Panic Attacks

Panic Attacks
by Mr B Robinson

What is the difference between a panic attack and an anxiety episode? It is possible for an anxiety sufferer to have a panic attack, and likewise, someone with Panic Attack Disorder can experience general anxiety. However, it is helpful if the sufferer can distinguish between the two different experiences of anxiety as often this is not the case.

Why does anxiety exist at all? Well, anxiety exists to serve two fundamental purposes. Firstly, it is a spur to action. When fight or flight is engaged it encourages the individual to escape from the danger. Escape is the main objective.

Secondly it exists to provide the sufferer with the means to escape. Stress hormones are released and they facilitate the action. You can run faster, run further, and if you have to stand and fight, you will be able to hit harder and endure longer. However, flight is always the preferred option. Fight or flight offers little in the way of courage.

What then is the logic behind panic attacks? It is certainly not an ideal state of affairs for the body to be flooded with stress hormones for long periods of time. It makes far more sense for the spur to action to be short and sharp provided it achieves the same outcome. Panic attacks then, are a more intense spur to action and are less of an overall drain on the body’s resources.

They usually peak after about five or ten minutes and then begin to subside after a further twenty minutes or so. It is unusual for an attack to last for an hour or more, having said that, in some cases it is possible for one panic attack to roll into another with a slight trough in between. However, it is quite unusual for this to happen and we can say with some certainty that panic attacks do not go on and on. The body is simply not disposed to maintain extreme levels of panic for long periods of time.

It is very rare for a person to pass out as a result of a panic attack, although many people do harbour this fear. Fainting can happen due to low blood pressure and the idea is that if we fall to the ground then our brain is more likely to get the blood and oxygen it needs. However, panic usually increases blood pressure due to the stress hormones being released so fainting is unlikely.

Panic attacks can often appear suddenly and unexpectedly with no obvious trigger or build-up. Another feature is that the person may be more inward-looking during the attack. You think you might be going mad or that something serious has gone wrong inside. This may be partly due to the absence of an obvious external trigger. Attacks can happen months apart or they may be quite frequent. They are often followed by periods of intense worry. This usually centres on the fear of having another attack.

People who have panic attacks can go on to develop triggers which may be linked to the first incidence. For example, if someone had their first attack in a supermarket then supermarkets may trigger other attacks. It is also possible for someone with Panic Attack Disorder to have attacks that fit both descriptions, i.e. sudden onset attacks and ones brought on by specific triggers.

Generally speaking, it is difficult to control panic attacks. Once initiated, they have to run their course. If we could control or stop them then the disorder simply wouldn’t exist. However, there is some scope to improve things, but there is likewise the potential to make the experience worse. The whole idea of a panic attack is to make the person panic and escape from the danger. So, if we really do panic and start running around, calling for help etc, this tends to confirm the idea that danger is present. It is far better to stay calm, perhaps get up and make a drink then sit down again.

One of the big problems with anxiety and panic is the natural tendency to resist. We try and fight or block the panic even though this is futile. Resistance can be physical where we tense up further, but resistance can also be emotional and psychological. The best thing is to allow the panic in and let it do what it has to do.

Because panic is so inward looking, it is also a good idea to try and shift our focus to the external world. Look at things in the room; look at pictures or watch TV; listen to music or the radio; talk to yourself with reassurance about the panic. Slow breathing exercises are also a good way to calm both elements of the nervous system.

It is possible to recover from panic attacks and the two main pathways are Relaxation Therapy and Cognitive Therapy. Relaxation, however, is a progressive endeavour but when we finally become relaxed we will have left our panic behind. We also have to address the causes of stress and tension which usually stem from unhealthy thought patterns and to some extent emotional turmoil. Cognitive Therapy can help calm the mind and so deal with the root cause of tension.