What is a panic attack really? As a Maui Psychologist, I hear many people with severe generalized anxiety or those who are emotionally activated by a significant stressor in their life state “I was so upset I had a panic attack.” While I have immense empathy for people who suffer from clinical anxiety and the many forms of it, I think it’s important to educate ourselves about what a TRUE full blown panic attack really is….knowledge is empowerment.
A panic attack is a rapid activation of the sympathetic nervous system, the branch of the autonomic nervous system that induces the “fight or flight” response. In dangerous situations, this is your autonomic nervous system doing its job, alerting you to help you survive. For those of us water lovers, you may or may not appreciate this example:
You are swimming through the water happy as can be, snorkeling or diving while exploring the underwater world and you see a shadow through the water. Your heart starts to beat faster and the sympathetic nervous system’s fight or flight response kicks in which induces: elevated heart rate, pupil dilation, circulatory constriction, elevated blood pressure, pause in digestion, feelings of fear or panic, shortness of breath, and bladder dyscontrol. But then, as the water clears you see that it’s only a large honu and as you swim closer to get a better look, it peacefully swims away. Now the parasympethic branch (opposite of sympathetic) of your autonomic nervous system kicks in which helps you relax and calm down, returning to a nice biological state of equilibrium. But what if, instead of seeing the honu, the water cleared and you saw what seriously resembled a dark shadow with stripes….your fight or flight response would activate you to get out of the water…fast! You’ve now survived a close encounter and are able to tell all your friends about this rare, but exciting interaction with a tiger shark thanks to your autonomic nervous system!
I hope no one gets anxious from my example and still plays in the water. But, I have a feeling if you are anxious about sharks, you were probably anxious before reading this post…Anyways, a panic attack is like reacting to a shark when it’s really only a turtle. A panic attack is an acute onset of cognitive, physical, and emotional symptoms usually reaching their peak within 10 minutes:
Signs and Symptoms of a Panic Attack:
*Shortness of breath or hyperventilation *Sweating *Nausea or upset stomach *Feeling dizzy, light-headed, or faint *Numbness or tingling sensations *Hot or cold flashes
Fear of dying, losing control, or going crazy *Heart palpitations or a racing heart *Chest pain or discomfort *Trembling or shaking *Choking feeling *Feeling unreal or detached from your surroundings
Many people can have a full blown panic attack without further recurrence. Some unfortunately develop what we call “Panic Disorder” which occurs when there are frequent, unexpected panic attacks that seem to come out of nowhere and are debilitating to the person’s life. People with Panic Disorder are often living in fear of having their next panic attack. Even though it seems like it is unexpected, what actually happens is something called “interoceptive conditioning” which is a conditioned panic response to your own internal bodily sensations. It is usually difficult to identify at first. However, if you look closely you will find that it is actually not coming out of nowhere, but rather triggered by those bodily sensations that mimic or remind you of having a panic attack. For example, being short of breath after a run, nervousness when your boss calls you into their office and you don’t know why, or elevated heart rate when your name is called on in class. People will often misinterpret, usually unconsciously, these physical sensations as the onset of a panic attack, which then in turn, induces the panic attack and becomes a self-fulfilling prophecy.
Panic Disorder can be a debilitating illness, but it is very, very treatable. Truly it is! With a knowledgable therapist you can learn to breathe and gain control over your physiology that previously made you feel helpless. Also of note, medications such as the benzodiazepines (Xanax, Valium, Ativan) are actually contraindicated. They are temporary band aids that reinforce a lack of internal control over your physiology. While they may be helpful and are appropriate pharmacological interventions in the short term for acute stress, long term recovery involves mastering a sense of self-efficacy (control) over your autonomic nervous system.
All treatment is hard work, but I have seen people get control of what they once thought was an impossible to treat Panic Disorder through biofeedback and cognitive behavioral therapy. If you might be suffering from panic attacks, or a more serious panic disorder, contact us and we can create a treatment plan that will get you your power back over panic.
Stay Connected!