Panic Attacks

The Panic Attack Experience

Spring is finally here to stay. You've just hung up the phone having made plans to meet a friend for lunch. As you prepare to leave the house, you feel the exhilaration that comes with pleasant anticipation. The glare of sunshine meets you as you step outside your door. Welcome sounds of spring's first robins and the fragrance of fresh-cut grass fill the air. You feel on top of the world.

A warm breeze blows through your open window as you maneuver the car through familiar streets. The roads are clear of traffic. You're looking forward to the good food and conversation you're about to share. As you slow to a stop for a red light, you're deciding if you should order an appetizer and desert at lunch.

And then you feel it. A chill speeds up your spine and your heart races. You think, What's happening to me? What's wrong?

You look around. The road and the car are the same as before, but you are different.

Your skin is cold and clammy.

You're having trouble breathing. Why is this happening? You ask again. You want to pull over or call out for help, but you're paralyzed by fear. An eternity has gone by and still the light is red. You can no longer hear the car radio, only the sound of your heart beating louder and faster. All of your energy is focused on that light. You're trapped. You're sure you are going to die if you don't go crazy first.

All you can do is wait and hope that this terrible menace that has you so totally within its control will leave, taking with it all your fear and paralysis.

Panic. Pure, simple panic. But there's no logic to it, no understanding. You must be crazy to feel this way. And no one understands....

I am past help, past hope: these are the thoughts of the panic victim. Total fear, total aloneness: these are the feelings of the panic victim.

The above and following information about panic attacks taken from:

By Janice N. McLean and Sheila A. Knights (1989)

What Is a Panic Attack?

1) The victim of a panic attack experiences at least four of the following symptoms:

the sudden onset of intense apprehension, fear, or terror; a feeling of impending doom; shortness of breath, or a smothering feeling; dizziness; heart palpitations or rapid heart rate; shaking or trembling; numbness or a tingling sensation; chest pain or discomfort; feelings of depersonalization or unreality; sweating, nausea, or intestinal distress; a choking sensation; chills or hot flashes; and a fear of dying, going crazy, or losing control during the attack and doing something impulsive and embarrassing.

2) As if this weren't enough, the victim experiences these symptoms unexpectedly, or out of the blue, and therefore with no warning to permit preparation. There is no clear reason for this transformation - the victim might be picnicking with good friends, relaxing at home, or standing in line at the bank when the attack occurs.

3) Finally, these attacks are not the result of any organic disorders that could generate such symptoms, such as thyroid irregularities, caffeine intoxication, or amphetamine use.

One of the most frustrating parts of having a panic attack is the inability of others to understand what you are experiencing and the types of thoughts, feelings, and behaviors that you develop in reaction to such panic attacks. It is unpleasant to experience even one panic attack. But imagine experiencing panic attacks over and over again, but without understanding why you were undergoing such a dramatic transformation, without the comfort of being able to say to yourself, "Well, of course I'm terrified - look what's going on!" This is the life of a panic victim.

How Does Anxiety Differ From Panic?

Anxiety symptoms are uncomfortable, but manageable; you can continue in your normal daily activities even while manifesting anxiety symptoms: dry mouth, stomach butterflies, shortness of breath. Indeed, there are times when a little anxiety is even good for us. Anxiety related to an upcoming exam spurs us to study a little harder. Anxiety about a job interview causes us to get a shoeshine or practice our handshake. Anxiety can sometimes give us that little edge we need to improve our performance.

The feeling of panic seems to come out of the blue. It doesn't seem to be related to present activities. It lasts for discrete periods of time, departing as suddenly as it arrived, and there is a sharp rise then as abrupt fall in the physical symptoms. While anxiety can last for days, it usually stays within manageable levels. Panic's intensity is self-limiting since the body cannot maintain that state of intensity for prolonged periods of time.

Could I have a Heart Attack or Die From a Panic Attack?

The answer is no. While the panic attack gives you physical symptoms, it is not connected to any medical condition and does not show any damage to the systems involved in a panic attack when medical tests are run during a panic attack. Of course, we recommend that you consult a physician to rule out any possible physical factors or medical conditions involved in your anxiety or panic. (Examples are thyroid irregularities and caffeine intoxication.) Your physician can also allay your worry by telling you under what circumstances your symptoms should be medically evaluated to rule out physical involvement.

Can I Totally Lose Control During a Panic Attack?

No! This is a common fear and one that keeps many panic victims from even attempting activities they fear might bring on a panic attack. Although most panic victims fear this total loss of control, most are unable to clearly define what they mean by "losing control." The general fear is of somehow "losing it" during a panic attack, and acting so dramatically that the victim is publicly humiliated forever. It is comforting to remember that, despite the panic victim's certainty that "everyone" can immediately detect a panic state, even panic disorder specialists have difficulty recognizing when a victim is experiencing a panic attack. The outward appearance of the victim appears normal to even the trained eye.

How Long Does a Panic Attack Usually Last?

During a panic attack, your sense of time passing is lost and the attack seems to be never-ending. In reality, it usually lasts for only a few minutes. The body cannot sustain the intensity of the panic state for very long and will move to balance itself and relieve the paniky feeling. In rare cases, the panic continues for a longer period of time. However, counseling teaches the victim to prevent anxiety from building to this level.

How Can I Control My Panic Attack?

Dr. Claire Weeks, in her book Peace From Nervous Suffering (1983), tells the reader to "float through" the panic rather than fight it. Like a swimmer caught in a strong current, if you fight the current, you exhaust yourself and are overwhelmed. If you ride the current, you eventually drift onto the shore. This is one of many coping strategies that panic attack victims learn in counseling.

What Is the First Step Toward Recovery?

Whether the panic attack victim has had the disorder for only months or for several years, recovery is possible. The first step to recovery is in the victims acceptance of certain facts. Here they are:

* There is a name for what is happening to you. * You are not going crazy. * You are not alone. One out of six Americans is victimized by an anxiety disorder, and panic disorder is the most common disorder among those seeking treatment. * There is effective, comprehensive treatment for the disorder. * With determination and hard work, comprehensive treatment can help you reach recovery.

As the secondary victim, or the concerned professional or friend, you can help the primary victim take this first step if he or she hasn't already. Your message is simple: panic, the formidable enemy, can be conquered, and you are there to help.

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