Sarah was seated right in the driver’s seat of her car with her tightened grip on the steering wheel and her pulse was racing in her throat. Her palms were wet and she felt that nausea that started from the hollow of her stomach. Finally, she decided that she couldn’t possibly fake it anymore and she must be having a heart attack because a moment later she was frantically pulling over to call 108 (Indian Emergency number). When she got to the emergency room, after all the tests there, it was concluded that Sarah had a panic attack. One million people worldwide can tell this sad narrative.
According to a study published in the Indian Journal of Psychiatry, the lifetime prevalence of panic disorder (PD) in India is 0.5%, while the current prevalence is 0.3%. However, other sources suggest that the prevalence of panic attacks in India could be as high as 3-5%. Also women are more likely to experience panic disorder than men.
Research published in the Journal of Clinical Psychology in 2023 also showed an increase in the porch of 25% on reports of panic attacks from the time the pandemic hit the world and this helps to stress this mental health disorder.
What Is Panic Attack
Panic attacks are intense, acute episodes of overwhelming fear and anxiety which peak in minutes and thus cause tremendous physical and emotional reactions. Unlike general anxiety, where the onset is gradual and accompanied closely by various apprehensions, panic attacks seem to strike out of the blue even during moments of quiet or even while sleeping.
Anxiety Attack Vs Panic Attack
Panic Attacks: A Sudden, Very Intense Episodic Buildup of Worry and Tension with Rapid Onset
Anxiety Attacks: Gradual Building of Anxiety and Tension
The differentiating aspect lies in the intensity and predictability. Anxiety attacks can often be traced to a specific trigger and tend to escalate, whereas panic attacks seem to occur out of the blue and, for that very reason are always especially more distressing to the sufferer.
Panic Attack Causes
Biological Factors
Studies in the Harvard Medical School have shown that panic attacks are genetically prone to a large extent, and studies have found that subjects whose close relatives, first-degree, have had panic disorder are four times more likely to develop the condition. The amygdala of the brain, which is responsible for the fear response center, has a great role to play in triggering these episodes.
Genetic Susceptibility:
Family history of anxiety disorders
Inherited patterns of stress response
Neurochemical imbalances
Psychological Factors
Together, trauma, chronic stress, and significant life changes can create the perfect storm that leads to panic attacks. The most revealing findings came from the innovative University of Pennsylvania study: 70% of victims of panic attacks reported having had a major life stressor within the year preceding their first attack.
Psychological Triggers:
Trauma or abuse that has left deep emotional scars and has affected one’s well-being.
Chronic stress
Chronic stress resulting from work stress, financial issues, or parenting, for instance often leads to a perpetual sense of anxiety and fear in a person.
Life Changes
A change of job, city, or loss of a relationship can destroy the balance of life and develop confusion and confusion.
This could result from many emotional conflicts arising from a relationship or experience that causes inner turmoil and translates into the inability for full emotional growth and healing.
Environmental Triggers
Most of the situations that may lead to a panic attack are as a result of environmental factors. Environmental triggers include;
Widespread crowds
Being under extreme pressure in times when decision-making must be very fast and where excellent performance is expected.
The struggle with certain phobias that create extreme fear and anxiety within specific settings or conditions.
– Feeling the weight of the financial stress and sometimes having to be concerned with “how much things cost” or “how much money is coming in.”
– Feeling strain from having to work within the all-needy workplace, where deadlines and high expectations are overwhelming and stressful at times.
Symptoms of Panic Attack
Physical Symptoms
As a panic attack engulfs, the body’s “fight or flight” response is overactivated, leading to intense physical sensations:
A quickened heartbeat or an uncomfortable feeling of palpitations in the chest
An uncomfortable, heavy feeling in the chest, a feeling it wants to constrict
Shortness of breath that often feels tight inside the chest
Sweating heavily and involuntary shivering
One feels dizzy or lightheaded, hence making it hard to maintain balance
– An queasiness in the abdomen, maybe even accompanied by nausea or plain uneasiness in the digestive system
– Sudden onsets of hot flashes or chills that bring about an unpleasant fluctuation in the body temperature
– Bizarre numbness or paresthesia for no apparent reason at all, especially in the extremities or face
Psychological Symptoms
The psychological symptoms of a panic attack can be as crushing, too:
A heart-stopping fear of death, like death is coming to get you from around the corner.
– Dominating feeling of foreboding as if being under a dark cloud with a possibility of something terrible happening.
– Fearing loss of control, making the highest human desire to keep cool and calm during chaotic situations.
– Feeling of unreality; the whole world seems abnormal and twisted, hence it becomes slightly difficult to understand what is going on.
A feeling of being torn away from oneself, having one’s life seemingly observed with the lack of a connection to reality.
