Many people experience some mild sensations when they feel anxious about something, but a panic attack is much more intense than usual. It includes 4 or more of the above symptoms, and peaks within about 10 minutes. As you can see from the list, many of the symptoms are similar to what you might experience if you were in a truly dangerous situation. A panic attack can be very frightening and you may feel a strong desire to escape the situation or to seek emergency assistance. Panic disorder is used to describe the condition where panic attacks seem to happen unexpectedly rather than always in predictable situations. Importantly, someone with panic disorder has a persistent fear of having another attack or worries about the consequences of the attack.
Many people change their behaviour to try to prevent panic attacks. Some people are affected so much that they try to avoid any place where it might be difficult to get help or to escape from. When this avoidance is severe it is called agoraphobia.
This situation is like a smoke alarm that is ultra sensitive. It is so sensitive that its alarm system gets activated at the slightest possibility of smoke. In fact, it is so sensitive it basically activates the alarm when no danger is present (eg, when someone is cooking, or even when hot air escapes from the bathroom!). Something similar happens with a person who is anxiety sensitive. They
continually find themselves becoming anxious (activation of fight/flight alarm system) at the slightest suggestion of threat (eg. “I’m feeling hot – I might have a panic attack”).
Focus on internal sensations
As mentioned, being sensitive to anxiety symptoms often results in the person scanning their environment for possible cues for anxiety. Often this means focusing inwards and noticing all the different physical sensations. By focusing on your own body reactions, such as sweating or trembling, it can be easy to convince yourself that you have a physical problem (eg, “I’m having a heart attack”) or a mental problem (eg, “I’m going crazy”). This can start the panic cycle that we described previously, leading to more frequent panic attacks.
So, what’s the end result? Well, because there seems to be no obvious external reason for the panic attacks, they appear to be unpredictable and to “come out of the blue”. They can also be very distressing because of the intensity of the symptoms, because they are unpredictable, or because it is difficult to escape from places where they might occur.
MEDICATION
Medication has been used to reduce anxiety symptoms and reduce the likelihood that you will have panic
attacks. While there are a number of different medications that may help to reduce anxiety symptoms, it is often difficult to know which one will work the best. You should always speak to your doctor if you have any queries about medication, and if your doctor prescribes them, make sure you follow all the instructions, and report any side effects.
Another treatment option for reducing panic attacks is cognitive-behavioural therapy (CBT).
Cognitive and behavioural strategies address the three components that specifically contribute to panic and intense anxiety. This includes Thoughts, behaviours and physiology. In this way, CBT strategies seek to change the anxiety habits that may have developed around panic and anxiety.
Thoughts
For people who experience panic attacks, thoughts can occur in the ‘here-and-now’ of the situation, and may include focusing on physiological sensations of anxiety and panic, and then interpreting them in a catastrophic way. Importantly, it is our perception of particular cues as dangerous that contributes to increasing anxiety. These cognitions are also part of a bigger picture of thinking processes. People who experience panic attacks often worry excessively about anxiety symptoms. They may overestimate the likelihood of having a panic attack and overestimate the consequences of having a panic
attack. It is this continued fear of fear that starts the feelings of anxiety, which then prompts the search for evidence of threat and danger.
Behaviour
One of the most important factors that needs to be addressed when overcoming panic and anxiety is the avoidance of symptoms of anxiety, avoidance of situations where panic attacks might occur, and the use of safety behaviours to try to prevent panic attacks.
Physiology
The physical symptoms that our bodies experience in reaction to anxiety-provoking events include: rapid breathing, pounding heart, sweating, clammy palms, and muscle tension, etc. For some people, changing breathing patterns can help to show that anxiety symptoms are not dangerous because they are under your control. However, we don’t want you to use breathing strategies, like the calming technique, as a safety-behaviour to avoid anxiety.