit there and think about it.
Get up and do something else! Don't remain in the same environment if you can change it.
Go wash the dishes in another room.
Grab the vacuum and vigorously clean.
Call a friend and ask them how they are.
Leave the house or the office to get some fresh air.
Leave your desk and go splash water on your face.
Walk quickly around the block (or from room to room) while counting how many steps it takes to get from point A to point B.
2. Breathe properly!
This is very important! If you control hyper- or hypoventilation, you can control the pins and needles sensation. Hyperventilation can cause the sensation of shortness of breath so people breathe deeper and then make the situation worse.
Inhale slowly through your nose by pushing your abdomen out for 5-7 seconds. Hold your breath for a few seconds and then exhale through your mouth slowly. It is important to make sure your abdomen is expanding and not just your chest.
3. Exercise!
When feeling panic it can be effective to match the intensity of the anxiety with physical exercise.
Go outside and do some sprints,
walk vigorously around the block,
do 100 jumping jacks,
or walk up and down the stairs until the feeling passes.
I find gentle exercise less effective because it is easier to still focus on how you are feeling while you are doing it. Intense exercise can make it difficult to think about anything else and therefore can be a very effective distraction.
Exercise can also help your muscles relax. When having anxiety and panic people often tense all their muscles leading to some of the feelings of chest discomfort.
4. Shift your focus:
Pick any item and study it intensely. Give yourself something objective to fixate on instead of focusing on your bodily sensations. Describe every detail of the item. When you finish one item move on to describe other items.
Here is an example of studying a plant:
What are the leaves like?
Does it have smooth edges?
What is the color?
Are some new leaves sprouting?
What does it feel like when you touch different parts of it?
The exercise of shifting your focus can help bring you back to the moment and away from focusing on physical sensations.
5. Progressive muscle relaxation:
Progressive muscle relaxation is a great tool for panic because it is active and requires focus to complete. It is an exercise that can relax your mind and body through slowly tensing and then relaxing each muscle group.
Start at one end and work your way throughout your entire body.
Tense your muscle as hard as you can and hold it for 5-10 seconds.
Feel the sensation that happens as you are tightening the muscle.
Once you relax, feel the muscles relaxing and the tension dissipating.
Relax for 20-30 seconds before moving on to the next muscle group.
Next time you feel the start of a panic attack use these tools to interrupt it: distraction, breathing properly, exercise, shifting your focus, and progressive muscle relaxation. Don't let anxiety and fear of a panic attack take control. The time spent fearing panic is never time well-spent. Anxiety and panic attacks are treatable so get help if you need it.
Are there other tools that help you? Let me know your thoughts in the comments!