Panic attacks: what are they and how to recognize them?

What is a panic attack

A panic attack is a sudden and brief attack of intense fear. It usually lasts from two to twenty minutes.

As a rule, an attack occurs spontaneously for no apparent reason. A panic attack can catch a person anywhere and anytime: driving a car, while walking, at work, and even while sleeping.

Most often, during a panic attack, a person feels horror and fear, and bodily symptoms “stretch” behind them .

Psychological symptoms of a panic attack:

• feeling of impending doom or danger
• fear of loss of control or imminent death,
• a feeling of unreality or detachment.

Physiological symptoms of a panic attack:

• heart palpitations,
• sweating,
• shortness of breath
• chest pain,
• nausea,
• dizziness,
• chills,
• hot flash,
• shiver,
• feeling of numbness or tingling.

Symptoms usually appear quickly, peaking within minutes.

At the moment of an attack, it seems to a person that he is about to lose consciousness, suffocate, go crazy or die. But you don't die from a panic attack. The intensity of experiences does not correspond to the real situation and may not be related to it at all.

A panic attack can be confused with a heart attack, which is just dangerous to health. But there are still significant differences between them .

Causes of panic attacks

Panic attacks occur both completely suddenly (an unexpected panic attack) and under the influence of certain triggers (an expected panic attack). So, a person who is afraid of flying can experience a panic attack already when boarding an airplane.

An unexpected panic attack is doubly frightening: fear arises not only during an attack, but also after. Since there is no real danger that provokes panic attacks, a person develops a fear of a new attack, which is reflected in his professional and daily life, sometimes leading to a complete refusal to leave the house.

Both varieties are united by the fact that scientists still do not know the exact causes of their occurrence. However, there are known factors that contribute to their development, among which are stress, psychological trauma, hereditary burden, and others.

It is known that severe stress can trigger a panic attack. So, more often seizures occur in people after the death of loved ones, dismissal, divorce, bankruptcy.

In addition, people who have received psychological trauma in childhood (bullying, violence, accident) are at risk of experiencing a panic attack.  

Genetics also play an important role. Having a family member with a panic disorder increases the “chance” of having panic attacks in other family members by 5.7%–17.3%, and for siblings or children, this figure reaches 40%.

Frequent panic attacks - panic disorder.

In some cases, the experience of a panic attack can have a domino effect: the heart beats faster and faster, tremors, dizziness appear, and the person begins to think that there is much more at stake than a panic attack. The fear of death causes even more panic and attention to their bodily symptoms, which only increases the excitement in the body and the symptoms of an attack.

In addition, panic attacks can be caused by somatic conditions. So, the abolition of certain medications, low blood sugar or thyroid disease can provoke seizures.

Mechanism of occurrence: about the violation of communication between the brain and the body

Sometimes a panic attack starts with changes in the body that send alarm signals to the brain, and sometimes an imbalance of chemicals in the brain triggers a fight-or-flight response in the body.

"Fight or flight" is the body's response to stress, which is provided by the sympathetic nervous system, which mobilizes the body.

It is still unknown why the brain decides that a person is in danger. But when this happens, a whole cascade of reactions is set off with a starting point in the amygdala - the brain center of fear.

When activated, it immediately sends distress signals to the hypothalamus, the center of the autonomic nervous system that regulates the functioning of internal organs.

The hypothalamus, in turn, sends a message to the adrenal glands, which release adrenaline and cortisol, the stress hormones. After that, the heart starts to beat faster, sending more blood to the muscles, and the breathing rate increases, allowing the body to absorb additional oxygen. The body is ready to face the danger, which, however, does not exist. It is through this chain of reactions that a person experiences real physiological symptoms.

What to do during an attack and when to see a doctor

Panic attacks are not permanent, they respond well to treatment. Cognitive behavioral or exposure therapy, breathing exercises, and medications usually help.

Experts recommend not postponing a visit to the doctor, even if the attack happened only once. Only a doctor can determine what is happening to you and whether there are any serious medical problems (heart and lungs).

In addition, you can alleviate a panic attack on your own (this will not replace the advice of a specialist). Here are some effective strategies during an attack:

• Normalize breathing. Since the person is breathing rapidly and shallowly during a panic attack, you need to stop doing everything you were doing (if the situation permits) and focus on your breathing. Inhale for 3 seconds, then hold your breath for 2 seconds and exhale again for 3 seconds. Try to inhale deeper than usual. Such breath control will help to contain the attack so that it does not intensify and end faster.
• Switch attention. To disconnect from negative thoughts, you need to switch your attention to something else, for example, the environment. You can look at any object (it can be a ficus in a pot, a chandelier, a picture or a neighboring building in the window) and concentrate on it. You can describe in your head its color, texture, shape and size. This will help you switch.
• Reframe thoughts. During an attack, as a rule, such thoughts visit: “I'm scared”, “people will think that I'm crazy”, “I can't handle this”. Try replacing these thoughts with positive and more reassuring affirmations like "I'm safe," "I'm safe," "I can handle it," "I'm strong." Life-affirming thoughts challenge anxiety and help relieve a panic attack.
• Relax your muscles. During a panic attack, the muscles are tense because they are ready to fight, but relaxing them will help you stay calm. Start mentally scanning your body, identifying the tense area. So, for example, you will notice that your jaw is clenched and your shoulders are raised. Try to relax them.