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