My first panic attack happened as I walked into an eighth-grade classroom to begin instruction at 10 a.m. It felt like a giant boulder crushed my chest. I couldn’t breathe.
A heart attack killed my father when he was 46 years old. I thought I was having a heart attack.
The second attack happened the next day at the same time. I was terrified. I thought I was going to die.
I made an appointment with my doctor. He said I was a hypochondriac and told me to go home.
The frequency of panic attacks escalated in the weeks that followed. I thought I was having a nervous breakdown. Embarrassment and fear shamed me into silence.
I was constantly on guard, anticipating the next wave of panic. Anxiety exploded into full-blown agoraphobia. I was afraid to leave my home.
The Anxiety & Depression Association of America (ADAA) defines a panic attack as “the abrupt onset of intense fear or discomfort that reaches a peak within minutes” and includes at least four of the following symptoms:
- Pounding heart or accelerated heart rate
- Trembling or shaking
- Shortness of breath
- Chest pain or discomfort
- Nausea
- Dizziness
- Chills or sweating
- Numbness or tingling sensations
- Feelings of unreality or being detached from oneself
- Fear of losing self-control or “going crazy”
- Fear of dying
It is reasonable to experience fear when faced with a dangerous situation such as blinding weather conditions while driving on an icy road. These fears typically disappear when the challenging situation passes.
A panic-inducing situation often causes individuals to feel as if they are in immediate danger and with no means of escape. Situations such as crossing a bridge or speaking in public may trigger a panic attack – especially if that situation resulted in a panic attack on previous occasions (Smith, Robinson, & Segal, 2019). This can lead to a fight-or-flight response, a reaction typically caused by life-threatening conditions.
“Anxiety is often accompanied by physical symptoms such as a racing heart or knots in your stomach,” explains Dr. Reid Wilson, author of Facing Panic. “What differentiates a panic attack from other anxiety symptoms is the intensity and duration of the symptoms.”
Wilson explains many people who struggle with panic attacks make repeated visits to the emergency room or doctors’ offices because they are convinced they have a life-threatening issue. They often feel guilt and frustration if they leave without a diagnosis.
Panic attacks can appear without warning or explainable trigger – even if an individual is asleep. A panic attack may happen only once. Some people experience recurring episodes of panic – and await the next attack with terror and dread.
Panic attacks often occur with other forms of mental illness such as depression, posttraumatic stress disorder, and obsessive-compulsive disorder. Regardless of the cause, there is good news: Panic attacks are 100% treatable. There are strategies you can use to reduce – and often eliminate – symptoms of panic and take control of your life again.
Panic attacks are 100% treatable and curable.
PANIC DISORDER: SIGNS & SYMPTOMS
Smith, Robinson, and Segal (2019) describe a panic disorder as “repeated panic attacks combined with major changes in behavior or persistent anxiety over having further attacks.” Fear of recurrent panic can crush one’s self-confidence and cause severe disruption to everyday life.
If you are struggling with panic attacks, you are not alone.
The National Alliance on Mental Illness (NAMI, 2017) explains:
Anxiety disorders are the most common mental health concern in the United States. Over 40 million adults in the U.S. (19.1%) have an anxiety disorder. Approximately 7% of children aged 3-17 experience issues with anxiety each year. Most people develop symptoms before age 21.
Panic attacks and disorders tend to run in families. There also appears to be a connection with major life transitions such as getting married or having a baby. Severe stress such as the death of a loved one, divorce, or job loss can trigger panic attacks.
The cycle of panic disorder symptoms includes:
Anticipatory anxiety – Anxiety that stems from a fear of having future panic attacks. A perpetual state of “fear of fear” can be disabling.
Panic Attack – Sudden episode of overwhelming fear or anxiety based on a perceived threat rather than imminent danger.
Escape and Relief – Fear becomes so intense that relief only comes through removing one’s self from the circumstances or place where the panic attack occurred.
