Panic Attacks

Signs of a panic attack

A panic attack can be very frightening. It may feel as if you:

• are fainting
• are having a heart attack
• are detaching from your body or surroundings
• are dying
• are losing control

It all happens in your head — there is no real danger — but at the time it really does feel real to you.

Physically, panic attacks can trigger these signs:

• difficulty breathing
• rapid heartbeat
• nausea or dizziness
• raised blood pressure
• heat or cold
• chest pain

To people who have never had a serious panic attack, it can seem like “child’s play” or some “imaginary bogeyman” — yet panic attacks can seriously affect life and daily functioning.

How long does a panic attack last?

A panic attack lasts about 10 minutes and then begins to fade. A strong panic attack may last longer, or you may experience several in succession (rarely). If you experience many panic attacks at unpredictable times and seemingly without obvious cause, you may be diagnosed with panic disorder.

What is a panic attack

When the body senses danger, it activates the “fight or flight” state, releasing hormones, neurotransmitters and so on. And this is genuinely useful if, at dusk, in an abandoned old building site, you spot a drunk repeat-offender striding briskly toward you — with a sword in hand. Then the fight-or-flight state is very useful (I hope you would choose the “flight” part).

Panic attacks happen when the fight-or-flight state is triggered even though no real danger is present.

At that moment the balance of neurotransmitters and hormones suddenly shifts. The calming ones (GABA) fall and the stimulating ones (adrenaline, dopamine) rise. You can read more about the causes of anxiety and panic attacks here.

When do panic attacks strike?

Panic attacks can strike each person at different times. Nocturnal panic attacks, obviously, happen during sleep. They occur at varying frequency and may recur once a month or several times a day — or even one after another. You may notice that certain places, situations or activities seem to set off an attack: before a tense meeting, after alcohol, after certain food (for example, poor-quality or fast food), and so on.

Our body always tries to protect us from danger, so after an attack the body “remembers” where and when it happened, or with which people. So it is normal for the mind to “help” us avoid those things in future. Say a panic attack hit you while driving — twice. What does the mind do? You start to fear or feel uneasy driving, and you start avoiding it, until eventually you stop driving. It can be anything: a place, an action or certain people. A panic attack during sleep is no exception — then anxiety can start to torment you at the mere thought of going to bed. Some people withdraw into themselves instead of looking for ways to treat panic attacks. And there really are ways to fight panic attacks!

Panic disorder

If you experience many panic attacks at unpredictable times and seemingly without obvious cause, you may be diagnosed with panic disorder. Panic disorder and certain phobias often appear together. You will understand more about this neurotransmitter-balance disorder by reading what anxiety is.

How to manage panic attacks

There are several strategies you can use to manage panic attacks. When an attack strikes, you will already know what to do:

• Remind yourself: this will soon pass. Recognize that this is a panic attack, not a heart attack.
• If you can, stay where you are. If you retreat to a calmer place, you may start to fear that place and avoid it in future.
• If you feel you are losing touch with your body, do “grounding” exercises: put your hands in cold or hot water, splash your face, touch or firmly squeeze an object near you.
• If a friend is nearby, tell them what is happening. They can help you calm down and reassure you that it will soon pass.
• Focus on your breathing. Only on your breathing. Breathing is the most powerful of all the exercises. To any attempt by the mind to frighten you further, respond by turning your attention to the exhale. Breathe deeply and slowly. Breathing directly influences neurotransmitter activity.

The golden breathing rule during an attack: the exhale must be longer than the inhale. Breathe in slowly, and breathe out even more slowly. The inhale drives stress; the exhale drives calm.

Panic attack treatment

Panic attacks and anxiety can be greatly reduced — or, at the least, strongly diminished — if the necessary lifestyle changes are made. Chemical drugs for panic attacks are not always the answer. In the fight against anxiety, every aspect of your lifestyle can be a powerful weapon: sauna and cold exposure, once mastered, can become strong tools. Your treatment will consist of several elements — understanding why anxiety troubles you, what affects your neurotransmitters, and what to eat and avoid.