In A Better You, Health Professionals, Wellbeing

Panic Attack 101: What You Need to Know

panic attack

Panic attacks interfere with the lives of 2.4 million Americans. Panic attacks can be debilitating and affect a person’s day to day life. Each panic attack causes more panic. Over time, the person is in constant fear of having another panic attack. This can lead to additional emotional and physical issues such as depression, alcoholism and drug abuse.

Panic disorder is more common in women than in men and usually begins in late adolescence to early adulthood.

What is a Panic Attack?

  • A panic attack is different than the usual anxiety and anxiety disorder in that:
  • Panic attacks erupt seemingly out of nowhere and for no reason.
  • There doesn’t need to be anxiety at the moment to cause a panic attack.
  • The reaction is usually disproportionate to the effect.
  • This means that while a trigger may occur it is usually not a danger or threat to the person.

Symptoms of Panic Attack

  • Panic attack symptoms include (but are not limited to):
  • Difficulty breathing
  • Profuse sweating
  • Racing or rapid heart rate
  • Feeling of dread that is intense in nature
  • Feeling or sensation of being smothered or choking
  • Feeling faint or dizzy
  • Shaking and Trembling
  • Stomach ache, nausea or “sour stomach”
  • Finger and toes tingling or numbness
  • Hot flashes and/or chills
  • A fear of losing control or that of imminent death

Beyond these typical symptoms, one of the worst and constant symptoms is the fear of having another panic attack. People with panic disorder can worry about having a panic attack so much that they throw themselves into the throes of another panic attack. It is a vicious circle until controlled.

What does a Panic Attack feel like?

Imagine that your deepest fear has come to life in front of you and is threatening to harm, kill or take control of you or someone that you love. Perhaps it’s a monster, a large dog or the feeling dying in an airplane accident.

You want to run away and save yourself. The terror, though, is overwhelming as your fear weighs down upon you. You are stuck. You can’t act or move. You breath heavily and your heart is about to bust out of your chest. You feel like crying and vomiting. There’s no way to get away from the danger and save yourself or your loved one. You’re stuck and you’re most likely going to die at the hands of your worst fear.

Imagine, now, that there is no large dog. No monster. No imminent death by falling out of the sky on a plane.

This feeling of the deepest fear and dread just came out of nowhere with no warning and was not real. How would you feel? Confused? Frustrated? Are you going crazy? What’s wrong with you?

And then, all those feelings that you had because you just panicked for no reason start to coalesce themselves into another episode. Another panic attack. Here you go again. You feel like crying because you know what’s happening. But you can’t cry. You’re in the midst of it already.

Thus is the life of a person with panic disorder and that is what a panic attack feels like.

One of the worst things about panic attacks is that you feel lucky to be by yourself if it does happen. Sure, it makes you more scared because you’re alone but at least you know what you’re going through and what it feels like…even if you don’t understand it.

If a person has a panic attack and they are in the presence of others it is even more frustrating. No one else around is experiencing the event. They can’t understand what is wrong or why the person is panicking for no reason. And one of the worst things to say to a person with panic disorder in the midst of a panic attack is, “Just try to calm down.”

So, the person with the panic attack just feels like running away. Often, they do.

How is Panic Disorder Diagnosed?

There are no specific lab tests that can be done to diagnose panic disorder. However, a person will usually have panic attacks with one, several, or all of the symptoms listed above.

Doctors will first do physical tests that target the symptoms to ensure there is not an underlying physiological problem causing the symptoms.

If a physical illness is not found then a physician may then refer the patient to mental health professionals, psychologist or psychiatrist for more specialized testing and observation. These professionals are highly trained in treating mental ailments. They will use a specialized interview and assessment to further evaluate for panic disorder.

Based upon the severity, duration and frequency of the panic attacks the doctor will be able to determine if the ailment is, in fact, panic disorder. Another key factor in diagnosis is the patient’s attitude and behavior toward their current life situation. If a person exhibits an attitude of melancholy or is “down in the dumps” about life then it is possible that depression may be present as a result of the anxiety and panic.

What Causes Panic Attacks?

There is no exact known reason (you can start to see why panic disorder is so frustrating) on what causes panic disorder and panic attacks. There have been studies that only suggest the reasons a person with panic disorder may stricken with the ailment.

Panic attacks may be cause by a combination of environmental and biological factors. Many parts of the brain are involved with the regulation and reaction to fear and anxiety. Further studying is being done by the scientific community in an attempt to further understand the way the brain handles anxiety and fear. The hope is that this continued study will aid in the developing of more advance treatment for anxiety and panic attacks and disorders.

  • Family Factors: It has been shown that panic disorder may run in families, passed down from one or both parents much in the same as eye and hair color are passed down.
  • Problems within the Brain: Panic disorder may also be caused by abnormalities in the way the brain functions or simple chemical imbalances that can be corrected with medication.
  • Drug and/or Alcohol Abuse: Illegally abusing substances may contribute to anxiety, panic attacks and depression.
  • Life Stress Events: Major life changes and stresses can trigger the onset of panic attacks and panic disorder. Examples of these kinds of life stressors may include death of a loved one, a terminal illness or even the loss of a job.

