Imagine yourself sitting unsuspecting there... and as you are sitting there, all of a sudden your heart starts beating like crazy, you feel that you cannot breath, you break out in a cold sweat, bad thoughts overcome you and you think you are going to die! This is the frightening experience of a panic attack.
People who have experienced panic attacks become distressed only at the thought of a recurrence, while they argue that people who have not had this experience cannot understand its severity. Most people who are hit by their first panic attack and know nothing about this anxiety disorder think they are having a heart attack or a stroke. Moreover, the symptoms of the panic attack mimic those of “physical” disorders. So, before visiting a mental health professional, they have already visited many doctors, they have undergone a number of medical tests, and every time this is the answer they get; “There is nothing wrong with you, it’s just stress!” Having excluded that the symptoms are due to any physical cause, let’s begin to look into the possibility of a panic attack.
But what are these panic attacks after all?
A panic attack is a period of intense fear, which appears abruptly. It lasts 5 to 30 minutes and includes cognitive and bodily symptoms. These symptoms may be; heart palpitations, sweating, trembling, dyspnea (shortness of breath), feeling of choking, chest pain, nausea, abdominal discomfort, dizziness, numbness, chills or hot flashes accompanied by the fear of dying or heart attack. Of course, not all sufferers of panic attacks have all of the before-mentioned symptoms, because they do not all occur at the same time. In any case, after the panic attack strikes, the sufferer feels overwhelmed and exhausted. What we call “anticipatory anxiety” is the fear of having future panic attacks.
If a person has at least two unexpected panic attacks (which are usually much more) followed by the lasting worry about having another panic attack, then we speak in terms of a Panic Disorder. Panic disorder is one of the most common mental disorders worldwide. It affects about 4% of the population, while it is 2 or 3 times more prevalent in women than in men. It usually manifests itself for the first time in late adolescence and up to the age of 35 years.
50% of the people with a Panic Disorder is likely to suffer from depression as well. Moreover, panic disorder in most cases is accompanied by agoraphobia. In this condition sufferers feel overwhelming fear in places wherefrom they cannot easily escape, or in which they would not be able to get help in case of a panic attack. Agoraphobia sufferers are most afraid of being in a crowded place (e.g. in a big club among many people), standing in line, going out alone, travelling by mass transit or by car. Because they fear lest a panic attack strikes them, they tend to avoid more and more these situations. As a result, they experience disruption on all levels of their life - social, family, professional - as well as their relationships and self-perception. Sufferers enter a vicious cycle, while family and friends interpret their behavior as laziness or lack of will power, failing to understand what is going on.
Still, what causes these panic attacks?
Panic attacks are usually a result of a combination of factors. Accumulated tension, stressful events (e.g. a recent loss or a divorce), everyday problems (family, financial, professional problems, etc.), chronic health problems in the immediate family environment, difficulty to bring together incompatible desires, several elements of the personality and hereditary causes are only some of the factors associated with the disorder. Also, high caffeine consumption, the use of substances, poor diet or extreme weight-loss diets may exacerbate panic attacks.
Despite the causes, the question is how we can get away from this vicious cycle and treat the panic attacks. They can be treated quite effectively with the right therapy, so it is very important that people seek professional help as soon as possible so as to avoid pointless suffering. In this case, the appropriate treatment is psychotherapy. Sometimes, when the crises are considerably frequent and intense, psychotherapy is combined with medication, which is administered for short periods of time.
Nevertheless, many people are reluctant to get help early, either because they deny that their symptoms are psychological in cause, or because they feel embarrassed to talk about them and they mistakenly think that they must overcome it without any help. So it is important that the person get informed, to understand and to accept his/her condition. To realise that it is something experienced by many other people and that, although it is a very frightening experience, it is not life threatening. Panic attacks cannot cause any physical harm, nor of course lead to death or “madness”. It is however a disorder that disrupts a person’s every day life and functionality, so proper treatment is necessary.
Accordingly, through psychotherapy, the person learns to identify the first signs of a panic attack and to act immediately, gaining control over the panic. He / she is trained to identify the thoughts and behaviors that trigger fear, and learns to replace them with other, more useful ones. Additionally, he/she can be trained in Relaxation Techniques and Breathing Exercises, which help anxiety management, and is encouraged to face the situations which previously avoided.
Apart from managing the panic symptoms, psychotherapy reveals the causes behind them. This is quite important, since a person can be treated from panic attacks, only once he/she understands and works on the causes of the symptoms. Therefore, through this individual self-discovery, a person learns to “listen” and satisfy his/her neglected personal needs, he/she sets new priorities in life, making changes in social relationships and changes his/her self perception.
Moreover, panic attacks are the alarm bell our body rings so that we can take better care of it. Our body sends this message in order for us to make changes in the way we manage things. These changes may vary for each person. This is why it is very important that one perceives the symptom itself not only as a problem, but also as an opportunity, a stepping-stone for meaningful and liberating changes. The majority of people who have experienced panic attacks and received psychological treatment, indicate that a different self appeared through this experience. A self they ignored until now, a self more forceful and more mature. They indicate at last that they are more satisfied with their life as a whole.
Health Psychologist (MSc) / Child Psychologist (MSc)