First time experiences of panic attacks can be really scary. They can make you feel like you are dying, having a heart attack or stroke. Usually people seek out medical help, go to the emergency room but after health examinations have been done, they are discharged as physically healthy.
It’s believed that panic attacks physiologically happen when there is overstimulation in the brain region known as amygdala. Amygdala is responsible for fight or flight response in times of danger.
When you are in danger, for example, car crash, school shooting, burning building, the amygdala releases several stress hormones in your bloodstream such as noradrenaline, epinephrine.
These neurochemicals alter changes in physiological functioning of your body’s organs. Some of those, also known as physical symptoms of anxiety, are summarized in the table below.
Physical symptoms of anxiety explained:
| Physical symptoms of anxiety | Meaning |
| Increased heart rate, heart palpitations | Increases oxygen flow to the organs for better performance |
| Difficulty breathing | Can be result of deep, rapid breathing which increases oxygen concentration in blood flow to the maximum, raising difficulty of taking next breath (even more oxygen) |
| Sweating | Cools off body for better performance |
| Tingling, numbness in hands, feet, face | Outer blood flow from the skin and extremities is partially redirected to internal organs important for survival |
| Dizziness, lightheadedness | Blood flow from the brain, causing oxygen deficiency, is partially redirected to internal organs important for survival |
| Cold, sweaty hands and feet | Outer blood flow from extremities is partially redirected to internal organs important for survival |
| Blurred vision | Blood flow from the brain is partially redirected to internal organs important for survival, also can be signs of body exhaustion, tiredness. |
| Dry mouth | Digestion, including secretion of saliva, is stopped for better optimization of bodies resources during fight or flight response |
Experiencing anxiety symptoms mentioned above in real danger can be nothing unordinary. People usually don’t even raise their eyebrows when such bodily reactions happen because they feel appropriate to the situation.
On the other hand, panic attacks can happen without the presence of real danger. For example, you might drink coffee in the morning and next thing you know, you feel your heart pounding, have difficulty taking a breath, feel dizzy and start sweating heavily.
Such experiences can be scary and raise your panic even more. There isn’t anything life threatening about drinking coffee on a peaceful morning. Evidently, you will assume that you are having a heart attack or dying.
Why do panic attacks happen?
1. Genetic predisposition
People can be born with a highly sensitive nervous system. Meaning the way they feel and process emotions, thoughts affects them more intensely. Those differences could be also reflected in intensity of physical symptoms associated with stress.
Some people get aroused by stressful events more easily and may perceive certain social situations more stressful than others. Genetic differences can be the cause of why some people worry more intensely and are predisposed to feelings of stress.
Potentionally there could be differences in functioning of brain regions that regulate fight or flight response (stress response). Case being, that those with highly sensitive nervous systems may have more active brain regions which naturally produce higher amounts of stress hormones.
When they are pumped into the bloodstream they make a person feel more anxious, hypervigilant and prone to stress on a day to day basis. In relation to panic attacks, when the nervous system is already stimulated without a present stressor and then an extra stressor is added, it becomes overstimulated and panic attacks occur.
2. Panic attacks can occur when a person feels trapped in a particular situation
For example, you may stand in the checkout line at the grocery store and the line is just not moving. You may feel frustrated and angry. Suddenly you notice that your body temperature is rising and you start to get hot and sweaty. Your heart beats faster and you may experience a feeling of choking, difficulty taking breath. You may try to swallow your own breath.
The reason for such a reaction is that suppressed anger creates pressure inside your body. If it’s not acted out, either through communication or action, it transforms itself as a form of anxiety, panic attack.
3. Panic attacks can occur when unfortunate, unexpected life event happen
For example, a close person which you rely on or trust passes away unexpectedly. Such an event can cause unimaginable stress on your mind and it might not be able to deal with it right away. You loose so many inner resources and stability at once that your mind can’t handle reality.
Emotional response to such an event is panic and helplessness because a person has lost healthy balance. To cope and mobilize the body to traumatic events, the brain is releasing high amounts of stress hormones that are dumped into the bloodstream. Panic attacks occur naturally. They tend to disappear once the mind gets used to a new reality.
4. Panic attacks can occur when a person has gone through long periods of stress, tension, illness and their body is exhausted
When the body is out of resources physically or mentally, for some people the natural reaction is anxiety and panic. Panic is an alarm that signals to your body: ,,Okay, something is too much and your body, mind needs to rest in order to restore resources.”
Human body is made out of cells that need regular rest and relaxation. People with panic disorder tend to be ambitious and hard working people that regularly overload their body and don’t get enough rest physically, mentally. Body cells get tired and accumulate toxic neurochemicals that disrupt normal functioning of cells. Usually the body becomes distressed and panic attacks tend to occur. Regular relaxation and taking a break from work is a must for people with recurring panic attacks.
5. Panic attacks can occur when a person feels that something bad will happen and he has no control over the situation
Panic attacks can occur after a traumatic events, for example, after a car crash, domestic violence, or the experience of a first panic attack itself. Let’s use a lighter example of a recurring panic attack. Recurring panic attacks usually happen when a person worries too much about experiencing another panic attack in a particular situation where they occured before. In simple terms, worrying is used as a defense mechanism to avoid possible danger of having a new panic attack.
For example, a person can drive in public transport and driving over the bridge experience out of the blue panic attacks. The tricky part here is that brain will associate that place, sometimes situation with possibility of having another panic attack.
Person might start to experience excessive worry before crossing the bridge again because the brain believes that it will trigger another panic attack. Counter-intuative part here is, that worrying about having another panic attack is actually what triggers the panic attack in itself, not the actual place – bridge.
