By Kristina Schwalm-Bacquet, BSW, MSW, RSW
The Anxiety Vortex: Coping with Panic Attacks is Part 3 of a four-part blog series on anxiety and anxiety disorders. In this series Kristina Schwalm-Bacquet, BSW, MSW, RSW, addresses the important issues surrounding anxiety and anxiety treatment. You might laugh, you might cry – okay, well you probably won’t do either of these things – but more importantly – you will learn to recognize when you are getting sucked into the whirling vortex of anxiety and what you can do about it. This week, we’ll discuss ways of coping with panic attacks.
Part 1: The thoughts that fuel anxiety
Part 2: Beliefs that fuel anxiety
Part 3: Coping with Panic Attacks
Part 4: Treating anxiety disorders and symptoms
Welcome back again! I hope you have found Parts I and II of this series useful in understanding anxiety and coping with your anxiety symptoms. This week, in Part III, we will address the issue of panic attacks. We will cover what they are and some useful techniques to begin to reduce and dissolve these incredibly unpleasant symptoms.
What are panic attacks?
A panic attack is an intense bodily response to overt and covert anxiety symptoms. They can be an incredibly frightening and uncomfortable experience and often include hugely distressing symptoms such as:
tightening in the chest
shortness of breath
trembling, or tingling in the limbs
belief that you are losing control, going crazy or dying
feeling unreal or detached from surroundings
They can pop up out of nowhere, or they might be clearly linked to specific events or fears. Either way, they are usually an incredibly frightening and uncomfortable experience lasting 20-30 minutes, but can be shorter or longer. It’s no wonder that most people end up seeking urgent medical attention. Because the symptoms are so similar to those of a heart attack, many people make frequent trips to their doctor or Emergency Room services.
Seeking medical attention is actually a great start for coping with panic attacks. Mainly because it is important to rule out any medical conditions other than anxiety for two reasons. One, because obviously, we want to make sure there is no other physiological condition that is causing the problems. And two, because the minute we begin to label panic attacks as just that, we can begin to dissolve the larger fears that provoke and prolong the panic: i.e., “I am going crazy” or “I am dying”.
Panic attacks are intensely uncomfortable, but they are NOT dangerous. We will not die, suffer physical damage or go crazy as a result of them. Unfortunately, because during a panic attack our body and mind is in an intense state of fear, often without a clear fear-stimulus, our minds begin to misinterpret that the fear we are feeling must be linked to the physiological responses themselves. Our minds quickly begin to infer, “because I feel this bad, I must be in serious danger” and thus, the panic is multiplied.
What to do If you believe you are experiencing panic attacks
If you believe you are experiencing panic attacks, the very first thing to do is seek medical attention to rule out other health issues. From here, it is important to understand some simple facts about your panic, and remind yourself daily or at every chance you get.
1. A panic attack will not cause heart issues or heart attack
The rapid heartbeat and palpitations that happen during panic are frightening, but not dangerous. Your heart is a strong and durable organ that is made up of dense muscle fibres. A healthy heart can withstand prolonged periods of rapid heart beat, even weeks, without any damage. What’s more, while EKG testing will show abnormalities in the case of heart disease, this is not so for panic attacks, there is only rapid heartbeat.
Even the symptoms are different. While panic symptoms in the chest are associated with increased heart rate, pounding, irregularity, and often chest pains in the left upper portion of the chest, heart attacks are characterized primarily by continuous, pressurized and often crushing pain in the centre of the chest. Check in with your medical doctor for further information about the differences between panic and heart disease and cardiac arrest symptoms.
2. A panic attack will not cause you to suffocate or stop breathing
Stress during panic attack allows for constricting in the chest and throat. This might make you feel like you are going to suffocate, but that is not the case. There is nothing wrong physiologically and the constricting sensation will pass. Your brain has a reflex mechanism that will force you to breathe if you are not getting enough oxygen, so even intense panic cannot cause constriction enough to stop this essential process. By all means, these sensations are unpleasant, but not at all dangerous.
