What is a Panic Attack?
A panic attack is described as the sudden onset of intense physical symptoms accompanied by intense feelings of fear and anxiety. The emotional state that prevails during a panic attack is characterized by both feelings of confinement and a sense of loss of control of the body. When someone experiences a panic attack, they experience uncontrollable fear. Therefore, we could describe the panic attack as a complex symptom of anxiety consisting of three dimensions: physical, emotional and behavioral.
Physical symptoms
Those who have experienced a panic attack report that they suddenly begin to feel a series of physical symptoms:
• Increased heart rate
• Breathing difficulty
• Sweating
• Trembling
• Dizziness
• Tendency to faint
Research has shown that reports of physical symptoms are valid and real, as they have been confirmed through laboratory experiments. Typically, researchers in their attempt to better understand panic attacks exposed experimental subjects to a stressor (placebo), while recording the physiological arousal (physical symptoms) that followed. They noted that subjects' reports of physical symptoms are directly correlated with heightened nervous system activity. Therefore, the physical symptoms that one experiences during a panic attack are very realistic.
Emotional symptoms
The second characteristic of a panic attack is an intense feeling of threat. Those experiencing a panic attack feel trapped in a life-threatening emergency. Uncontrollable anxiety, fear of death, anxiety that one is losing reason are some of the diagnostic criteria of a panic attack. These feelings are directly related to the gradual increase in the intensity of the physical symptoms.
Behavioral symptoms
The third characteristic of a panic attack is behavioral. The behavioral tendency strongly recorded in the descriptions of those experiencing a panic attack is an "overwhelming need to run" and the desire to escape. However, it appears that during a panic attack people may adopt different behaviors, such as trying to stay still until the attack passes. However, the common denominator in all these behaviors is that they are intended to alleviate physical symptoms, as an attempt to escape the panic attack.
What is Panic Disorder and how does it differ from Panic Attack?
A Panic Attack is described as one or repeated events with the characteristics listed above and is differentiated from Panic Disorder. Panic Disorder has some additional features mainly involving persistent worry about future crises, fear of possible consequences of a crisis, and changing behavior in an attempt to control the crises.
In panic disorder the intense worry associated with possible future attacks gradually consolidates and emerges as a constant regardless of the frequency of panic attacks. Those who experience panic attacks may gradually enter a state of constant worry about the consequences of these attacks, such as a state of constant fear of survival. When anxiety and frequent thoughts about the dangers of panic attacks become entrenched, then we have moved into the Panic Disorder spectrum.
Causes and Risk Factors
While the causes of Panic Attacks have not been clearly identified, risk factors have been documented. Both heredity and environment belong to them. People with a family history of panic attacks or panic disorder have a 22% increased chance of having a panic attack. However, someone can develop panic attacks regardless of the presence of a hereditary factor. Environmental characteristics, such as experiences of negative events associated with increased anxiety, may themselves increase the likelihood of a panic attack.
Panic crisis occurs in the population with a frequency of 3.7% while panic disorder with a frequency of 10%.
Some important information to remember about Panic Attacks:
• Panic attacks are quite common and not dangerous.
Much of the world's population will experience at least one panic attack at some point in their lives, so attacks are not as rare as we might think. In addition, panic attacks are incredibly intense but do not lead to the outcomes people fear when having an attack, such as a heart attack, death, or insanity.
• Panic attacks happen for a good reason.
You may have asked yourself "what is the reason for panic attacks?". They actually have a good purpose, to help you survive through of the activation of the "fight or flight" response. When we were still in caves and fighting daily to stay alive, panic attacks were a basic and helpful survival mechanism. They helped us fight more effectively, run faster, and even pretend to be dead when we were attacked by a wild animal e.g. bear. When, for example, we saw a lion in front of us we had to be ready and inflate our lungs to get as much oxygen as possible to be able to run and escape the danger. Now, most of the time the danger we experience may be inside our mind and come from thoughts we have and worries we have, but the same survival mechanism is activated again. So when during a panic attack you feel like you don't have enough oxygen, the exact opposite happens. You have too much oxygen in your lungs. That is why it helps to breathe in a paper bag, because it is a visual stimulus for the brain to realize that we are breathing normally.
• Panic attacks last for a short time, not forever.
Panic attacks are self-limiting since your body cannot sustain this incredibly high level of stress for a long period of time. After 5-15 minutes, panic attacks calm down on their own. This is important to know because often people believe that panic attacks have lessened and/or stopped because the person has left a stressful situation. In fact, even if subjects remained in a stressful situation, panic symptoms would still quickly subside.
• Panic attacks continue to cause problems when you are afraid of having more attacks and when you change your behavior to try to avoid additional panic attacks.
Examples of behavior change include stopping in public traffic because you're afraid you're going to have a panic attack and haven't practiced, and because your heart is racing and you're afraid you're going to have another attack. Fear and avoidance (of situations or physical reactions) send the message to your body that you are in danger and that only avoidance will make you feel safe. This leads you into a cycle of increasing panic attacks and avoidance.
• When people have a panic attack, they tend to pay more attention to physical symptoms (heart palpitations) and this appears to increase the likelihood of additional attacks occurring.
When you monitor your heart rate or other symptoms constantly, you are sending the message to your body that you are still in danger, and this increases the chance of additional seizures. Many people who have panic attacks experience additional attacks triggered by observing their body as they begin to fear even small changes in their physiology, such as an increased heart rate.
So if you notice yourself doing this, turn your attention outward by quietly describing the world around you. Imagine you're talking to someone on the phone and you're trying to paint a mental picture of what you're seeing. Use words to describe colors, shapes, textures, and other aspects of what you see. This mental activity is incompatible with internal monitoring and will help you get out of the habit of over-monitoring your body.
How are Panic Attacks Treated?
The intervention that has been shown to be the most effective for dealing with panic attacks is psychotherapy, which can in some cases optionally be accompanied by medication. When the underlying reason why the person enters the panic crisis process is found, then work can be done in order to stop the problem from the "root".