Anatomy of Panic Attacks & How to Overcome It

By Victoria Ward

http://www.removepanicattack.com/

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Anxiety and Panic Attacks What Are They? It is estimated that 1 in 10 people will have an isolated panic or anxiety attack in any given year. 1 in 75 will experience panic disorder - that is, a sequence of two more panic or anxiety attacks over time (US Surgeon Generals Report 1999). When we talk about anxiety attacks or panic attacks, were really talking about the same thing a sudden, defined period of extreme anxiety or terror. Interestingly - not all panic attacks are the same. Types of Panic Attack Anxiety attacks can be spontaneous seemingly arising out of the blue; associated with specific situations or places, such as driving or shopping malls; or associated with types of situations or places some people experience panic attacks in any crowded space, for instance. The American Psychological Association considers that the classic anxiety attack lasts for about thirty minutes. However, panic attack symptoms can be experienced in seconds, or they can come in waves over a period of hours. Panic Attack Symptoms People suffering panic attacks often report the following symptoms rapidly increased heart rate (palpitations) rapid, shallow breathing (hyperventilation) churning stomach or nausea increased perspiration physical shaking or trembling dizziness choking sensations feelings of unreality feelings that this is happening to somebody else inability to think clearly

In addition, the anxiety attack may produce frightening thoughts that drive the attack further. fear of having a heart attack fear of going mad fear of being publicly humiliated

As these symptoms arise suddenly and apparently out of nowhere, it can seem as if the mind and body are being attacked. However, as we shall see, in many ways panic or anxiety attack is really a misnomer. Whats Physically Happening When A Panic Attack Occurs?

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An anxiety attack is a sudden release of adrenaline (epinephrine) into the body. This is the fight or flight hormone, a primitive survival mechanism designed to keep us alive in the face of real, physical threats. All panic attack symptoms can be attributed to this survival function. The increased heart rate and hyperventilation are designed to stimulate movement, either to fight a predator or to run away from it. At the same time, non-essential functions are switched off easy digestion and clear, rational thought are of no immediate use when being attacked by a sabre-toothed tiger! Reframing Panic Attacks So perhaps we can begin to see anxiety attacks in a new light. Theyre part of a mechanism that has evolved over millions of years to keep us alive. The human race wouldnt exist without it. During a panic attack, nothing is happening in the body that isnt supposed to happen, in the right context. Panic attacks are perfectly normal human responses theyre just happening when they dont need to. The mind and body are not being attacked, any more than an intruder alarm attacks a building. It is simply an alert to the presence of danger. However, intruder alarms can be set too sensitively or more precisely set to low. They can be triggered by low flying aeroplanes or even a gust of wind. In just the same way, people suffering panic attacks have their own alarms set too sensitively. What Causes Panic Attacks? At its most basic level, an anxiety attack is caused because the unconscious mind has mistakenly sensed a threat and switched on the fight or flight mechanism. Panic attack symptoms can develop after genuinely frightening or traumatic experiences. Just as often, theres no obvious single cause, or it may seem that there are lots of different reasons. There are as many causes as there are individuals suffering panic attacks. There is little real evidence for a genetic basis for panic attacks, although individuals may report a history of anxiety in their family. In such cases, it may be that the individual has learned how to panic all mammals, including humans, learn behaviours from their parents, after all. The Stress Bucket The general pattern seems to be a build-up of anxiety or stress over time, suddenly tipping over into a full-blown panic attack. One way to think of it is as an internal stress bucket. If its filled up for too often and for too long, it doesnt take too much extra stress for it to spill over. Or another way to describe it could be like filling a balloon with water sure enough, at a certain point pass the threshold - its going to burst.

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This is why panic attacks can seemingly arise out of the blue, in otherwise ordinary or normal situations. It only takes a certain situation to trigger the response. A Real Life Example Here are some genuine case studies that illustrate this process (names have been changed). James is a man in his twenties, who has worked as an electrician since leaving school. Recently, he left his employer to set up his own firm. He now employs two other electricians. As time goes on, he finds that he is spending less time on site, and more time tackling paperwork and bookkeeping. This is something he doesnt find particularly easy or enjoyable. Also, he finds the responsibility of finding work for two other men quite stressful. At the same time, his marriage has endured a bit of a crisis, as his wife wrongly suspected that he was having an affair. Although this was resolved and their relationship is back on track, the experience left him shaken. One day he is in a traffic queue when he has a panic attack. Alison is a woman in her forties, who works in local government. She recently changed jobs, acquiring responsibility for a larger team. At the same time, she had a minor operation which meant she had to take some time off work. A couple of days after returning to work, she has a panic attack in an elevator.

