Everyone gets nervous from time to time.
Some people, however, suffer panic attacks that are frightening and can be debilitating because episodes are known to occur suddenly and pass quickly.
Those who experience them may dismiss them or keep the experiences secret from family and friends to avoid the often-associated negative reactions that come with sharing.
If this is true for you or someone you know, take heart: panic attacks are treatable and do not necessarily indicate a serious psychological or physical condition.
What is anxiety?
Occasional anxiety over a particularly troubling task or event is normal. Chronic anxiety, however, does not reflect a healthy mental state.
Generalized anxiety disorder (GAD) is a psychological condition in which constant and excessive worry over a variety of situations cause anxiety to the extent that it affects everyday function. GAD afflicts almost seven million American adults (over three percent of the population).
People with GAD can anticipate catastrophe in every aspect of their lives, regardless of whether there’s true immediate cause for concern. (1) GAD has been associated with serious comorbidities, such as life-limiting phobias, depression, and thyroid disorders. (2)
Panic disorder (PD) is a type of anxiety disorder. It manifests as sudden and overwhelming fear. PD, like other psychological disorders, can be hereditary but isn’t always. It is theorized that panic disorder is caused by certain mechanisms in the brain that trigger imbalanced—and often unfounded—fear and anxiety. Panic attacks are one of the signs of PD. (3)
What is a panic attack?
“Attack” is an apt word for the experience. Sudden severe anxiety can come out of nowhere or can precede a situation that is anticipated with trepidation, such as in the case of someone who must deliver a presentation and is tremendously uncomfortable speaking in front of others.
A panic attack is defined by the Anxiety and Depression Association of America (ADAA) as “the abrupt onset of intense fear or discomfort that reaches a peak within minutes” and includes at least four of the following symptoms:
- Palpitations, pounding heart, or accelerated heart rate
- Trembling or shaking
- Sensation of shortness of breath or smothering
- Feelings of choking
- Chest pain or discomfort
- Nausea or abdominal distress
- Feeling dizzy, unsteady, light-headed, or faint
- Chills or heat sensations
- Paresthesia (numbness or tingling sensations)
- De-realization (feelings of unreality) or de-personalization (being detached from oneself) – the ADAA has published a podcast describing de-personalization disorder; click here to access.
- Fear of losing control or “going crazy”
- Fear of dying
A “limited-symptom panic attack” is one that involves fewer than four of the above symptoms. (4) Whether limited or full-blown, a panic attack occurs when there is a perceived threat but not necessarily a real one.
Panic attack symptoms usually reach their peak intensity within ten minutes of their onset and then slowly dissipate.
Reading through the list above, you can see how the symptoms mimic those of more serious conditions; so much so that many people who experience panic attacks go to hospital emergency rooms for treatment, thinking their lives are in danger.
What causes panic attacks?
Generally speaking, panic attacks can be part of a panic disorder or any number of other psychological disorders. They may be triggered by sensitivity to certain circumstances or experiences that cause discomfort or anxiety. Someone with an obsessive-compulsive disorder, for instance, may suffer a panic attack if s/he is prevented from acting on a personal compulsion.
A panic attack can occur when in a state of extreme anxiety or it can come out of the blue during a state of calm. It’s this nature of panic attacks that those who suffer from them find most disconcerting (and a cause for anxiety): while someone can try to avoid known triggers, there’s a constant fear of a panic episode occurring for seemingly no reason.The popular television show “This is Us” depicted one of its main characters experiencing a panic attack. Audience feedback on the episode found it compelling and realistic. You can watch the scene by clicking on the link below.
What to Do if You Have a Panic Attack
If you find yourself experiencing two or more of the symptoms listed above and are feeling overwhelmingly anxious, you may be having a panic attack. The four techniques below have been found extremely effective in quelling an attack, providing coping mechanisms to work through it.
1. Acknowledge the panic attack.
Telling yourself to calm down or trying to convince yourself that nothing is wrong won’t really help you; it will exacerbate your anxiety. The best way to meet your panic is head-on. Accept that you are experiencing those terrible feelings and take control to get on top of them. Focus on the moment and your immediate surroundings: what you see, hear, smell, and what you were doing just before your anxiety mounted.
