15 Mar

Disclaimer: this post is not intended for medical diagnoses or treatment. If you feel your symptoms are unbearable, please look for professional advice or ask your parent to seek professional advice.

What is a Panic Attack 


Panic attack is not a “thing,” but instead it is a dynamic process made up of interconnected thoughts, feelings, and behaviours. Knowing about how panic attacks is activated may help you to manage your symptoms and feel better. 

Have you ever had sudden attacks of anxiety and overwhelming fear that last for several minutes? Maybe your heart is pounding, you're sweating, and you feel like you can't breathe or think clearly. You might have had a panic attack. 

Do these attacks occur at unpredictable times with no obvious trigger, making you worry about the possibility of another attack? Panic attack can develop into panic disorder when someone has more than one occurrence. Untreated panic disorder can affect your quality of life and cause difficulties at work or school. The good news is that panic disorder is treatable!

The Main Elements of Panic Attacks

Do you know that bodily sensations, thoughts, and behaviours are the three elements of a panic attack? 

     1 - Among the bodily sensations are heartbeat, sweating, trembling, shortness of breath, nausea, dizziness, and a sense of suffocation. 

     2 - Anything we think or tell ourselves counts as a thought. 

     3 - Our actions or inactions constitute our behaviours. 

These three components can interact with one another. Your thoughts can cause or be affected by the physical sensations in your body, and vice versa. Your behaviours can influence your thoughts, and your thoughts can influence your behaviours. Both your actions and the way your body feels are influenced by one another.

Your thoughts and your body sensations can both influence and be influenced by each other. Both your actions and thoughts can influence one another. Both your body sensations and your behaviours can have an impact on one another.

What is a Panic Disorder

Panic disorder is an incapacitating anxiety condition that manifests as frequent, unanticipated panic attacks that are accompanied by physical symptoms like trembling, a racing heart, dizziness, and a sense of being out of control. Because it may feel frightening, the individual may alter their behaviour or even stopping going to places that they enjoyed before the panic attack, or change their routine in an effort to stop further attacks if they are afraid of suffering another attack. It typically has a negative effect on a variety of aspects of adolescents' lives, including social interactions with peers and academic performance. If you suffer with panic attacks you are not alone! 

Do you know that one of the most prevalent anxiety disorders is panic disorder, with lifetime prevalence rates in the general population being between 2.1–4.7%?

How does it Feel to Have a Panic Attack

When someone is having a panic attack they describe their symptoms as follows:

  • A feeling of immediate danger or doom
  • An intense need to escape
  • Heart palpitations or a pounding heart
  • Sweating 
  • Trembling
  • Shortness of breath or a smothering feeling 
  • A feeling of choking
  • Chest pain or discomfort
  • Nausea or abdominal discomfort 
  • Dizziness or light-headedness
  • A sense of things around you being unreal 
  • Feeling unreal
  • A fear of losing control or “going crazy” 
  • Fear of dying
  • Tingling sensations
  • Chills or heat sensations

According to the DSM-V, the diagnostic and statistical manual of mental disorders, panic attack can feel as a period of intense fear or discomfort with four or more of the above list of symptoms developing abruptly and can reach a peak within minutes.

What to do after a Panic Attack

The Panic Cycle

It is the most normal thing for human being to try to avoid the things that cause them uneasiness and discomfort. However, avoidance tactics and safety behaviours, such as avoiding situations or activities that are thought to cause panic attacks, can interfere with recovery from panic attacks and can actually make it to stick overtime. For examples, people try to avoid being in hot environments because they might be triggered by them, as well as situations where they might experience physical distress, such as on a roller coaster or an airplane. Another form of anxiety, such as social anxiety or a specific "phobia," can also develop as a feature of panic attacks.

For instance, a client who fears going crazy and losing control might continue to hold onto this thought even after experiencing multiple panic attacks during which they maintained control over their behaviour. Those misinterpretations and avoidance tactics can prevent the mind to add new meanings to what is actually happening. 

