Hadley Tarantino, M.A.
All About Panic Attacks
“If you miss a step on the stairs and your stomach lurches - it feels like that, but lasts much, much longer.”
Panic attacks can be a frightening and perplexing experience. The term itself can be seen as a bit of a misnomer because these attacks can arrive without warning with no real identified panic. The panic can result from the actual experience of the attack. Women are 2-3 times more likely to be affected than men. 2-6% of the population in the United States experience panic attacks.
Panic attacks are described as “an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes” (Diagnostic and Statistical Manual, 2015). It typically comes with a variety of other physical symptoms, such as a pounding heart rate, sweating, shaking, and nausea. Fears of dying, losing control, and depersonalization are also common in individuals who experience panic attacks. When the panic attack occurs, it can stem from a calm state or an anxious state. This fact can make the experience even scarier or more confusing due to the unexpectedness of a panic attack.
Being in the midst of a panic attack can be a harrowing experience. According to cognitive theory, beliefs that one is experiencing a medical condition and may die at any moment play a large role in panic attacks. This catastrophic causal misinterpretation between the individual’s physical symptoms and the belief they may die is what can perpetuate a panic attack by increasing the physical symptoms. Once the physical sensations heighten, the initial cognition of death or inevitability of something bad happening is reaffirmed (de Cort et al., 2013).
The key to overcoming a panic attack is to respond to the panic in calm, accepting ways. Distractions and trying not to think about it are not useful. It is best to address the anxiety when it first appears by acknowledging that it is there and accepting the emotions that accompany the anxiety. For instance, non-judgmental acknowledgment and acceptance can sound like, “I’m acknowledging that I’m feeling afraid, and I’m accepting that this is my present reality.”
Another helpful tool in the midst of a panic attack is to breathe. It seems quite simple, but during a panic attack it is common to have accelerated breathing. Breathe with the diaphragm. The panic attack will subside no matter what you do (this is a very comforting thought!), so try to make yourself as comfortable as possible by taking long, deep breaths until the panic attack ends.
Because panic attacks can arise out of seemingly calm situations, is there any way to avoid them? Most mental health professionals agree a combination of psychotherapy and medication makes a large difference in treating mental health issues. To help avoid panic attacks, relaxation techniques and breathing exercises are very valuable. In accordance with cognitive behavioral therapy, it is important to challenge negative thinking.
Secondly, getting a handle on panic triggers can help avoid panic attacks altogether. Some individuals know exactly what can trigger the panic attack, while others do not. Past trauma has a way of making itself known in present life circumstances if the trauma is not dealt with or processed. Certain triggers related to past trauma can be the catalyst for panic attacks, therefore, it is extremely beneficial to process any past trauma or triggers. This can be effectively done through trauma therapy and/or eye movement desensitization reprocessing (EMDR).
Panic attacks themselves are not a disorder and are typically diagnosed as a specifier with a concurrent anxiety disorder. Panic attacks can also present themselves in a variety of other anxiety disorders, such as agoraphobia and social anxiety disorder. Panic disorder is a disorder characterized by individuals having panic attacks. These panic attacks can range from several per day to only a few per year.
Panic attacks are very well researched. There are a variety of effective therapies that target how to deal with panic attacks. Cognitive behavioral therapy is one of the most popular therapies used for treating panic attacks and anxiety disorders. It is based on the idea that panic attacks are due to a positive feedback loop of cognitions and bodily sensations. Strong physical symptoms, such as heart palpitations and excessive sweating, activate catastrophic thoughts, which then create more physical symptoms (Roth, 2010). This particular therapy teaches individuals to identify the physical sensations and develop alternative interpretations of them. Panic disorder treatment has a higher efficacy rate for those who experienced a brief duration of symptoms and for those who functioned well prior to the panic symptoms occurring. It is important to seek help from mental health professionals if you suffer from panic symptoms or if you know someone who is experiencing this issue.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. Washington, D.C: American Psychiatric Association.
Craske, M. G., Kircanski, K., Epstein, A., Wittchen, H., Pine, D. S., Lewis-Fernández, R., & Hinton, D. (2010). Panic disorder: A review of DSM-IV panic disorder and proposals for DSM-V. Depression And Anxiety, 27(2), 93-112. doi:10.1002/da.20654
de Cort, K., Hermans, D., Noortman, D., Arends, W., Griez, E. L., & Schruers, K. J. (2013). The weight of cognitions in panic: The link between misinterpretations and panic attacks. Plos ONE, 8(8),
Roth, W. T. (2010). Diversity of effective treatments of panic attacks: What do they have in common?. Depression And Anxiety, 27(1), 5-11. doi:10.1002/da.20601