3. A panic attack will not cause fainting
During a panic attack we often feel extremely light-headed. This physical sensation can lead to a belief or fear that we might faint. However, that light-headedness is caused by a reduced blood circulation to your brain, usually due to rapid breathing, and it too is not dangerous.
While fainting is caused by a sudden and significant drop in blood pressure, panic attacks involve an increase in blood pressure due to adrenaline increase and hyperventilation. Though fainting is not entirely impossible, it is incredibly rare and only occurs in the presence of a secondary medical condition that would lower the blood pressure enough to overcome the increase.
4. A panic attack will not cause you to lose balance or fall over
Dizziness during panic may be caused by tension affecting the canal system in your inner ear. The dizziness will definitely pass, it is not dangerous and it is likely that you will not lose your balance. However, if these dizziness symptoms persist for more than a few seconds, you might want to consult your doctor to look for secondary issues.
The weakness in the limbs that occurs during panic often makes us feel as though our legs will give in and we will fall over. This sensation is a result of your adrenaline dilating blood vessels in your legs and causing blood to not circulate correctly. This too is not dangerous and is just a sensation. Though you will feel as though your legs are not sturdy, your legs are strong and will continue to hold you regardless of temporary constraint to blood circulation.
5. A panic attack will not make you go crazy or lose control of yourself
It is common to feel disoriented and out of touch with reality during a panic attack. This is usually the result of reduced blood flow to your brain due to rapid breathing. It is a strange and often frightening experience, but it is not dangerous, and cannot cause greater mental health conditions. It is harmless and fleeting, and a normal consequence of panic.
Don’t fight it!
This might sound entirely counter-intuitive but it is important to understand that fighting panic only provokes and maintains it. When we get tense, or attempt to avoid panic symptoms we get the message that we can’t handle them, and that only increases our fear. Alternatively, we want to adopt a response of acceptance, “Here is the panic, it is uncomfortable, but it won’t kill me. I’ve been through it before, and I know it will pass.”
As simple or strange as it may sound, we want to imagine panic like a wave that we can float with, instead of struggle against it. If we can achieve this, most of the adrenaline that rises as a result of the panic will resolve and metabolize within the first few minutes of an attack. If we fight against it, or allow beliefs that we are experiencing something dangerous or harmful, the panic will just be maintained over a longer period of time.
Develop some coping statements
Coping statements can be incredibly helpful when they anxiety is taking over. Write out some that speak to you and keep them in your wallet, or somewhere where they will be with you at all times. Sift through the examples below and make them specific to your anxiety symptoms.
“This is uncomfortable, but it won’t kill me”
“I have handled these symptoms before and I can handle them again”
“Anxiety is here, and I can float with it”
“This is not an emergency and I will be okay.”
“Nothing serious will happen to me”
“Anxiety and panic symptoms can’t hurt me”
“I can take all the time I need to wait for this to pass”
“Fighting it won’t help, I can ride it out”
“I’ve survived this before and I will survive it again”
This is just the beginning of the skills we can learn in order to cope with panic. If you have experienced these symptoms, be sure to consult with your doctor and ND. If symptoms do not fully subside, it’s probably time to seek out a qualified Cognitive Behavioural Therapist to help you approach panic treatment through a structured CBT process.
For more on coping with Panic Attacks, The Anxiety and Phobia Workbook is the source material for the majority of this post, and is an excellent source for more detailed approaches to coping with panic.
If you have questions or you’d like to make a comment, head over to twitter and find me @KristinaSchwalm, or to my website, CBTinTrinityBellwoods.com.
See you all again on Tuesday July 26th for Part 4 of the series: Treating Anxiety Disorders and Symptoms.
Bourne, Edmund J. “Coping with Panic Attacks.” The Anxiety and Phobia Workbook. Oakland, CA: New Harbinger Publications, 2010. N. pag. Print.