The Panic Attack Experience
Suddenly a wave of anxiety engulfs you, catching you completely off guard. Your heart races, breath quickens, and your body trembles uncontrollably. Chaotic thoughts swirl. An overwhelming urge to flee takes hold, yet there’s no escape from the intense grip of anxiety. Terrified that something is seriously wrong with your body or mind, you live in constant fear of the next attack. Your only semblance of control is avoiding situations where a panic attack might jeopardize your safety or dignity.
Frequency & Consequences of Panic Attacks
In this suffocating grip of anxiety, it’s easy to feel isolated and misunderstood. Yet you are not alone. Statistics indicate that approximately 10% of adults have experienced a panic attack, with around 5% developing panic disorder. Panic disorder involves recurrent unexpected panic attacks and persistent concern about future attacks. Maladaptive changes in behavior result and activities are limited. These intense and unpredictable bouts of anxiety disrupt daily life, making normal functioning a challenge. Venturing out in public while battling relentless anxiety can feel insurmountable. Your world constricts, leaving you feeling powerless.
Symptoms of a Panic Arrack
Panic attacks parallel the fight-flight response: rapid heart rate, shallow breathing, sweating, trembling, chest tightness, nausea, lightheadedness, tingling sensations, and hot flashes. These reactions naturally occur in dangerous or threatening situations, such as encountering a charging bear. The difficulty with panic is the fight-flight response activates when no discernible threat is present.
What Causes the Panic Response?
The pivotal question arises: “Where’s the bear?” Extensive research has pinpointed that our fear does not stem from an external threat, but from fear of our own bodily responses. We develop an intense fear of anxiety itself. It begins with an initial panic attack, a sudden and uncontrollable spiral into anxiety unlike anything previously experienced. While the catalyst for this first attack varies from person to person, the outcome remains consistent. A fear takes root that an anxiety attack could erupt at any moment. Given the unpredictability of these attacks, we may begin to avoid certain places or activities. Soon anxiety dictates our decisions. We begin to constantly monitor our body for any subtle shift that might signal another attack. While our bodies are marvels of biology, they are not free of glitches. Even minor changes in our bodies trigger the panic alarm.
Where’s the ‘Bear’?
In panic attacks, the ‘bear’ is the anxiety itself, driven by fear that something is seriously wrong. Research reveals that panic attacks stem from a conditioned fear of our anxiety response or from sudden fight-flight activation. We catastrophically misinterpret normal anxiety symptoms. Even innocuous stimuli, like flashcards containing words like “lightheadedness”, “fainting”, heart attack”, or “losing control” can trigger a full-blown panic attack in individuals with panic disorder. This illustrates the profound fear individuals with panic disorder have towards their bodily reactions and their perceived lack of control.
The 3 Components of the Panic Cycle
The panic cycle involves 3 interconnected components: thoughts, emotional reactions to those thoughts, and physical symptoms resulting from these emotions. Panic can begin from any of these points. When our mind worries, emotional anxiety ensues which causes physical symptoms. Catastrophic thoughts, such as “Here it comes again”, “I can’t breathe”, “I’m going to have a panic attack!”, greatly intensify emotions. Adrenaline is triggered, pushing us into fight-flight mode. The cycle can also start when feeling anxious for no reason. The bodily sensations begin to appear and our mind catastrophically misinterprets these changes as signs of an impending panic attack, launching us into fight-flight mode. Finally, any change in physical functioning, like dizziness or shortness of breath, are interpreted as being the onset of a panic attack, thus initiating the cycle.
How Fears Form & Expand
Our mind forms fears based on past experiences, like dog attacks or car accidents. Fears by nature expand. For instance, if a horrible event occurs during Christmas, fears or emotional reactions can expand to related symbols and situations such as Christmas music, snowfall, even the month of December. Fear expansion helps us avoid anything associated with past traumas, even.specific dates associated with past traumatic events. In the case of panic, fears extend to how we feel when anxious or to any change in our body functioning. When fear expands to normal yet uncomfortable anxiety sensations or any noted change in our body, panic is likely to follow.
Treatment Options
Several treatment options exist for panic disorder. Medication is often sought to relieve the anxiety. Anti-anxiety medication poses the risk of developing tolerance and dependence. Medication alone doesn’t help you understand the panic cycle and the skills to manage the bodily responses of panic attacks. Cognitive Behavioral Therapy (CBT) offers a well-researched psychological intervention. It teaches individuals to reframe their thoughts into more logical reasoning, disrupting the panic cycle. However, it can be challenging to adopt rational thoughts during a panic attack. Lars-Gören Öst, a Swedish psychologist, proposed a simpler approach. He suggested breaking the cycle at the physiological level. While we cannot directly control symptoms like sweating, trembling, heart racing, or nausea, we have excellent control of our breathing. Breathing is a behavior mastered since birth. Learning controlled breathing to counteract the typically shallow and very rapid breathing during panic can eliminate symptoms like dizziness, accelerated heart rate, and ultimately all the symptoms experienced during a panic attack.
Treatment Goals
Success rates for treating panic disorder are encouraging. Understanding the root cause, stemming from a learned fear of anxiety-related bodily changes, demystifies why panic occurs. Developing a skill that serves as an ‘off’ switch brings reassurance. Learning to engage in deep, diaphragmatic breathing to reverse fight-flight activation and effectively applying this skill when panic ensues is empowering. In therapy, there are methods to create the physical sensations you have learned to dread. This lets you experience these sensations, see that they are uncomfortable yet ultimately harmless, then eliminate them by switching to a controlled breathing technique learned and practiced in therapy.
Medical-Psychological Collaboration
Seeking treatment for panic should involve collaboration with a physician. A diagnosis of panic disorder should only be made after any underlying medical conditions that may be causing the symptoms are ruled out. Once medical issues have been addressed or ruled out, therapy will help you understand clearly the panic cycle, solving the mystery of ‘where’s the bear”. That ‘bear’ can be tamed. The effort is worthwhile, as unmanaged panic attacks greatly impair quality of life and the activities you once enjoyed without fear.
