A basic Guide to Panic Attacks

By Aya Anan

​If you’ve ever had a panic attack, you’ll know it can be both a terrifying and exhausting experience that leaves you drained and shook. I wrote this article to help others learn about panic attacks, to empower and provide them with a few tools they might use so that they can learn how to manage the attacks and live their lives to its fullest.

What is a Panic Attack?

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According to the DSM a panic attack is an abrupt surge of intense fear or discomfort that reaches its peak within minutes, and during which time a variety of psychological and physical symptoms occur. These symptoms include rapid heart rate, sweating, shaking, shortness of breath, hot flashes, and lightheadedness—as well as a sense of impending doom, chills, nausea, abdominal pain, chest pain, headache, and numbness or tingling.

What does a Panic Attack feel like
Panic attacks cause various distressing symptoms that can be terrifying for the individual experiencing the attack. 
Some people may mistake panic attacks for heart attacks and some may believe that they are dying. While others feel a mixture of self-doubt or impending doom. 
Some can also find the episodes extremely embarrassing and refrain from telling their friends, family, or a mental health professional.

Anxiety vs. Panic Attacks: What’s the difference
​Anxiety is basically what happens when we are expecting a negative or undesirable outcome (worrying about what might happen). Anxiety normally develops gradually (it doesn’t suddenly appear), and it can be often associated with muscle tension and a general feeling of uneasiness. 
While a panic attack is associated with a very sudden onset of acute fear as a reaction to a sense of threat that is occuring right now, this is known as the fight-or-flight response humans are ingrained with, this response sets of their alarm bells so that they are ready and able to handle and respond to immediate danger. 

How long do Panic Attacks Last
Although duration varies between individuals, typically, panic attacks reach their peak within 10 minutes or less and then symptoms begin to subside. Panic attacks rarely last for more than an hour, with most lasting for around 20 to 30 minutes.

How to Tell if It’s a Panic Attack  Here are 10 symptoms of panic attacks to look for:

• Shaking.
• Sweating.
• Numbness.
• Dizziness.
• Heart Palpitations.
• Chest Pain.
• Abdominal Distress.
• Shortness of breath.
• Fear of “going crazy”, losing control, or dying.
• Chills or hot flashes.
• A sense of being detached from yourself or your surroundings, or observing yourself from outside your body​

​Panic attack management    
   1- Acceptance and recognition; During an attack, it can help to remember that they pass and cause no physical harm, though they are unpleasant. A person should acknowledge that the attack is a brief period of concentrated anxiety and that it will end.
   2- Deep breathing can sometimes bring a panic attack under control. Rapid breathing can increase anxiety and tension, so taking long, slow breaths can help. A person should breathe steadily, counting slowly to four while breathing in and to four when breathing out. A feeling of tightness in the chest can cause a person to take short breaths during an attack. ​ 

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• Start by breathing slowly and purposely. This will counteract the shallow breathing.
  
• If possible, place your hands on your stomach (or ribcage) and fill your body with breath. When you inhale and exhale, pay attention to the feeling of your center rising and expanding.
  
• It may also be helpful to count each breath. This will not only help you breathe better, but it will also help you feel calmer by giving your mind something to focus on.
  
• Do not suggest breathing in and out of a paper bag. People used to think breathing in and out of a paper bag was helpful, but breathing out in panic results in the loss of carbon dioxide in the blood, and breathing into a bag restores the lost CO2. Additionally, it is extremely dangerous to individuals who have asthma as it can make things considerably worse.
  

   3- Engage your senses; Inhaling strong scents (like lavender or eucalyptus oil) during a panic attack may help relieve some symptoms. Alternatively, you can also bite into a lemon. Using strong scents/flavors are grounding techniques that can help bring a person back as they can take one’s concentration away from their mind to their mouth or nose. After inhaling or biting into your lemon pull away and start taking deep breaths (if it doesn’t work then try again).
​   4- Mindfulness exercises The intensity of anxiety can overtake other senses. Mindfulness can help to re-ground a person and direct their focus away from sources of stress.
   5- Focus on a nearby object can help a person stop a panic attack. A person who experiences attacks regularly may want to carry something for this purpose. Focusing on one thing can reduce other stimuli. As a person looks at the item, they may want to think about how it feels, who made it and what shape it is. This can help to reduce the symptoms of a panic attack.

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   6- Repeating a mantra can help a person to come out of a panic attack. The mantra can take the form of reassurance and may be as simple as, “This too shall pass.” Or, it may have a more spiritual meaning. As a person focuses on gently repeating a mantra, their physical responses can slow, allowing them to regulate their breathing and relax muscles.
   7- If panic attacks frequently occur in the same environment, such as a workplace, it may be helpful to tell someone and let them know what kind of support to offer. If an attack happens in public, telling even one person can help. They may be able to locate a quiet spot and prevent others from crowding in.

   8- If the attacks persist or are escalating, consider reaching out to a certified professional. 

Remember, no storm lasts forever..
Hold on, Be brave, and have faith! 
This one will pass too, just as every other storm has.

Sources

• APA. (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). Washington, DC: American Psychiatric Publishing. 
• Brain and Spine Team. (2018, December 19). Panicking In Public? 5 Surprising Tips for Getting Through an Attack. Retrieved July 10, 2020, from https://health.clevelandclinic.org/panicking-in-public-5-surprising-tips-for-getting-through-an-attack/
• Hammett, E. (2020, February 27). How to help someone having a panic attack and the signs to look out for. Retrieved July 10, 2020, from https://firstaidforlife.org.uk/how-to-help-someone-having-a-panic-attack/
• Hur, M., Song, J., Lee, J., & Lee, M. S. (2014). Aromatherapy for stress reduction in healthy adults: A systematic review and meta-analysis of randomized clinical trials. Maturitas, 79(4), 362-369. doi:10.1016/j.maturitas.2014.08.006
• Joy, K. (2017, January 11). Panic Attack vs. Anxiety Attack: 6 Things to Know. Retrieved from https://healthblog.uofmhealth.org/wellness-prevention/panic-attack-vs-anxiety-attack-6-things-to-know
• Mind. (2020). Anxiety and panic attacks. Retrieved from https://www.mind.org.uk/information-support/types-of-mental-health-problems/anxiety-and-panic-attacks/panic-attacks/
• Rachman, S., & Maser, J. D. (2016). Panic: Psychological perspectives. London: Routledge.
• Robert, M. A. (2019, October 24). How to Calm Yourself During a Panic Attack. Retrieved from https://www.cfpsych.org/blog/how-to-calm-yourself-during-a-panic-attack/
• Wei, M. (2015, August 14). How Mantras Calm Your Mind. Retrieved from https://www.psychologytoday.com/us/blog/urban-survival/201508/how-mantras-calm-your-mind