By Dan Blair, a marriage counselor and family counselor.
Suddenly your heart starts beating out of your chest and you can’t catch your breath. You feel tingling sensations creeping up your arms and at the same time you realize you are light-headed. You’re thinking “Something bad is happening,” and you feel trapped. This is what a panic attack feels like. Even though you may feel like dying during the panic attack, they are harmless. The first step after a panic attack is to go to a doctor to determine possible causes and risk factors. The doctor could recommend treatment to prevent further complications.
Signs and symptoms can affect you from your head down to your feet. Starting from the top down, one could feel dizzy, disoriented, or lightheaded. Next you may notice heavy breathing, difficulty breathing, or even choking sensations. In your chest you may feel your heart pounding or tightness. In your arms one may feel tingling sensations or sweaty palms. You may feel stomach upset or sharp pain in your stomach. You may feel you’re losing control or something bad is happening. Panic attacks can affect every area of the body.
Panic attacks erupt from the unsettling effects of stress hormones. People worry about money, their job, their health, or relationship issues. You are more likely to have a panic attack if your parents have had anxiety or panic attacks. It’s possible you could have a medical condition like heart or thyroid problems, or maybe you are just tired or even hungry, which causes low blood sugar. Drugs or alcohol could contribute to a panic attack along with caffeine or nicotine. Other causes include hiding emotions or unrealistic fears. These could come from life situations, physical conditions, substance use or drug use, and disturbing emotions.
Panic attack sufferers can be a man or a woman, young or old. But, you are more likely to experience a panic attack if you are female between ages of sixteen and thirty. If you have a sensitive or sensitized nervous system from stressful events, physical or sexual abuse, or a family history of depression/anxiety, your chances of a panic attack are higher. Finally, high blood pressure, heart disease and stroke are also risk factors.
Even though a panic attack feels like you could be having a heart attack, or that you are having trouble catching your breath, or feel like your about to die, most panic attacks are not medical problems. In fact, it is completely safe to have a panic attack. Though a panic attack itself does not cause any damage, it may mimic actual medical problems. Therefore, it is good idea to report to your doctor after your first panic attack or seek medical advice if you have experienced any signs or symptoms. The doctor can rule out high blood pressure, heart disease, stroke, or any physical illness.
Doctors can make the diagnosis of panic attacks if you have four or more attacks with in a four week period. In addition to the signs and symptoms listed above a doctor may ask if you experienced a fear of places or situations where getting help or escape might be difficult, such as in a crowd or on a bridge. An important factor in diagnosis is to determine how much the panic attack is interfering with quality of life.
Panic attacks complicate one’s life when it is hard to function in their job, social, or family roles. If the panic attacks are not treated they can keep happening or lead to a mental illness. Possibilities include phobias, depression, social problems, work or school problems, financial problems or substance abuse. It can even lead to possible suicide. In these ways anxiety affects quality of life.
Treatment can consist of a combination of counseling and medication. Cognitive-Behavioral Therapy focuses on thinking patterns and behavior that trigger the attack. Exposure therapy is one kind of treatment that involves recreating the triggers and developing coping skills while the fear lessens. In addition breathing, relaxation training and communication training or conflict resolution can help. If interventions are inadequate, a doctor may recommend medication.
Managing adrenaline flow when anxiety is at full volume is akin to riding the rapids. You try to stay afloat. Anxiety fueled by adrenaline are useful for short-term emergencies but are quite destructive and unpleasant long-term. In fact, adrenaline affects the same areas of the brain as alcohol, undercutting the ability to see options, see other points of view, make effective decisions, and think clearly about the consequences of your actions. Many of the symptoms are akin to what you may feel after running a marathon.
Anger and anxiety won’t go away until you effectively deal with its source. You may be trying to control too much. Anger may precipitate an aggressive approach whereas anxiety is avoidance. A prevailing treatment approach suggests only by not avoiding the symptoms can the fear of the symptoms be reduced. By learning that rapid heart beat, shallow breathing, and surges of adrenaline can be tolerated without trying to stop it, reactivity can be lowered.
Responding to adrenaline requires an observation mode without trying to control it, which can be a difficult choice to make. It includes mindfulness: observation of one’s feelings, thoughts, and sensations without reacting or judging them. Allowing an emotion lessens it over time. Breathing techniques include belly breathing, deep breathing using your diaphragm. Many do not realize they the hyperventilate, which leads to emotional reactivity, insufficient carbon dioxide, and a higher pH level in the blood. To lessen the intake of oxygen and balance with carbon dioxide, breathe in through the nose and out through the mouth. Breath out slower than you breath in. Your stomach should extend, not your chest. The goal is to focus on what you need to learn rather than fear reduction or staying in the situation until fear declines. Learn whether the expected negative outcome occurred or not, or was as “bad” or unmanageable as expected. Distraction may be counter-productive because the brain may not learn the difference between healthy fear and unhealthy fear.
Initial panic attacks are unexpected and therefore difficult to prevent. You can reduce the chances of a future panic attacks in other ways besides counseling and medication. One can work on a building self-confidence through a sense of accomplishment, connection with others, enjoyment, and self-care. Developing social support is important to making changes. These are all ways to take care of one’s self along with good sleep, eating habits, and exercise. Taking breaks throughout the day to meditate or practice acceptance, breathing, calming approaches or healthy distraction, and then using assertiveness (versus aggressiveness or passiveness) has been shown to be effective. It is a skill that needs to be developed over time.
Knowing the signs and symptoms of a panic attack can greatly reduce one’s fear of fear. This is not to say one should avoid going to a doctor to determine possible causes and risk factors. An accurate screening will provide a good diagnosis. Panic attacks are treatable.