For instance, a patient who worries that their throat will tighten and they won't be able to breathe might carry a bottle of water, and a patient who worries about fainting might hold tightly onto something substantial. These actions prevent the unhelpful catastrophic belief from being refuted because the absence of the feared catastrophe is attributed to the safety action rather than to the fact that the catastrophe was unlikely to happen and therefore would not have happened (i.e., "the only reason I didn't fall was because I held on tightly"). Sadly, safety precautions frequently result in a worsening of the feared sensation. For instance, trying to suppress unwanted thoughts can make them more likely to surface (Wegner, 1994), and deep breathing, in some cases, can exacerbate shortness of breath.

For example, attempting to control unwanted thoughts can make them more likely to intrude (Wegner, 1994).

Did you know that?

All the uncomfortable sensations of panic actually have a vital purpose in protecting you from an immediate threat.

Remember that our brain does not know the difference between imagined danger and real danger. Our brain only reads on the signals that the amygdala sends on to it. When the amygdala is super active, it overworks and keeps sending signals to the brain that we are in danger. The brain nervous system starts a cascade of reactions to release adrenaline and cortisol to gives us enough energy to fight or flight the dangerous situation or to freeze if escaping the situation is impossible. 

The human brain still works in the same way it used to work in ancient times, when civilisations lived in tents or among the wild life. The brain is specialised at looking for any sign of danger so it could alerts its person to prepare to evade the dangerous situation. In modern times, we no longer live in tents or among the wild life, but through traumatic events from the past, the brain learned that we are not completely free from danger. Too much stimuli on the brain may make it to overwork as result, releasing stressful substance in our blood which can initiate the symptoms of fear, anxiety and panic attacks. Imbalance in the neurotransmitter in the brain can also lead to anxiety and panic attacks, so you should seek professional assistance because only a medical professional can assess your situation. 

Difference between Panic Attack and Anxiety

What Happens in the Brain During a Panic Attack

The amygdala is where the anxiety response is primarily generated. Despite being small, the amygdala is made up of tens of thousands of circuits of cells with various functions. These circuits have an impact on feelings of affection, behaviour, anger, and fear. The amygdala's function is to create emotional memories by associating emotional significance with events or things. These feelings and emotional recollections can be either good or bad. However, the amygdala's processing of emotions has a significant impact on our behaviour. The amygdala picks up on sounds, sights, and events as you go about your day, even if you aren't consciously paying attention to them. The amygdala is alert for anything that might suggest potential harm. The fear response, a bodily alarm that protects us by getting us ready to fight or flee, is activated when it detects potential danger.

The amygdala is what causes the anger you experience when someone intrudes on your personal space or confronts you. On the other hand, the amygdala can also be seen at work when you meet a stranger who resembles your grandmother and you feel a warm sense of affection for this woman you don't even know. In this instance, the amygdala is retrieving a pleasant emotional memory. Understanding how the amygdala creates and recalls emotional memories will likely help you better understand your own emotional responses. For example, "Melinda, a 10-year-old girl who was searching her home's basement for camping supplies. She stepped back in fright as she passed through a doorway. Her response was brought on by a coat that was hung on a coatrack. She jumped out of the way of the "intruder" before she even realized what she had seen because her amygdala reacted to the coat's shape, which could have been an intrusion. The amygdala is wired to react earlier than the cortex can as a safety measure based on evolution. Processing information from the thalamus requires more time in the detail-oriented cortex. In Melinda's case, the visual data must be transmitted to the occipital lobe at the back of the head, where it is then sent to the frontal lobes, where it is combined and rational decisions can be made. Melinda immediately jumped back, but she quickly recovered and continued searching for the camping supplies because it took her cortex a moment to register that the dark shape was actually a completely harmless coat".