Self-Doubt and Criticism – Feelings of shame and fear lead to self-doubt and self-criticism. These feelings lead to anticipatory anxiety and restart the cycle.
The Cycle of Panic (Wilson, 2019, p. 13)
PANIC DISORDER WITH AGORAPHOBIA
I experienced a severe panic attack in an automobile while driving in an unfamiliar highway. The weather was cold, but the conditions were not hazardous. After the attack, I was afraid to drive and afraid of unfamiliar areas.
Two weeks later, I had a panic attack at a large department store. I avoided malls. I had a panic attack at church. I stopped going to church. I had a panic attack while watching television. I was afraid to sit down or relax. I frantically paced when I felt anxious. Panic attacks robbed me of the freedom to leave my house.
Agoraphobia is an “irrational or disproportionate fear of a range of situations in which a person believes escape or access to help may be impossible, very difficult, or very embarrassing if he or she develops panic-like symptoms or some other incapacitating loss of control” (Bienvenue, Wuyek, & Stein, 2010).
Someone who is agoraphobic avoids situations that may induce panic, especially places that may be crowded such as malls or stadiums. They avoid social gatherings because they fear being embarrassed by an attack in public. Sometimes they refuse to go anywhere alone.
Unfortunately, agoraphobes often withdraw from the company of others and activities they enjoy. Their fears of oncoming panic attacks strip them of freedom. They become locked in prisons of fear.
PROFESSIONAL SUPPORT FOR PANIC ATTACKS & DISORDERS
It is essential to make an appointment with your doctor to rule out medical factors that may be causing discomfort. Results from a medical exam can put your mind at ease if you are worried about physical causes for the attacks.
The most effective form of professional treatment for confronting and healing panic attacks, panic disorder, and agoraphobia is therapy. Contact your local mental health services in your area if you want to make an appointment with a mental health professional.
Psychology Today provides a Find a Therapist online directory on their website. Pastors and friends may also recommend quality therapists they trust.
Medication can be temporarily prescribed by your doctor or health professional to control or reduce symptoms of panic. It is most effective when combined with quality therapy and lifestyle changes.
PANIC ATTACK RELIEF & SELF-HELP TIPS
“Before you can learn to gain control over panic, you must first believe that you have the ability to take control,” insists Wilson. Symptoms of panic attacks can be managed, decreased, and eliminated.
These techniques will help you regain control and restore peace to your mind and body:
Learn about panic and anxiety. Knowledge is power. Understanding anxiety and panic attacks empower you with tools to relieve distress. The following books are outstanding resources:
Dare: The New Way to End Anxiety and Stop Panic Attacks (McDonagh, 2015)
Declutter Your Mind (Scott & Davenport, 2016)
Facing Panic: Self-Help for People With Panic Attacks (Wilson, 2019)
The Anxiety & Phobia Workbook (Bourne, 2015)
NAMI and the Substance Abuse and Mental Health Services Administration (SAMHSA) offer free information about anxiety and panic attacks. They also provide helpful resources for families and those who care about someone struggling with panic attacks.
Avoid smoking, alcohol, and caffeine. These stimulants can trigger anxiety and symptoms that mimic panic attacks. Non-drowsy medications can also make you feel agitated and uncomfortable.
Breathe. When I experienced panic attacks, I held my breath and prepared for the next assault on my body. I did not know it was physically impossible to inhale and exhale in slow, deep breaths and experience a panic attack at the same time. Deep breathing relieves the symptoms of panic.
It is impossible to inhale and exhale in slow, deep breaths and experience a panic attack at the same time.
Practice relaxation techniques. I found an old cassette tape of guided meditations that helped me relax my body, mind, and breathing. I listened to the tape until it fell apart. By the time I threw it away, the voice on the tape had become part of my inner self-talk.
Activities such as yoga and meditation help the body to relax. Excellent resources for guided meditations include:
Guided Meditation to Help with Anxiety and Pain by Belleruth Naparstek
Guided Meditation for Relaxation and Wellness by Belleruth Naparstek
There are exceptional online apps that offer guided meditations and tools for relieving anxiety including Calm, Headspace, and Insight Timer. Stop, Breath, & Think is an online app that offers guided meditations and activities that will help you to identify your emotions.