An attack of massive anxiety that overlays every idea with an unbreakable hold on panic.
A fear paralyzed by the anticipation of another attack, causing one to permanently live in vigilance, coming to dread in anxiety what shall befall the person next.
Duration and Frequency
Most attacks peak within 10 minutes and usually don’t last longer than 30 minutes. However, sometimes a person might have several attacks in a row, which can extend the episode to a much longer period. Episodes can vary considerably, appearing quite rarely or even to the point of having multiple per day.
Also Read : What Is The Link Between Anxiety And Diarrhea
Diagnosis of Panic Attack
DSM-5 Criteria
A panic attack, says the DSM-5, must involve at least four of the following symptoms in the person
- Palpitations or Accelerated Heart Rate: The most palpable of these is pounding in the chest, as if it is racing; this usually feels like it is skipping its beats or beating much harder than it would normally.
- Sweating: Profuse sweating that may come without warning and so leaves one feeling clammy and in awkwardness even in relatively cool conditions.
- Trembling or Shaking: Involuntary movements of muscles which take the form of shaking, often felt in the hands or legs, an instance of instability.
- Breathlessness: Feeling winded or short of breath, which provokes intense choking or anxiety about breathing in.
- Closure or Choking: Inability to swallow or constriction sensation, which is so frightening.
- Ache in Chest: Severe pressure or tightness or sharp stabbing pain in the chest along with anxiety about its cause.
- Nausea or Abdominal Upset: An uncomfortable feeling in the abdomen, accompanied by nausea or uneasiness. Vomiting sometimes takes place.
- Dizziness or Light Headedness: A spinning or whirling sensation in the head, in which one has a feeling of being about to fall or lose balance. In such conditions, the patient cannot stand or walk properly.
- Cold or Heat Chills: A bodily temperature condition, where the patient suddenly feels chill or overheated. As such, nothing works to decrease the heat or chills in the body.
- Dissociative Numbness or Tingling: There could be prickling or numbness in extremities, which creates a frightening disconnection between the mind and body.
- Derealization or Depersonalization: It creates a feeling of detachment to the surroundings or even to one’s own self, just as if watching from outside the body.
- Fear of Inability to Lose Control: A persistent fear of losing the ability to control one’s emotions or responses to impending doom.
- Fear of Death : A strongly triggered terror of something of death threat coming upon them with morbid thoughts in mind usually.
Professional Diagnosis
The doctors will be able to use a wide scale assessment protocol that includes
Good history with an elaborate clinical history
Physical examination
Mental status examination
Laboratory studies to confirm other illnesses.
– Monitoring of the heart, if necessary
Panic Attack Treatment
Cognitive-Behavioral Therapy (CBT) For Panic Attacks
Cognitive Behavioural Therapy (CBT) has been quite effective because it has been reported that, based on a study, 80% of panic attack patients improved significantly at the end of 12 weeks. CBT interventions for panic attacks assist individuals in several ways, including the following:
– It assists in the recognition and challenging of negative patterns in thought.
- Developing coping skills
- Learning relaxation
- Builds confidence in fighting symptoms.
- Exposure Therapy
This is a systematic process aimed at increasing the exposure of an individual to panic-provoking conditions within a safe and controlled condition. Exposure therapy assists individuals to:
– Improve control over panic symptoms
– Reduce avoidance behaviors
– Raise tolerance to bodily sensations
– Develop control over fear responses
Panic Attacks Medication
- Anti-anxiety Medications
- Benzodiazepines for the acute episode
- Beta-blockers for body symptoms
Breathing Exercises For Panic Attacks
The 4-7-8 breathing exercise has particularly proven useful:
- Inhale for 4 seconds
- Retain 7 seconds
- Exhale for 8 seconds
Panic Attack Meditation and Mindfulness
Results from new studies indicate that panic attacks can be reduced by as much as 40% through habitual practice.
Also Read : Meditation Techniques For When You’re Stressed
Lifestyle Adjustments
– Engage in physical activity daily (30 minutes)
– Healthy diet with omega-3
– Sleep sufficient (7-9 hours)
– Restrict intake of caffeine and alcohol
How Do You Calm Down A Panic Attack
Crisis Intervention Strategies
When you are having an attack:
- Acknowledge the attack
- Focus on breathing
- Apply the 5-4-3-2-1 exercise to earth yourself
- Reassure yourself it will pass
- Do Not Relocate
Also Read : How To Manage Work Anxiety
How To Get Rid Of Panic Attacks On The Long Run
Build resilience for panic attacks through:
Exercise Routine: An exercise routine that best suits your lifestyle may be good for bettering both your body and mental health. Good options include jogging, running, practicing yoga, and strength training to increase energy levels as well as even improve your mood.