The amygdala is in charge and you are a passenger when you are going through a fight, flight, or freeze response. Because of this, when an emergency arises, you frequently feel as though you are watching yourself reacting rather than actively choosing how you will react. The amygdala is not only faster, it also has the neurological capacity to take control of other brain functions, which is why we don't feel in control of these situations or our anxiety. Even though you might question this arrangement's usefulness, there are times when it's essential. It is obvious that the ability of the amygdala to override the cortex can literally save your life. In fact, it most likely has already saved your life many times and you haven’t even noticed it has done so. Would it be prudent for your brain to wait for the cortex to analyse the make, model, and colour of a car crossing the centre line toward you and consider details such as the driver's facial expression before reacting? No!

Things you can do to help with panic attacks

Calming your mind can help you to feel better. The key to decrease unnecessary stimuli on the brain is to have a consistent sleeping routine without any electronic devices at bed time, to exercise daily, eat healthy food and be mindful not allowing your mind to go awry or daydreaming. You can train your mind to be your best friend instead of letting it cause you mental issues such as anxiety, phobias and panic attacks.

There are some examples below what you can do to help you.

1 - Cognitive Behavioural Therapy 

You have specific thoughts, feelings, and behaviours in almost every situation you face in life, and that these three aspects of you interact and influence one another. Because of this relationship, you can learn to alter your ways of thinking and behaving to lessen your negative feelings when you can recognize and identify the thoughts and behaviours that cause your distressing feelings, such as fear and anxiety. The ABC triangle, which stands for affect (feelings or emotions), behaviour (actions), and cognition (thoughts), is a useful tool for understanding this. The triangle's three points are interconnected, so altering one of the points can have an impact on the other two. 

Let’s take this simple example:

  • Thought:“I am not qualified for this job.”
  • Feeling: Sad, defeated, embarrassed
  • Behaviour: Quitting the job

With the help of the cognitive triangle, a person will be able to challenge this negative thought and replace it with a positive one:

  • Alternative thought:“I can learn and improve with practice.”
  • New feeling: Empowered, interested, hopeful
  • New behaviour: Doing your best

2- Meditation

Numerous meditative practices have been around for thousands of years and have roots in Eastern traditions. The term "meditation" refers to a number of techniques that integrate the mind and body, calm the mind, and improve general wellbeing. Some forms of meditation require to keep the attention fixed on a specific sensation, such as the breathing, a sound, a picture, or a mantra, which is a word or phrase that is repeatedly many times. The practice of mindfulness, which entails focusing attention or awareness on the present moment without passing judgment, is one of the other types of meditation.

3- Mindfulness

Doing mindfulness entails being focused, inquisitive, and open while fully present with everything you are feeling in the present, including your body and your thoughts. It's a way to help us live more in the present and stop getting caught up in the past and future. A body scan is a common way to start a mindfulness meditation practice. This entails mentally tuning into or scanning your entire body, from head to toe (or vice versa), to become aware of any pain, tightness, or other unusual sensations you notice, and observing them without passing judgment.

4 - Hypnotherapy

Focus and concentration are enhanced by hypnosis, an altered state of awareness and increased relaxation. A different name for it is hypnotherapy. With the help of verbal repetition and mental imagery, hypnosis is typically performed under the supervision of a healthcare professional. Most hypnotized people report feeling at ease and relaxed. People who are hypnotized tend to be more receptive to suggestions for altering their behaviour. 

Deep breathing is one of the best things you can do when experiencing a panic attack. Hyperventilation, or breathing too quickly, is a direct cause of some panic attack symptoms, including tingling or vertigo. A good place to start is by breathing slowly, fully, and deeply while stretching your chest and diaphragm outward.

5 - Medication

Health care providers may prescribe medication to treat panic disorder. Different types of medication can be effective, including:

  • Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs)
  • Beta-blockers
  • Anti-anxiety medications, such as benzodiazepines

6 - Communicate

Discuss your feelings openly with someone you trust if you are exhibiting symptoms of panic disorder. Seek professional assistance to help you overcome or manage your symptoms.

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