How to Deal with Panic Attacks in Children

The first step in helping your child deal with panic attacks is to educate them. Children are still developing and a panic attack will cause them to become more confused and anxious on a constant basis. Adults have trouble dealing with panic attacks when they know what is going on. You can imagine what it must be like for a child to go through this.

Try using these Home Techniques for Easing Your Child’s Fear and Panic

Relaxation Strategies: A Child may need help in learning how to relax. Even letting a child know that it’s okay to relax can be a huge help!

Breathing Exercises:

Teaching your child to slow breathe, in through the nose and out through the mouth, can have an almost instantaneous effect. Let your child know that we tend to breathe deeper when we are panicked or anxious and that tends to make us “fuzzy” or dizzy.

Relaxing the Muscles:

This is another great one that works well. By tensing various muscles in the body and then relaxing those muscles puts the body more at ease. There is also something known as the “rag doll” approach with children. Have them “flop” so that their whole body relaxes at once.

Put it in Perspective (PIIP): This is a technique that is taught at UPENN’s Resiliency Course. By teaching your child to practice realistic thinking you can help them control the panic by putting their thoughts in perspective. Many children and adults are “catastrophizers” which is when we think about the worst thing possible that could happen. Instead, teach children to think about the worst thing that could happen, then about the best thing that could happen, and then what is most likely to happen.

The PIIP methodhas a purpose. The mind is already thinking about the worst case scenario and is in panic mode. By thinking about the best possible outcome next it brings the body and mind more towards center and rational thinking. At this point it will be easier to think about the most likely scenario. Keep in mind that while the worst and best may both be exaggerated the point of the exercise is to bring the mind back to a neutral, even keeled approach to the situation.

To help put your child’s thoughts in perspective, help them by asking the following questions:

  • What would be bad about that?
  • What happens then?
  • What would that lead to?

You can use these questioning techniques for the “worst”, “best” and “most likely” scenario.

Night Time Panic Attacks

Nighttime panic attacks can be the worst. Like most panic attacks, these tend to come without warning and with no trigger. Some parents mistakenly think that young children had a “bad dream” instead of realizing that they may be having night time panic attacks.

Nocturnal panic attacks demonstrate all of the same symptoms of day time panic attacks but it gets worse because of the loss of sleep. While most panic attacks, daytime or nighttime, will last less than 10 minutes it may take more time to actually calm down enough to go back to sleep.

This can cause more anxiousness in older children, for instance those in junior high school and above, because they know they have to go back to sleep and rest for school or activities the next morning.

If your child or you are having night time panic attacks then try to use the relaxation techniques mentioned above. It is okay to relax your child by reassuring them that there is still plenty of time to sleep and feel rested, or in the most extreme cases, letting them know that it may be okay to stay home from school the next day if they are that worried about it.

Note: If this is happening too often then counseling or medication may be needed to ensure that your child is able to rest at night. Also, keep in mind that going to school the next day may be the actual cause for the anxiety and panic in the first place.

How to Control a Panic Attack

Unfortunately, there is no way to control a panic attack from occurring. While it is possible, through medication, counseling or relaxation techniques to control the anxiety people feel, once a panic attack is upon us it is something that must be dealt with.

However, there are certain things we can do in the midst of a panic attack to better cope with it and get through it, keeping in mind that it will probably be over in a short period of time.

The key here is the ability to remember to practice these control techniques when having a panic attack. In most cases, the hardest thing to do during a panic attack is to think calmly and logically. It is a matter or practice.

Here is more detailed instruction on how to practice the relaxations mentioned above:

  • Breathing techniques: Breath in the through the nose and hold it for 5 seconds with your eyes closed. Exhale slowly with your eyes open.
  • Muscle relaxation techniques: Start with the arms and tense the muscles for 5 seconds before relaxing them. Work your way down the body, concentrating on all the major muscle groups.
  • Mild exercise such as walking or yoga: Don’t run away. However, simply getting up from a desk or situation where you feel the onset of the panic attack and going for a brisk walk may help control the severity of the attack.

What are the Treatments for Panic Attack Disorder

While many panic attacks and anxiety disorders are the result of an innate fear, for instance a fear of flying or claustrophobia, panic attacks do not have triggers.

If the panic attack is caused by anxiety due to a fear then the best method of treatment is understanding what the trigger is and learning how to control that fear, through counseling, for instance. For some, the “facing your fear” method will not work but for many more it is very effective.

Joining a support group is another good way of dealing with panic attacks. Support groups are so effective because they are filled with people who also suffer from panic attacks and relate much better than anyone who has never had anxiety or panic attacks.

Therapy sessions, with a counselor or other mental health professional, are also effective because they can help those with panic attacks understand what causes their attacks and how to best deal with them. Therapy sessions also act as an outlet for the frustration that comes with panic disorder.

Medication is not always the best route but it may be used effectively in conjunction with therapy to help control the anxiety that eventually leads to panic attacks.


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