Panic Attacks
What are Panic Attacks?
Humans have an inbuilt fear mechanism that is set in motion when we are in danger. Imagine that
you walked out of your office or home right now and were confronted by a vicious dog. What would you do? Run
back inside? Scream? Wave your arms or grab a stick and ward off the animal? Whatever you decide to do, you
are in the process of a flight/fight reaction. It is a defense mechanism that helps you to either escape
(flee) a threatening situation or attack (fight) a dangerous person/animal. Some dramatic changes take place
in your body: your heart starts pounding, your breathing may become labored or you might hyperventilate, you
might start shaking or trembling, your hands might become sweaty, your legs will probably feel rubbery. All
of these things happen because adrenaline has been sent soaring throughout your body, preparing your muscles
and heart to fight or flee.
A panic attack occurs when we have all of the symptoms created by a fear response, but there is
no real threat. It is the fight/flight reaction when no real danger is apparent. It is a false alarm.
What causes Panic Attacks?
There are several theories about what causes an initial panic attack. Some believe it is due to
chemical or hormonal imbalances in the brain or a hypersensitive nervous system. There does appear to be a
genetic link. Others theorise that there is some malfunction in the autonomic nervous system. The most likely
cause is a stressful life event like death of a loved one, divorce, or school or job stress. Another common
cause seems to be the cumulative effect of stress in one’s life. So, if you have experienced a lot of
stressful events over a long period of time, it can come out in the form of panic attacks.
We understand better what causes subsequent panic attacks. Once you have experienced the terror
of one panic attack, it is understandable that you have some fear about experiencing another one. The panic
attack itself is associated with several internal cues (palpitations, light headedness, shortness of breath)
and external cues (the place or situation where you had the initial panic attack). What happens is that you
associate these cues with experiencing another panic attack and create the false alarm again. For example,
you have a panic attack on the train on your way to work. Now, every time you go to take the train, you
associate it with panic and you set off your fear response. Or, you are racing to get to an appointment on
time and your heart is thumping and you are out of breath. Suddenly, in your mind, these “normal” symptoms
become catastrophic. You are associating them with the same symptoms you had during the panic attack. You may
say something to yourself like: “Oh no, here comes another panic attack!” or “Oh no, I can’t breathe! I’m
losing it!” Once again, you set off the fear response and have a panic attack.
Let’s look at some of those symptoms and see why people are so afraid of them.
Symptoms of Panic Attacks:
Any of the following bodily symptoms may occur during a panic attack:
Palpitations or racing heart
Chest pains or tightness across the chest
Dry mouth
Sweaty palms
Cold, clammy hands
Dizziness, lightheadedness, faintness
Butterflies in the stomach
Nausea and/or diarrhea
Chills or hot flushes
Weak or rubbery knees or legs
Tingling or numbness in the hands, arms or feet
Shortness of breath, feeling of being smothered
Choking sensation or feeling a lump in the throat
A feeling of partial paralysation
Trembling or shaking
Dreamlike sensations or disorientation
Feeling detached from oneself (depersonalisation)
Intense fear: of losing control, going mad, or dying
Important Truths about Panic Attacks:
1. They are not dangerous! The symptoms feel dangerous, but they are the body’s normal reaction to
a threatening situation. Doctors have told me that we are built to handle a lot more adrenaline rushing
through our bodies than we might realise. So we could continue feeling all of the symptoms caused by
adrenaline for hours and still be okay. We won’t die! We won’t have a heart attack! We won’t faint! We won’t
go crazy! We won’t suffocate!
2. Our emotional reaction to the symptoms keeps the symptoms going! When you are scaring yourself
with thoughts like: “Oh my God, I can’t stand this!” or “I feel like I’m going to die!” you feed your own
fear and keep the adrenal pumping through your body, which keeps the symptoms going.
3. If you can calm down (stop the scary thoughts and slow your breathing down), the “attack” will
subside within about 3 minutes. That’s how long it takes for the adrenaline to be absorbed by your liver and
kidneys.
How to Cope With Panic Attacks:
During an intense panic attack, people have said it
is the most frightening experience of their entire life, leaving them feeling helpless and lost. Once you
have had a panic attack, the fear of having another one plays on your mind. You don’t want to put yourself in
any situation that might trigger another one. This is understandable. However, by not facing any fearful
situations, you are feeding the fear. So, although it can be helpful to retreat from the situation until you
calm down, it is most important to go back into the situation and face it head on. If you don’t, you will
find your activities and movements becoming more and more restricted. I have known people who are almost
housebound because they fear panicking in their job environment or on the bus or train or when they are out
shopping.
Do you want to be free of the fear and reclaim your life?
Let’s look at a few coping strategies, starting with some that you can use when you are in the
midst of all those horrible symptoms:
During a full fledged panic attack:
1. Retreat from the situation causing the panic. This does not mean you escape, but rather you
leave for a short time while you recover from the symptoms. You then re-enter the situation.
2. After retreating to a “safe place,” slow your breathing down. You can immediately hold your
breath for 5-10 seconds, and then take a slow breath in and out through your nose. Each breath should take 3
seconds to inhale and 3 to exhale.
3. Talk to someone if possible. Express your feelings. Speak to yourself in a soothing voice. Tell
yourself “It’s okay, I can handle this.”
4. Don’t fight the symptoms. Notice them as if they are floating past you. Remind yourself that the
panic symptoms are not dangerous and they will subside in about 3 minutes.
5. Keep breathing slowly until you feel calm again. Then go straight back into the situation that
triggered your panic attack.
When you notice oncoming symptoms of panic:
1. Learn to recognize what happens for you before a full-fledged panic attack. It is different for
each person. Perhaps your first sign is nausea, followed by sweaty palms. Or you notice you feel wobbly or
your face becomes hot.
2. At the first sign of a panic attack, slow your breathing down as in #1 above. Use a few drops of
lavender oil on a hanky, tissue or on the palm of your hand and hold it near your face as you breathe. If you
are at home, burn some lavender oil in a burner or take a bath with several drops in it.
3. Distract yourself: Talk to someone. If you are in a public place, ask a salesperson to show you
something. Talk to the person at the checkout. Ask someone for directions. Do some repetitive task like
counting backwards from 100 in 3’s. Snap a rubber band against your wrist. If you are at home, try taking a
hot shower, scrubbing a wall, or cleaning out a drawer.
4. Get physical: If you are at home, go outside and walk around the yard or around the block. Do
some vigorous housework or gardening. Go for a bike ride. If you are at work or school, go for a walk to the
toilet or outside for a few minutes.
5. Use positive self-talk: I recommend writing a few sentences on a small piece of paper or
cardboard and keep it in your handbag or pocket. Choose statements that are soothing to you. Things like:
“This will pass.” “You’re doing well.” “You can do it.” “Go girl!” “It’s only some anxiety symptoms. It won’t
kill you!”
Lifestyle changes that help if you suffer with panic attacks:
1. Exercise daily: Physical exercise decreases stress in the body and is one of the best strategies
for overcoming panic attacks. Find something you enjoy and make it part of your life. Walk, run, bike ride,
swim, use an exercise bike or treadmill, roller blade. Join a gym
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