What is a Panic Attack?
Panic attacks are defined as rapidly occurring episodes of anxiety in which at least four from a variety of symptoms occur. These symptoms include:
- Heart palpitations
- Feelings of choking
- Feeling short of breath
- Trembling or shaking
- Chest pain
- Feeling that you are not experiencing yourself or reality normally
- Fear or losing control or going crazy
- Fear of dying
- Chills and hot flushes
- Tingling in the fingers and toes
These attacks usually occur suddenly and build to a peak rapidly. They usually involve a feeling of intense fear, impending doom, and an urge to escape.
Panic Disorder and Agoraphobia
Although panic attacks can occur when a person comes into contact with a particular situation, such as public speaking, they can also occur out of the blue. When these keep happening and the person has become fearful of them occurring again, it is called panic disorder. Some people are affected so much by the fear of another unexpected panic attack occurring, they may start to avoid certain situations which they perceive as places where they may panic and be unable to escape or get help (eg. crowds, public transport, elevators). This avoidance is called agoraphobia.
Understanding Panic Attacks – The First Step To Recovery
The physiological reactions which people with panic disorder become fearful of are caused by the body’s natural alarm system when it believes it is under attack – the fight-flight-freeze response. The symptoms of panic are actually the result of changes the body makes to increase your chance of survival if you are being attacked by a predator. For example, the increase in heart rate is due to allow for more blood and oxygen to be pumped around the body. Similarly, the feelings of nausea and dry mouth are due to a reduction in activity in the digestive system, to allow more energy to be diverted to fight/flight systems. We naturally begin searching for threat with our attention, and because no external threat exists, we then interpret our own body symptoms in a catastrophic way – “I must be dying / having a heart attack/ losing control / going crazy”.
Cognitive behaviour therapy for panic disorder and agoraphobia begins with this initial understanding, and teaches people how to challenge their thinking about the symptoms they are having. Exposure to the symptoms in the clinic help the person tolerate these feelings in a safe environment, so that they build a belief that the symptoms cannot actually hurt them or result in a loss of control. The person is then helped to re-enter the places they have been avoiding.
- Clinical Research Unit for Anxiety and Depression: Excellent resource for learning about each anxiety disorder and initial steps to take to begin overcoming the symptoms.