Yes, it’s really hard to separate these two because the thought of going close to the bridge triggers the worry and worry triggers panic attacks. So a persons mind, who suffers from panic attacks, believes if there is no bridge there is no panic attack. Yes, that’s true, but it doesn’t help to solve the issue. The right way to look at it would be – if there isn’t worry and fear then there is no panic attack. Easy to say, hard to execute in real life.
How to overcome a panic attack?
Panic attacks are scary. They can make you feel like you are having a heart attack or stroke, even dying. Experiences of panic attacks can traumatize you to the point where you start to experience dreadful fear of having another panic attack.
You may start to avoid daily activities in which you participated in before. That can be really tough. You may want nothing to do with having a panic attack but still they keep appearing, happening.
Understand function of anxiety, panic..
First, in order to overcome panic attacks you have to understand different aspects of how the brain is functioning under such conditions.
From the standpoint of nature fear and panic has its functionality of protecting your body from danger. For example, if someone tries to attack you, the brain region called amygdala is responsible for appropriate response, also known as flight or fight response. It prepares your body to either attack back or run away from the predator.
Every human is born with such a unique survival feature. Of course, it’s important to note that there are genetic differences that affect how our amygdala is responding to threat related ques.
Individuals born with a more sensitive nervous system may respond with more anxiety to events related to possible danger. For example, they may be more inclined to naturally enter flight (run away) responses in times of stress. Meaning that they may perceive others as more threatening and fear of being judged, punished, rejected, feeling incomplete or unworthy in social situations might be far more intense.
Differences are important
These differences are important to point out because they are one of reasons why psychic pressure builds up and panic attacks occur. When you are under pressure, stress the amygdala is stimulated and our physical body reacts accordingly to its signals.
For example, when we experience stress our heart rate goes up, we breathe faster, our body temperature goes up, blood from outer extremities is pumped to internal organs that are important for survival. We may experience cold, sweaty hands, tingling in the body. Our physical body becomes a mirror of what happens inside of us emotionally, mentally.
In terms of panic attacks, we could say that the amygdala gets overstimulated and experienced body sensations are rather deviation from the norm, because not everyone will experience a panic attack in their lifetime. It takes unfortunate life circumstances to get to that point.
What should you do if you ever experience a panic attack?
- Firstly, panic attacks aren’t dangerous to your health. They usually last up to 1 hour. Your heart rate at one point might reach 140-160 beats per minute but for most of it, it stays in the 110-135 beats per minute range. You can achieve the same heart rate with moderate to vigorous intensity activity like running.
- Secondly, you should check in with your family doctor to exclude other somatic illnesses. If tests come back negative, you are more than fine.
- Thirdly, you should try to forget that you even had one. The less you think about them or associate them with a particular situation, the higher chance that they will not recur again. Your mindset should be: ,,Okay, I have one. I will let it go out and be fine next time. Just hold on tight, relax and let it pass.”
Case example on how to overcome panic attacks
Over the next few paragraphs I will go over a case on how to overcome panic disorder. Examples will include a person who’s stuck in a panic attack cycle. Panic attacks tend to recur again and again in specific situations. I will use a person who uses public transport, train to get to work. This method could also be applied to fear of flying, going to crowded concerts, visiting shopping centers, etc.
For anxious people staying in fear, panic states feel really familiar. You may feel itchy to slip back into a fearful, panic state of mind. This is a major problem why panic attacks tend to recur time and time again.
Since then Mark hasn’t used public train for 3 years. He feels intense fear thinking about taking a train ride and crossing that bridge. He just can’t bring himself to do it, fear is so intense that he feels like he might die.
Steps to overcome panic attack:
1. Gain little bit of courage to go back to place which causes your panic attack
It won’t be easy. You will have to force yourself back into that situation. You may feel uncomfortable as you posibilly could be, but you have to back in order to solve the problem. There is no other way.
2. Accept your fear
Your brain has created strong defense where anxiety, fear gets triggered before you enter place in order to avoid panic attack. In this case, the defense is the problem not the place. You might be so focused on not having a panic attack that it creates even more pressure and strengthens the defense even further.
Counter-intuitive approach to this issue is allowing yourself to have a panic attack. Accept that it’s okay to have one. This is probably the worst thing you will have to accept. But, it will take off all that pressure you have put on yourself and weaken the defense.
3. Practice self-control
When you have gained some courage and accepted the fear you will enter the place. It’s fine if you feel panicky right away, it’s completely normal. This step is all about self-control. Your only goal will be to stay as calm as possible.
Just focus on your body and try to relax it. You will feel surges of anxiety coming out wild, try to push them back. You can do that by holding your breath and swallowing a lump that is coming out from your throat. Just try to push it back, breathe nice and slowly, you will do it.
4. Repeat third step a couple of times
Each time you will get a little bit better. Just focus on relaxing and keeping your body calm. You don’t have to do anything else. Eventually you will teach your brain to relax and have less anxiety every time you try.
5. Move forward
Once you get better there will be times where your mind questions if panic attacks might come back. Now you can work on the internal belief that everything is going to be fine and you are over it. It’s important that you tell yourself these things and gain back some confidence. You can practice short visualization exercises. Close your eyes and visualize yourself being in that place calm and relaxed. Everything is okay around you, continue practicing calmness.
6. Relapsing
There will be days where your anxiety surges back. Just repeat the third step. Don’t make a big deal out of it. It just happened once and that’s all it was. Try to give as little attention as you can, you are doing great!