People
describe panic attacks in different ways, but there are similarities I tend to
hear. “It came out of the blue, without
warning.” “I was afraid I was dying.” “I keep worrying about when the next one
will come.”
Panic disorder is an anxiety disorder that is experienced
as sudden episodes of intense fear, in which the person feels that something
bad will happen or that he or she is dying.
Panic attacks can mimic heart attacks. In fact, panic attacks account for almost 40
percent of visits to the emergency room with complaints of chest pain. Panic
disorder occurs in twice as many women as men. The symptoms usually begin in late teens or
early adulthood, but may occur in children and not be diagnosed until they are
older. This speaks to the importance of noticing
possible symptoms at an earlier age. Early identification can lead to early
intervention and the learning of coping skills to stop the occurrences.
A panic attack is different from general anxiety in that
it has a distinct beginning and an end.
It most often lasts for about 10 to 20 minutes, but some symptoms may
linger for an hour or more. People will
sometimes describe a lingering feeling of dread all day. People with panic disorder may have sudden and
repeated attacks of fear, a feeling of being out of control, an intense worry
about the next attack, and an avoidance of places where panic attacks have
occurred. Physical symptoms can include
racing heart, heart palpitations, sweating, shortness of breath, weakness or
dizziness, hot or cold feelings, numbness or tingling, and chest or stomach
pain.
The term anticipatory anxiety describes the fear that
develops about having another panic attack. This results in people avoiding
places that are similar to where they were when they had an attack. If someone
has a panic attack in a supermarket, they may avoid going to that supermarket,
then all supermarkets, and perhaps all large stores. It is as if the brain is learning that these
are dangerous places to avoid. Other
avoiding behaviors can develop regarding going over a bridge, going on the
highway, avoiding social situations and large crowds, or traveling. In severe cases, the person begins to avoid
going out of their home in order to avoid possible triggers to the next
attack. Unfortunately, these behaviors
don’t prevent the attacks. In fact, some people can wake up in the middle of
the night and have a panic attack out of nowhere. Some people, in an effort to cope with the anxious
feelings, may turn to alcohol, marijuana or feelings of
unreality.
Panic attacks
cannot be predicted. In the early
stages, there are no distinct triggers that start an attack. Over time, there is a possibility that prior
situations involving an attack will trigger another one. As the disorder is
biological, the longer it goes untreated, the more frequent the attacks become. The brain begins to interpret more and more
situations as dangerous, resulting in increasing interference in one’s
functioning.
There are no
specific tests for Panic Disorder and the diagnosis is usually given once
medical causes are ruled out. The first step towards treatment is to get a
correct diagnosis. Often people feel they are being told that it’s all in their
heads, and that they are being dismissed by their medical doctor. Panic disorder is real and biological and
there is a treatment that is effective.
Cognitive
Behavior Therapy has been demonstrated to be very effective in its treatment of
Panic Disorder. It is a short-term, skills-based program that can teach the
individual how to change his or her thoughts and reactions to the feelings of
panic, eventually resulting in a reduction if not elimination of these
episodes. When the panic attacks are more
frequent or powerful, an option to consider is medication. Antidepressant
medicines called Selective Serotonin Reuptake Inhibitors (SSRIs) are most often
prescribed. People are more familiar with the names Zoloft and Prozac, for
example. Sometimes, other short-acting medications are prescribed, but they are
not usually used for a long time.
In CBT one
learns how to:
-
Notice and change one’s views or beliefs about life
events
- Recognize and replace anxiety-provoking thoughts
- Manage stress and practice relaxation techniques
- Practice
in real-life situation to help overcome one’s fears
Practicing
wellness strategies such as eating healthy and regularly, exercising, getting
enough sleep and reducing caffeine may also help to reduce the frequency or
intensity of panic attacks.
The key to
remember is that these attacks are very treatable with short-term treatment.
There is no reason to continue to suffer in silence.