Manage Stress: A good stress management plan would incorporate a viable plan of mindfulness, deep breathing exercises, or proper time management to alleviate the tension that always seems to be on the daily grind.
Sleep Management: Healthy sleep habits are fundamental to well-being. To achieve better sleep, one needs to establish the proper habits of sleeping. For instance, one must smooth out his or her sleep routine at bedtime, keep regular schedules, and observe less use of screens during the evenings.
Peer Support Group: It is also important to relate and understand peers who go through similar experiences, with whom one can identify, belong, and bond. And in times of crises, bonds formed in this group can be a comforting and encouraging factor.
Journaling and Self-Reflection: It always helps if you take time to journal and think about yourself. This way, you will be introspective and discover yourself. Whatever mental and emotional feelings you may have are clarified while putting pen to paper, thus finding even deeper understanding of growth over obstacles.
Building a Strong Network: You can turn your life’s hassles into something you can enjoy by making sure you have created a support network that can help you navigate through this gauntlet. Identify positive people who uplift and motivate you.
On some days when one is going through really hard times, there is nothing better than relying on close family members and friends to give emotional support and practical assistance. Their presence can make a big difference in coping strategies.
Mental health professionals are licensed personnel, such as psychologists or counselors, who can offer expert guidance tailored to one’s needs and ensure proactive mental wellness.
Support Group Members: One of the best sources of comfort is to join a support group where one can share experiences and emotions with others who understand. Knowledge about others may help heal and open eyes to different perspectives.
Online Message Boards: Online message boards are relatively easy ways through which to find others facing a similar challenge. The collective virtual support network could provide an easy space for conversation and acceptance and advice whenever needed.
Breaking the Stigma
There is: “That’s just nerves”, “You’re over reacting”, “Just calm down.”
Education and open discussion is very important to break these stigmas.
Also Read : How to Deal with Eco-Anxiety
Panic Attack – When to Seek Help
Seek help if:
- The attacks disrupt daily life
- You avoid activities or places
- Physical symptoms are distressing you
- You feel hopeless or depressed
Panic Attack Support Resources
– Tele MANAS (National Tele Mental Health Program of India) Hotline: 14416 / 1-800 891 4416
– Anxiety and depression support groups
– Local mental health clinics
– Online therapy platforms
Panic Attack – Conclusion
Panic attacks, though challenging to overcome, are managed when understood and supported well. By professional counseling with self-help measures and having the correct supportive framework, people can get a handle on the symptoms and guide themselves towards a healthy life.
Consult a Psychiatrist today for guidance regarding panic attacks.
Panic Attack FAQs
Is the heart affected permanently after a panic attack?
Panic attacks do not lead to any kind of heart damage. Nonetheless, you should consult a doctor to eliminate the possibility of cardiac disorders.
Is there genetic predisposition to panic attacks?
Yes. Definitely, there is a genetic component to panic attacks; however, there is an environmental component as well. If you get a family history then it does not necessarily mean that you will develop panic attacks.
Can my child have panic disorders?
Of course, children can get panic attacks. Presentation may be different from that of the adult, and only a professional should interpret so that correct diagnosis and management can be done.
Do I ever have to take the medicine for the rest of my life once I start?
No. If people learn proper ways of coping with stress or other symptoms through therapy and different lifestyle approaches they are often able to withdraw from a medication with the help of a doctor.
Is it possible to happen during sleep?
Indeed, nocturnal panic attacks are those that occur during the night while a person is still asleep as it will wake them up. They tend to happen at night and although they are rarer than day attacks, they can be just as unpleasant for the victim
References:
- Panic disorder: Epidemiology, disability, and treatment gap from nationally representative general population of India. Indian Journal of Psychiatry [Internet].
https://journals.lww.com/indianjpsychiatry/fulltext/2023/65120/panic_disorder__epidemiology,_disability,_and.8.aspx. Accessed Dec. 06, 2024.
- Panic Disorder: When Fear Overwhelms. National Institute of Mental Health (NIMH)[Internet].
https://www.nimh.nih.gov/health/publications/panic-disorder-when-fear-overwhelms. Accessed Dec. 11, 2024.
- Anxiety and panic attacks. Mind[Internet].
https://www.mind.org.uk/information-support/types-of-mental-health-problems/anxiety-and-panic-attacks/panic-attacks/. Accessed Dec. 05, 2024.
- Understanding panic attacks: Symptoms, causes, and how to cope. Financial Express [Internet].
https://www.financialexpress.com/life/understanding-panic-attacks-symptoms-causes-and-how-to-cop-3655065/ . Accessed Dec. 10, 2024.
