WHAT IS A PANIC ATTACK?

Panic means a sudden spell or attack when you feel very frightened and anxious, and you might fear losing control. Panic attacks involve a 'rush' of physical symptoms or feelings. These reactions tend to happen very quickly, and often come “out of the blue” – in situations where most people don’t feel afraid. This can make them feel even more frightening.

COMMON REACTIONS IN PANIC

These reactions are part of the ‘fight or flight response’ - this reflex is a natural response that occurs when we feel threatened. Our heart beat increases, our breathing rate speeds up, our muscles get tense and ready for action, and so on.  These changes in our body help us to run quickly or fight. 

These reactions can occur at any time when we feel threatened – either mentally or physically.  The ‘threat’ can be stressors in our life – like relationship or work hassles.  They are a normal, natural response to threat and our body is designed to be able to handle them. 

Unfortunately, if the fight or flight response gets triggered and we can’t work out a reason why it has, some people interpret these physical reactions as being dangerous.  We might think that our racing heart means that we’ll have a heart attack, or feeling dizzy means that we are 'losing it', or going crazy.

It is important to realise that these feelings are part of a normal physical reflex that our body is designed to handle. They are not a sign that you are dying, have a disease, or are going crazy.  If we hyperventilate, we can feel dizzy, if our heart beats faster, it can feel like palpitations, if our muscles tense, we can feel a tightness in the chest.  There is usually a simple physical explanation behind each symptom.

THE PANIC CYCLE

Many people want to know why their panic attacks keep coming back. The most important thing that keeps panic going, is our thoughts about the physical feelings.  The physical symptoms cannot hurt you. However, if we think these physical reactions are dangerous, then it can start a vicious cycle where we start to watch for and be scared of these physical feelings.  This can mean that these physical reactions are triggered even when there is no threat. For example, if we walk up stairs and get short of breath, we may interpret this change in our breathing as dangerous and this interpretation may consequently trigger anxiety and a panic attack.

    THE PANIC CYCLE

Feel anxious or threatened

                      Worry about how bad the                                            
                      physical sensations are and                                         Flight/Fight
                      increased focus on the body                                          response          
               ("I could faint, what is wrong?, Am I losing my mind?")                                           

                                                             
Physical sensations
(e.g., heart racing, light-headed, can't breathe)

WHAT IS THE DIFFERENCE BETWEEN A PANIC ATTACK AND PANIC DISORDER?

Many people experience panic attacks from time to time during their life, but this doesn't necessarily mean that they have Panic Disorder. Someone is said to have Panic Disorder when they experience repeated panic attacks, and most importantly, when they begin to worry about getting their next panic attack. Many people with Panic Disorder also begin to live their lives differently because of panic attacks. They might avoid particular situations or places where they believe they are likely to get a panic attack, or where it is difficult to escape or get help (e.g., public transport, crowded places, standing in line, lifts or movie theatres). This avoidance is known as agoraphobia. People suffering from Panic Disorder might also begin to take extra precautions (e.g., carrying medication or water at all times, staying close to home, never go out alone, etc). These strategies are known as 'safety behaviours' and whilst they might help the sufferer to feel safer in the short term, in the long term they simply keep the fear going.  

How is Panic treated?

Some people take medication for panic disorder. Medications dull the physical symptoms, however controlled research trials have shown that psychological therapies such as CBT are more effective than medications in the long term.

The most effective psychological treatment for panic attacks and Panic Disorder is Cognitive Behaviour Therapy (CBT). The focus of this treatment is to break the panic cycle (outlined above). This involves learning that the physical symptoms of a panic attack are not dangerous. Learning not to overreact to these physical reactions is vital, and usually involves challenging catastrophic beliefs about panic. It is also important to gradually face situations that are usually avoided because of panic. Slowly facing these situations allows the sufferer to learn that they are unlikely to panic and can cope with the situation, and ultimately allows sufferers to regain control over their lives. Learning to relax, reducing your stress, and slowing down your breathing when you feel anxious can also help.

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