Western health practices have finally recognized the importance and versatility of simple breathing for a variety of situations. It’s common during a panic attack to have difficulty breathing or to find yourself hyperventilating. Once you have acknowledged that a panic attack is occurring, begin to focus on your breath: deep inhalation in through the nose, slow exhalation through the mouth. This practice will give you something constructive to concentrate on and help to restore normal breathing and heart rate.
Watch the video below for instructions on how to practice deep belly breathing to relieve a panic attack.
3. Engage progressive muscle relaxation.
Dr. Edmund Jacobson was a physician in the early twentieth century who developed a method for systematically relaxing each part of the body to help his patients relieve anxiety.
It’s a good idea to practice the technique when you are calm so you can call upon it when undergoing a panic attack. You can perform this exercise along to soothing music or a visual aid (such as a pleasant photograph or a video of waves on the ocean).
A study comparing anti-anxiety medication versus progressive muscle relaxation for anxiety and depressive symptoms found them equally effective. (5)
Furthermore, this relaxation practice is great for relieving muscle as well as emotional tension. For step-by-step instructions provided by AnxietyBC, click here.
4. Talk through it.
Be your own coach. Don’t try to hold in all the emotion you’re feeling.
If possible, remove yourself to a quiet place and talk yourself through the panic attack. Remind yourself that it’s temporary and will soon pass.
Fall back on the techniques above that you’ve practiced and focus on working through the moment, allowing the anxiety to wash over and leave you.
How to Help Someone Having a Panic Attack
When you are in the middle of a panic attack, it’s extremely difficult to step back and become objective. The thoughts and emotions swimming around in your head, coupled with the intense and frightening physical reactions, can make you feel like you’re drowning.
If you are with someone who is experiencing a panic attack, consider yourself the strong branch needed to pull him/her out of the torrent.
Apply the same techniques that you would if it were you that was drowning. It’s much easier for a staunch anchor to provide the coaching, calm, and stability that are required for a quick resolution to the episode.
1. Remain with the sufferer.
As depicted in the clip above from “This is Us”, physical presence goes a very long way in helping someone through a panic attack. Alone, the episode will most likely be more intense and of longer duration than if you stay with the sufferer.
2. Relocate the sufferer to a quiet place.
Very often, an attack is triggered when someone is confronted with an uncomfortable social situation. Anxiety is made worse when the victim feels watched and judged—embarrassment and shame often result, making the attack worse. If possible, move together to a private, quiet place to ride out the storm.
3. Provide assurance.
Saying “calm down” or “just relax” will do the opposite of helping during a panic attack.
You cannot feel or think what the other is experiencing, so telling him what to do will only add to the anxiety he’s feeling. Speak periodic quiet reminders that the attack will pass soon and you are there for support while it lasts.
Let him know that he is safe and everything will be all right once the symptoms subside. Above all, remain calm yourself; it’s not hard to get caught in the maelstrom.
4. Encourage breathing.
The impact of slow, deep breathing is almost miraculous during a panic attack. Breathe with the sufferer: deep inhalations through the nose – hold – exhalation through the mouth – hold – repeat. Ask her to focus on you and the breaths you share.
Panic attacks are treatable. If you or someone you know experience these bouts of extreme anxiety, you are not alone. Mental health professionals are becoming more knowledgeable and adept at helping to manage the disorders responsible for extreme anxiety. From the ADAA:
“In the past it might have taken months or years and lots of frustration before getting a proper diagnosis. Some people are afraid or embarrassed to tell anyone, including their doctors or loved ones about what they are experiencing for fear of being seen as a hypochondriac. Instead they suffer in silence, distancing themselves from friends, family, and others who could be helpful. Other people suffering from panic attacks don’t know they have a real and highly treatable disorder. It is our hope that through increased education, people will feel more empowered to discuss their symptoms with a healthcare professional and seek appropriate treatment.” (4)