Understanding a Panic Attack

Sam is casually grocery shopping after having gone through another stressful week of the New York City grind. As Sam is navigating the fruits and vegetables section, something stops her in her tracks. Around her, nothing has significantly changed from a few moments ago and people continue with their shopping routines. Sam however, is suddenlyinvaded by an overwhelming feeling of fear. She stops what she is doing to take a moment to process what is going on. Her heart is beating really fast, her vision becomes a bit blurry and she is having a hard time thinking straight. Her hands get clammy, she gets lightheaded and thinks that she might faint as she struggles to keep a steady breath and her chest feels like it’s sinking. This is the first time she has experienced something like this out of the blueand the fear intensifies as she entertains the thought that something terrible is happening to her. Since there is no imminent danger around her, she can’t clearly explain where these feelings are coming from. The quality and appraisal of everything around her has changed completely and protecting herself from whatever is happening becomes a priority. She craves nothing but to stop feeling this way as soon as possible. The thought that she is losing control, and perhaps her mind, creeps in and the feelings intensify. She leaves her groceries and finds a way out of the store struggling to keep a steady balance. Sam calls a friend and tries to explain what’s going on. She thinks she can’t handle hopping on the train back home so after taking some extra time to calm down she heads home in a cab still feeling shaken and confused by the whole experience.

If Sam’s experience sounds familiar to you, or if it reminds you of an experience a friend or family member related to you had, then you probably know the name of the phenomenon Sam is experiencing.

Wikipedia defines a panic attack as a sudden episode of intense fear that may include palpitations, sweating, shortness of breath, dizziness, numbness, or a feeling that something bad is going to happen. Panic attacks vary in length and in intensity and can last from seconds to a few hours.

They are sometimes associated but not limited to coincide with high levels of prolonged stress, post- traumatic stress disorder, social anxiety, drug use, depression and some other medical conditions.

Common treatment for panic attacks include the use of medication and counseling.

Medication is often used to treat the symptoms while counseling addresses the underlying psychological causes.

Many people experiencing panic attacks will mistakenly interpret their symptoms as symptoms of having a heart attack or another medical condition which makes them prone to end up in an emergency room. Often, many people don’t know how to deal with someone having a panic attack and any attempt to problem solve in the moment worsens the situation for the person experiencing it.

So what exactly is going on when you or someone else experiences a panic attack?

From a neurobiological perspective a panic attack is essentially a fight/flightresponse. Your system is going into survival mode, drawing blood and energy sources from your brain and other organs, and delivering it to critical parts of your body to increase your chances of making a safe escape or attaining a victory in a potential fight. A panic attack involves the exact same chemical reactions in your body as when you experience imminent danger (like encountering a bear in the woods).

They are, needless to say, not pleasant reactions as they involve the circulation of stress hormones such as cortisol and adrenaline flowing through your veins. All of these bodily reactions have a function related to survival in the event of experiencing imminent danger and they are as old as our species.

Experiencing these symptoms in a non life-threatening environment, without an apparent immediate threat, will make people think that they are having a mental or medical breakdown. This lack of understanding often leads people to assume the worst and this in turn feeds the positive feedback loop intensifying the anxiety and panic.

Here are a couple of thoughts to have in mind that can help you get through a panic attack:

• You can’t die from a panic attack.
• Panic attacks are caused by a mix of genetic and environmental factors including deep rooted psychological symptoms that can be worked through in counseling.
• A panic attack is essentially a fight/flight response deep wired in your brain to help you survive. In other words, your system is perceiving an imminent threat that might not be apparent to you in the moment but that it’s likely rooted in a significant area of your life.
• The state of panic that you are in will eventually pass.
• Cognitive behavioral therapies (REBT, ACT, and MBCT) have been shown to be highly effective in the treatment of panic attacks.
• Controlled breathing exercises can be instrumental in helping your system regulate and come down from a panic attack.
• Avoid making the situation worse for yourself by rating yourself negatively or getting angry at yourself because this is happening. You are not weaker than, or crazier than the next person because this is happening to you.
• A panic attack can be seen as a red flag that your system uses to tell you that something needs your attention in order to optimize your overall wellbeing.
• If you are the person witnessing someone having a panic attack, remember the following points:
• Remain calm. Losing control of your emotions will likely just intensify the positive loop of the person experiencing the panic attack.
• Avoid trying to problem solve for them.
• Let the person get through the panic attack before trying to get them distracted with something else.
• Provide an empathic and supportive stance and let them know you are there for them and avoiding making them feel judged.
• Often, just being there and offering your company and your presence will make a big difference. Ask the person to let you know if there’s anything you can do to help.