Connect with a support network. Reach out to family and friends to support you on your recovery journey. If they lack tools or do not understand your experiences with panic attacks, connect with a support group. Contact your local mental health directory to find support groups in your area.
The Anxiety and Depression Association of America (ADAA) offers a support group directory. NAMI also offers information about support groups as well as programs for youth and families.
Exercise regularly. Physical exercise offers natural anxiety relief. Rhythmic aerobic exercise such as walking, running, swimming, or dancing is good for your heart, lungs, and help regulate your breathing. Yoga is particularly good for helping you slow your breathing and develop mindfulness habits. Exercise keeps your body busy and shifts your focus away from the anticipation of the next panic attack.
Get enough restful sleep. Insufficient or poor-quality sleep intensifies anxiety. Try to create a sleeping schedule that allows you to get at least seven to nine hours of sleep every night. Health and wellness expert, Micah Kidd, offers these tips to get the rest your mind and body need.
WHEN SOMEONE YOU LOVE EXPERIENCES A PANIC ATTACK
Seeing a friend or loved one suffering a panic attack can be frightening. Statements such as “Calm down” or “Stop being so dramatic” are not helpful and will not minimize their fears.
Try these suggestions if someone you care about is experiencing a panic attack:
Stay calm yourself. Try to over-react. Non-judgmental words and calm physical reactions will help their panic attack more quickly subside.
Focus your loved one on their breathing. Find a quiet place for your friend to sit in a quiet place. Encourage them to take slow, deep breaths for a few minutes.
Do something physical. Encourage your loved one to raise and lower their arms or march in place. Move with them. This deflects their attention from the attack to the physical movement.
Help them shift their thinking. Say, “Describe 10 things you see.” Invite them to repeat a positive affirmation such as “I am in control of my body.” Positive affirmations help shift negative thinking to positive thoughts. Provide positive feedback.
The last severe panic attack I ever experienced lasted four hours, but the words of a friend changed my thinking forever:
“I know I look crazy,” I admitted to her, feeling despondent.
“No, you don’t look crazy. You look worried,” she calmly said. “You look tired. You look scared.”
Her feedback shifted my perspective. My self-perception changed immediately. I stopped trembling. My friend confirmed I did not look crazy. I looked worried, tired, and scared. Those were conditions I can do something about. I was relieved.
Reassure them that help is available. Once a panic attack is over, your loved one may feel embarrassed. Reassure them that there is a difference between “frightened” and “crazy.” Offer to help them explore support and therapy options if they are open to it.
THERE IS HELP. THERE IS HOPE.
I shared my fears of “losing my mind” when I experienced panic attacks with a psychologist. I told him I heard voices.
“What are the voices saying to you?” he asked.
“The voices say I’m broken. And damaged. And sick,” I answered.
“Those are scary voices,” he replied. “Those voices are coming from inside of you. Negative thoughts are like an old hat: If you don’t like it, don’t wear it. You have the power to change your own thoughts.”
Negative self-talk is like an old hat: if you don’t like it, don’t wear it.
“Your life just doesn’t happen,” insisted Stephen Covey, author of The 7 Habits of Highly Effective People. “You choose happiness. You choose sadness. You choose courage. You choose fear,” Covey added. “Remember that every moment, every situation provides a new choice.”
Every day offers an invitation to celebrate your life journey, regardless of the circumstances that may storm around you.
You decide where to go – and how you go – from here.
What habits of self-care can you begin today?
If you or a loved one are experiencing a crisis, contact the National Suicide Prevention Hotline. Call 1-800-273-TALK (8255). Trained counselors are available 24/7. Visit www.suicidepreventionlifeline.org for more information.
You can also send a text to the Crisis Text Line. Enter 741741 and type “HOME” to speak with a trained counselor. More information is available at www.crisistextline.org.