What is a panic attack?
• A panic attack is a feeling of intense fear and anxiety and often accompanied by physical symptoms. The person gets a sudden feelings of terror and thinks she is going to die or going crazy. The fear that a person experiences during a panic attack doesn't stand in a relation to the real situation and happening around them.
• Panic attacks arise without warning and last often less than 10 minutes (even tough they feel longer) but some symptoms may exist for a longer time.
• Many panic attacks are misinterpreted as a heart attack as some physical symptoms are the same. This often causes even more fear for the affected person.
How is a panic attack caused? Can it affect everyone?
In general, everyone can have a panic attack. But people, who already had an panic attack, have a higher risk to have a panic attack again. Panic attacks can be caused by aphobia (a strong fear of something) or by social situations and activities. They can occur at any time.
When a person has a panic attack, the brain sends an emergency signal which causes adrenaline. This stimulates the heart to pump extra blood. This extra blood gets pumped to he major muscles and into the brain to boost the ability to react in an emergency. Three minutes after the emergency signal of your brain, the body is completely adrenalated. The person having a panic attack experiences how the heart pumps heavily and the extra blood flows through the body. The production of adrenaline will not stop until the brain stops sending an emergency signal.
If the attacks appear repeatedly and the person has a great fear about having more attacks, this person has likely a panic disorder which requires professional help.
Symptoms
There is no perfect list of panic attack symptoms as they can vary from person to person. The symptoms often resolve little by little when the panic attack ends. During a panic attack the body is completely under stress (fight or flight” mode) which causes some of there (distressing) symptoms.
• Sweating
• Choking
• Shaking
• Numbness or tingling sensations (pins and needles in the arms / legs)
• Feeling weak, faint or dizzy
• (Hot) flushes or chills
• Depersonalisation or derealisation
• Chest pain or discomfort
• Strong fear of dying, going crazy or doing something uncontrolled. Sense of impending doom
• Nausea or abdominal distress
• “Racing” heart
• Shortness of breath with rapid breathing (or smothering sensations)
• Hyperventilation
Treatment
• Stay calm
• Make direct eye contact; speak clearly and slowly
• Give short and clear instructions
• If you are not familiar with the person: introduce yourself calmly
• Give the victim some space, minimise embarrassment and avoid an audience
• Get the person to sit down and make calming gestures
• Sit with them at eye level
• If needed: remove any triggers of the panic attack from the person
• Don't abandon the person but call the ambulance or organise the transport for a person if she wants to go home
• Encourage the person to breather normally and start a breathing cycle:
1. Inhale, take in long slow deep breath
2. Hold breath for +1 seconds
3. Exhale slowly (pucker your lips a little like you're going to kiss)
4. Tell them to relax in a clam voice, just before they reach the end of exhalation
5. Start a new breathing cycle while telling them how well they are doing
6. Encourage them to copy your breathing pattern
Important: A panic attack and an asthma attack look very similar and can even occur together. A paper bag is therefore not recommended for re-breathing. If you have concerns about the patient's breathing call the emergency service immediately.
How to help yourself if you have a panic attack
• Relax. Breathe controlled and slowly. Remember that you are just having a panic attack, nothing more serious is happening. Remind yourself that the panic attack will end and your task is only to make yourself feel as comfortable as possible till the attack will end by itself.
• Try to relax the tense parts of your body. First tense and then relax the different body parts; if you have the feeling you can't move start with only one finger.
• Accept your feelings, don't try to play them down.
• Say “STOP” to negative thoughts. You are also interrupting the emergency message of your brain and stop the adrenaline production.
• Repeat a positive statement over and over in your head to replace the negative thoughts with positive ones. Make a list of positive statements before as it is difficult to come up with them during your panic attack. Maybe write them down and read them loud.
• If you worry about your health, consult your doctor and make regular health check to take your concerns. When your are sure that you are healthy you can use this as a positive statement. In case of a panic attack, may victims think they are having a heart attack. Remind yourself that your heart is healthy as you just checked it.
• Think about starting a panic diary that you always fill out during a panic attack. You fill out questions which calms you down, observe how the panic works and how you respond to it. You can not only react better in the future as you see how your panic attacks work but you also take the role of an observer not of the victim which helps a lot and stops your feeling of helplessness.
• Don't run away if it is not necessary. Remind yourself that you have he option to leave but try to stay in the situation. By this you don't search for relief but let relief come to you.
• Get back into the present by going back to your activities and become involved with the people that surround you. By this you stop thinking about bad things in past or present which probably caused your panic attack.
Repeat these steps as often as you need to!
Does the person suffer of another illness and is long-term help needed?
• People diagnosed with a panic disorder are persons who have several, spontaneous seeming panic attacks and a strong fear of a returning attack. Just in America, about six million adults experience panic disorder every year.
• Panic disorder requires specialist assessment but fortunately is it a treatable illness. It is said that Psychotherapy and medication can aid the recovery – singly or in combination.
• Agoraphobia is the fear of being in public places or situations from which escape may be difficult (or embarrassing) or they may feel help may not be available in the event of having an unexpected panic attack. They avoid situations or places in which they had a panic attack, because they are afraid that it could happen again. About one of three people with panic disorder develops agoraphobia which restricts the daily life.
If you had a panic attack or even have panic disorder or agoraphobia – don't be afraid to tell someone! It is not only a very common illness but also treatable! Talk to your doctor or loved ones and you have a good chance to feel better soon!