Dr. Angela Hanford
Our bodies have a built-in fight-flight-or-freeze response that mobilizes us to respond to a threat. For example, when you are hiking and meet a coyote or you smell fire coming from your heater, your body may sense danger and trigger this response that prepares you for life-saving action. When this occurs your heart rate and breathing quicken as your body prepares for a life-threatening situation. Many of these same reactions occur during a panic attack, although there is no obvious danger present to trigger such a response.
Panic attacks can be very frightening. Even being present while a friend or a loved one has a panic attack can be a heart-wrenching experience. It’s also challenging to feel helpless and unable to help the person and to watch them as they struggle. This is why it is important to gain an understanding of what panic attacks are and how to cope with the symptoms.
What is a Panic Attack?A panic attack is a sudden episode of intense fear that is accompanied by severe physical and psychological reactions that occur when there is no actual danger or clear cause. This episode reaches a peak within minutes, usually peaking within ten minutes or less, at which time the symptoms start to diminish.
The symptoms of panic attacks can be very scary, although panic attacks themselves are not usually life-threatening. Some people may experience just one or two panic attacks in their lifetimes, with no recurrence. However, if your panic attacks occur more often, and you begin to live in fear that another attack is imminent, you may have panic disorder.
When people experience a panic attack, it can be frightening as they feel a loss of control. Sometimes an individual may even fear that he or she is dying or having a heart attack. According to the Diagnostic and Statistical Manual for Mental Health Disorders 5th Edition (DSM-5) (2013), people with panic attacks experience several of the following physical and psychological symptoms:
- Accelerated heart rate, palpitations, or a pounding heart
- Feeling weak, unsteady, faint, light-headed, or dizzy
- Sweating profusely
- Shaking or trembling
- Tingling or numbing sensations in the hands and fingers (“pins and needles”)
- A sense of terror, or impending doom or death
- Feeling hot or having chills
- Chest pains or discomfort
- Shortness of breath or having breathing difficulties
- Feeling like you’re choking
- Stomach cramps
- Feeling like you’re losing control
- Fear of dying
- A feeling of detachment from yourself or your surroundings
What Causes Panic Attacks?
There is no single known cause for someone developing panic attacks or panic disorder. Therefore, we will talk more about “risk factors” than specific causes. Furthermore, there are likely a variety of factors at play when someone develops panic attacks or panic disorder.
The following risk factors may play a role in the development of panic attacks:
- Genetics. If there is a family history of diagnosed anxiety, panic attacks, or panic disorder, there’s a greater likelihood of developing panic attacks.
- History of experiencing physical or sexual abuse as a child.
- Experiencing a traumatic event such as sexual assault or a serious accident.
- Experiencing major life stress or changes, such as a divorce, the serious illness or death of a loved one, starting a new job, or the addition of a baby to the family.
- Lifestyle choices such as smoking or excessive caffeine intake can increase the risk of developing panic attacks.
- A temperament or personality that is sensitive to stress or prone to feeling negative emotions.
What to Do About a Panic Attack
When a panic attack begins, it can be frightening, and the end of it feels like a long way off. As you or a loved one go through a panic attack, there are a few things that you can do to reduce the severity of the attack.
Make sure you have a plan in place When you start having a panic attack, you likely won’t have the presence of mind to think of how best to handle the situation on the spot. It is far better to create a plan and to have someone like a friend, family member, or colleague be aware of your plan so that they can help you if they are available.
Your plan may consist of sitting down in your office or a quiet room or having someone on speed-dial who can help you with your breathing or distract you while you calm down.
Use muscle relaxation techniques
This could include progressive muscle relaxation. When a panic attack sets in, your body may feel tense, your heart rate is through the roof and you may feel a loss of control. Muscle relaxation techniques can help you to regain a sense of composure and control. A technique like progressive muscle relaxation helps you by relaxing your muscles, and by giving you something to focus on other than your symptoms.
You can begin by clenching your toes and holding this clench for about ten seconds. When you get to the count of ten, release that clench and allow your toes to relax completely. Next, using the same technique, gradually work your way up your body, clenching and relaxing the different muscles in your body, from your legs, glutes, stomach, back, shoulders, hands, arms, chest, neck, and facial muscles.
Practice deep breathing exercises
This type of breathing can counteract the hyperventilating that often occurs during a panic attack. You can begin by taking a deep breath through your mouth for 3-5 seconds. Hold your breath for a second or so, and then release it slowly through your nose for another 3-5 seconds. Repeat this until your breathing comes under control and is stable. Other types of breathing exercises include square breathing and 4-7-8 breathing.
Repeat a prayer or mantra
This can be both encouraging and help you to cope with the panic attack. You can try repeating something like “This will pass, and I’ll still be here” or “God has me in his hands. I just need to breathe.”
Use your five senses
Find something soothing or grounding that taps into one of the five senses. For example, peppermint or lavender essential oils may be calming for some people. Others may be soothed by something tactile like a weighted blanket or a fluffy object.
Treatment for Panic Attacks
While panic attacks seem devastating, thankfully there are effective treatments available. After conducting a thorough assessment, including history and symptoms, your therapist will work to create a treatment plan that best meets your needs and unique symptoms.
A referral to a medical doctor and/or psychiatrist is often provided to rule out any physical causes to the panic attacks (e.g., thyroid problems) and to determine if medication may be helpful for managing symptoms.
Regardless of the treatment modality, your therapist will likely help you to understand what panic attacks and anxiety are, along with the neurological underpinnings (e.g., the fight-flight-freeze response).
Cognitive-Behavioral Therapy (CBT) has been shown to be effective for treating panic attacks and panic disorder. During CBT, you will learn that the symptoms of a panic attack are not actually dangerous, along with ways to cope with the panic. Your therapist will work with you to understand the negative thoughts and behaviors that may be linked to the panic attacks.
They will help you to restructure these thoughts and behaviors, reorienting them towards positive and healthy outcomes. Relaxation exercises (e.g., progressive muscle relaxation), mindfulness, and other stress-reduction techniques are used when treating panic disorder.
Armed with this knowledge, your therapist will help you face the panic attack symptoms so that you can gain mastery. Using CBT, many who suffer from panic attacks notice a decrease in their symptoms, and in some cases, the panic attacks go away after a few months of treatment.
The onset of panic attacks is a terrifying experience that feels like your life is out of control. It can be very disorienting. Thankfully, panic attacks and panic disorders are treatable. By consistently following your treatment plan, you can regain your quality of life and the peace that God intends for His people.
If you or a loved one have experienced the symptoms of a panic attack, do not hesitate to go to your doctor or a licensed mental health professional for a proper diagnosis. If you are suffering from panic attacks, the sooner you can embark on your treatment plan the better. We are here to help!
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