Understand what a panic attack does to the human body – 04/30/2023 – Equilibrium

Panic attacks revolve around terror. Although primarily associated with the mind, they are actually constellations of symptoms, both physical and cognitive. The person’s brain is taken over by fear. The body reacts and it can be difficult to understand the situation.

Most experts define a panic attack as a sudden onset of intense fear, as opposed to a condition like general anxiety, which often manifests as near-constant worry.

A person suffering a panic attack is bombarded by physical and mental symptoms that can vary. Your heart might race. She may feel like she can’t breathe. Your limbs can tingle. Sometimes she shakes or may feel nauseous. Her chest may feel tight. Some people may suddenly feel hot and sweaty, while others experience chills.

Then there is the agitated and destabilizing fear. During a panic attack, people may fear that they are going crazy, losing control of their minds and bodies. They might think it’s a heart attack or even that they’re going to die.

Most people who have panic attacks on a regular basis do not experience all of these symptoms, but they may have several of them. A small subset of people, however, have panic attacks with limited symptoms, where they identify three or fewer.

And, almost as suddenly as they start, the symptoms usually dissipate. They build up over 10 minutes and usually disappear within half an hour, although there may be lingering effects.

The experience can be traumatic, however, and people may begin to fear sensations that remind them of their symptoms, such as feeling short of breath after walking up a flight of stairs. They might also avoid anything that reminds them of the episode — the grocery store where their heart skipped a beat, the food they were eating when the panic hit.

Some people may develop panic disorder, which psychologists define as repeated, unexpected panic attacks that interfere with daily activities. While 15% to 30% of people will have at least one panic attack in their lifetime, only 2% to 4% will develop panic disorder, says Franklin Schneier, co-director of the Anxiety Disorders Clinic at the New York State Psychiatric Institute.

A subset of these people – about 1 in 3 – also develop agoraphobia, an anxiety disorder that can involve extreme fear of public or crowded places, public transport, standing in lines or leaving the house.

The causes

A diverse array of stressors — such as traumatic events, financial worries, or even public speaking — can lead to panic attacks. But they can also occur unexpectedly.

Intense stress activates the sympathetic nervous system, a network of nerves that triggers the “fight or flight” response to perceived danger. The body releases chemicals like epinephrine, also known as adrenaline, and norepinephrine, which make the heart race. The pupils swell and the skin sweats. The parasympathetic nervous system is responsible for bringing the body back to its original state. If the system is not activated after some time, a panic attack can leave the person suspended in this state of high arousal.

Many researchers believe that panic attacks can occur when the brain fails to send messages between the prefrontal cortex, which is associated with logic and reasoning, and the amygdala, which commands emotional regulation. During a panic attack, the amygdala is overactive, while the prefrontal cortex is less responsive, leading us to a kind of vertigo.

Anyone can experience a panic attack. The risk, however, is higher for teenagers and people in their 20s. If you don’t have a panic attack until age 45, you’re less likely to have one later in life.

Women are twice as likely to have panic attacks as men, but researchers aren’t sure why.

Mitigating an attack

If you’ve never had a panic attack before and you’re experiencing chest pain and shortness of breath, you should go to the emergency room to confirm whether you really are having an episode or are experiencing a heart condition. But if you’ve had panic attacks in the past and find yourself starting to have another one, these tips can help you ground yourself in the moment.

• Talk to yourself: remember that you have survived panic attacks.
• Know who to call: A trusted friend or relative can help calm you down. Just talking to someone can help stabilize yourself.
• Count Colors: Some therapists recommend a simple calming exercise, such as counting and naming the colors around you. Say the name of each one out loud, or just write them down in your mind as you register that the rug is blue or your shirt is red. Doing so can help distract you from the mounting anxiety.
• Get something cold: put your hand in the freezer and hold an ice cube, or place a cool, damp cloth over your wrist. Cold shock can help you stabilize
• Breathe like a baby: Hyperventilation, common in panic attacks, can make people dizzy, so slow breathing can help. This floods the brain with oxygen and triggers the parasympathetic nervous system, signaling that we don’t need to fight.

How to avoid future episodes

If you have frequent attacks, it’s best to see a therapist. Forms of cognitive-behavioral therapy, in which a clinician encourages you to challenge the fears and feelings you may experience during a panic attack, can be among the most effective treatments. The process helps change your thought patterns, desensitizing you to the underlying distress that can trigger panic attacks.

Some medications, including antidepressants such as selective serotonin reuptake inhibitors (SSRIs), can also be helpful in controlling panic attacks.

As disturbing as panic attacks can be, it’s important to remember that they are highly treatable and that, as suddenly as they can strike, they begin to disappear.

Translated by Luiz Roberto M. Gonçalves