What Is a Panic Attack?
When we are scared – due to a physical threat, stressor, or fear – our fight-or-flight response kicks into high gear. In prehistoric times, this bodily response was incredibly helpful when lions, tigers, and bears started chasing you: your heart would beat more quickly, your senses would heighten, and your breath would kick into high gear – all of which would allow you to cultivate a greater awareness of your surroundings and run faster; in essence, these reactions to stress helped to save your life. Today, however, even though we are rarely in physical danger when we feel stressed, our body may still react to fear and anxiety in quite the same way.
Yet given the absence of a real threat, these overblown physical reactions to an everyday stressor can make us feel like we’re losing control, having a heart attack, or even give us the false idea that we are dying. For some people, a panic attack may be a one-off occurrence, whereas other people may suffer from them more regularly.
WHAT DOES A PANIC ATTACK FEEL LIKE?
Although it varies greatly from person to person, most people describe a panic attack as an extremely scary and overwhelming experience. Although usually short-lived in duration, panic attacks can feel like they last forever and typically include a combination of physical and emotional symptoms.
The most common symptoms of a panic attack are a racing heart, a sense of impending danger, shortness of breath, and a tightening sensation in your throat or chest. Some people will also describe feeling a loss of control, a sensation that they are detached from themselves and their surroundings, and a sense of dread that invokes fears of death.
Although each of these symptoms may appear individually without any concern (e.g., your heart races after climbing a few flights of stairs), when they occur simultaneously, it’s a good indication that your body has flipped a switch and a panic attack has begun. It’s also important to note that panic attacks may have various presentations and durations depending on the person, although most commonly, these aforementioned symptoms generally occur in a cluster and usually peak within just a few minutes and subside after about 10 to 15 minutes. Afterwards, people tend to feel exhausted and worn out once the main symptoms subside.
After having a panic attack, it’s normal to feel exhausted and run down.
WHAT CAUSES A PANIC ATTACK?
Surprisingly, there are no known nor specific causes of panic attacks. As mentioned above, a panic attack is often experienced as a sudden, overwhelming sense of fear that engenders physical reactions in the body as if there is a threat nearby; yet they tend to appear when no true danger exists.
In theory, anyone can experience a panic attack. However, some factors may make some people more prone to having one, such as significant life stressors, genetics, or even one’s personality (e.g., more easily triggered by stress or affected by negative emotions). Additionally, there can be a self-fulfilling prophecy phenomenon that begins once you have had one panic attack: the fear of a subsequent one – and feeling embarrassed by it or the fear that you could be put into harm’s way – can actually help prompt another one to begin.
WHAT SHOULD YOU DO IF YOU THINK YOU’RE HAVING A PANIC ATTACK?
When you notice symptoms of a panic attack, try using mindfulness techniques that allow you to bring yourself back to the present moment. More concretely, connecting one’s mind and body through breath is a great way to start this process. Breathing too rapidly tends to increase one’s heart rate, which can then cause dizziness, increased sweating, and even the possibility of fainting; as such, slowing down the breath to diminish these symptoms is always the first step to slowing down the panic attack.
To effectively engage in deep breathing, you’ll want to take a slow and deliberate breath — in through your nose, hold it for a couple of counts, and then exhale through your mouth. Each subsequent breath can slow down a little more, until your breath returns to normal.
Additionally, bringing your attention back to the present moment using a grounding technique is another effective tool to help mitigate your symptoms. I usually suggest to patients to use their surroundings and engage all of their senses to remind themselves that they’re not in danger in that moment. For example, you can name out loud everything you see, smell, hear, touch, and taste. I usually suggest that patients try to get as detailed as possible by naming the shapes, textures, colors, and sizes of every object they see in front of them. When you are able to get out of your head and back into your body in the here and now, this pulls your attention away from worries and anxieties that can increase a panic attack’s duration and intensity; and ultimately, this will help ground you in the present moment where you can once again feel safe and secure.
WHAT SHOULD YOU DO IF YOU THINK SOMEONE ELSE IS HAVING A PANIC ATTACK?
If you see someone else having a panic attack, it’s important to engage with them and gently remind them that they are safe and secure, and that they will get through the experience. Try to remain as calm as possible and model a sense of ease and patience. Ask them to listen to your breath and mimic your deep breathing, reminding them to breathe in through the nose and out through the mouth, pausing briefly after the inhale. If it’s a stranger, it’s important to ask that person what they need (e.g., do they have medication or tools of their own that may help?).
If you notice that someone is having trouble breathing (i.e., it may look like they are hyperventilating), complaining about a racing heartbeat or a tightness in their chest, and/or shaking and sweating, it’s fairly likely they are experiencing a panic attack. However, please keep in mind that the signs and symptoms of a panic attack can mimic a heart attack, so it’s always important for someone to be assessed by a medical professional if you’re unsure about how to distinguish between the two.
HOW DO PANIC ATTACKS DIFFER FROM ANXIETY ATTACKS?
Whereas a panic attack tends to be unprovoked, unpredictable, and hard to pinpoint a cause, an anxiety attack typically is a reaction to a tangible stressor (e.g., work, social situations, chronic medical condition, phobias, past traumas). So, although some of the symptoms are similar – feelings of fear or worry, a racing heart and shortness of breath – anxiety attacks are often experienced for a shorter, more finite period of time that is dependent on the stressor being relieved.
Of course, given that anxiety attacks are typically a heightened cluster of anxiety symptoms that can gradually become more intense over time, understanding and working on overarching anxiety through therapy can decrease the frequency of anxiety attacks – large and small.
HOW TO DECREASE THE FREQUENCY AND DURATION OF PANIC ATTACKS
Although there are no surefire ways to prevent panic attacks, learning mindfulness tools, deep breathing techniques, mind/body exercises (such as Progressive Muscle Relaxation), and working through anxieties and fears through therapy will help diminish the frequency and duration of your experiences. Below are a few concrete tools to employ:
Mindful breathing techniques: When we connect mind and body through breath, we’re able to be more present and less concerned in the “what ifs” of the past and future. By spending two to three minutes per day breathing and connecting with the present moment, you’ll be more able to acknowledge that the feelings and ideas behind a panic attack are just feelings and thoughts – nothing more and nothing less. For example, if you feel out of control during an attack, the ability to notice that feeling and acknowledge that it’s uncomfortable, yet acceptable, without allowing it to take over, will help the emotions move through you. Learning how to live more mindfully means you give yourself permission to feel an emotion or think a thought without giving in to them; they can come and go without judgment.
Progressive Muscle Relaxation (PMR): PMR helps to diminish our physical reaction to the fight-or-flight response. In essence, you teach your body how to tense up and then relax, allowing all parts of your body to release tension in a deliberate fashion that brings your whole system down to a more calm, relaxed place. To practice PMR, you’ll want to find a comfortable location to lie down. You’ll then close your eyes, begin to breathe deeply, and then, starting at your feet, tighten and release your muscles. You can squeeze your toes or pull your feet up towards your shins. Hold that position tightly for a few breaths and then release your feet. You’ll then continue this process through your whole body – tightening and releasing each muscle group from your thighs to your abdomen to your back, then shoulders, arms, neck, and face. Feel free to repeat any areas that feel particularly tight or tense. Repeat this daily to help your entire body feel more relaxed and tension free.
Therapy: By talking about anxieties and stressors in your life and learning about the patterns that heighten those anxious thoughts, you can better understand what behaviors, thoughts, emotions, and situations tend to contribute to increasing your overall sense of worry. Integrative therapy and hypnosis can also offer concrete tools and skills that will help you relax and slow down your breath and body so that you can ground yourself even more easily.