After A Panic Attack James subsequently discovered that he was likely to experience panic attacks when he had to drive somewhere, or even if he had to take public transport. Alison found that she was likely to have panic attacks not only in elevators, but also in any confined or crowded room. Again, this can be traced back to the primitive survival function that underlies anxiety attacks. When the attack happens, the brain takes a snapshot of whats going on, and labels it emergency situation. It subsequently scans the environment for anything that resembles that situation, and triggers the fight-or-flight response every time it encounters it. This can be quite specific. For example, some people might be fine driving on minor roads, yet experience panic attacks on major roads. Or the panic attacks might only happen whilst driving at certain times of day. However, its often the case that the brain is alerted by quite vague resemblances the survival instincts dont take chances! A small crowded room is sufficiently like an elevator, a bus ride is sufficiently like a car journey, for the panic attack response to kick in. A vicious circle develops, since every time a panic attack occurs, it reinforces the message that here is a situation which is threatening.

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Overcoming Panic Attacks So how do you overcome a panic attack? They broadly fall into two groups. The first is using medication where the drug help control the symptoms. The second is natural where the cause of the attack is addressed. There are many medications available for the treatment of anxiety attacks, which fall into the following broad groups: Medication mild tranquilizers anti-depressants tricyclics (such as Amitriptyline), SSSRIs (such as Prozac), and MAOIs (such as Phenelzine) beta-blockers benzodiazepines such as Diazepam

These may be prescribed to control the physical symptoms of panic attacks, to reduce the underlying anxiety, or to control associated symptoms, such as depression. Drug-Free Methods Once their true nature is understood we can begin to see ways of dealing with panic attacks that do not involve medication. Many people prefer this approach. Drugs may produce side-effects that are just as unpleasant as the panic attacks, if not more so. Moreover, since the panic attack is a misplaced natural response, it is not a disease or a disorder the mind and body just need to learn to do something different. This puts control back in the hands of the panic attack sufferer, rather than simply suppressing symptoms by artificial means. The following are all easy but powerful techniques that will re-set the alarm, so that it only goes off when appropriate. Techniques For Panic Attack Relief Breathing rapid, shallow breathing is a major symptom of anxiety attacks. Hyperventilation produces too much oxygen for the body to deal with, like flooding an engine with gasoline. There are two ways to return oxygen in the blood to more normal levels, which in turn lets the mind and body know that there is no genuine emergency to deal with. breathe into a paper bag. This is the classic method for dealing with hyperventilation, as it gets more carbon dioxide into the system, balancing out excessive oxygen.

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if its not comfortable or appropriate to use a paper bag, then it can be just as effective to pay attention to the breathing, consciously breathing out for longer than breathing in. Some people find that it helps to count inhale for 5 and exhale for 9, or in for 4 and out for 7, or whatever feels most comfortable. This has three benefits it returns oxygen to more normal levels in the bloodstream; it activates the parasympathetic nervous system, the bodys natural relaxation mechanism (we naturally breathe out for longer when were deeply relaxed); and it focuses the attention away from the immediate source of panic.

AWARE this acronym describes a way of gaining control over the anxiety attack. It stands for A Accept that the panic attack is happening (fighting the anxiety can make it worse, since it adds to the general sense of threat). W Watch the anxiety happening. Describe whats going on. This activates the higher functions of the mind which tend to get swamped when the primitive survival instincts kick in. By consciously bringing them back online, it sends a message that this situation does not threaten survival. A Act Normal. Again, consciously deciding to carry on as normal reinforces the message that this is not a life-or-death situation. R Repeat. Cycle through the above steps as often as necessary. E Expect The Best. Knock Out Dominoes the sequence of biochemical events that lead to panic attacks can be thought of as a row of dominoes. A mistakenly perceived threat is the first one which knocks down all the others, so it makes sense to remove a few. There are many effective ways to do this, all operating on the principle of signalling to ones self that this is not an emergency. eat or drink something, or chew gum. If you really needed to run for your life, you wouldnt be standing around eating! use maths. Doing sums or multiplication tables in the mind activate the more advanced, logical areas of the brain. use scaling at what point on an anxiety scale of 1 to 10 is this attack? How does that compare with previous attacks? At what point is it a minute later? look upwards. This is remarkably beneficial for changing our frame of mind again, possibly because if you really did need to run from a predator, you wouldnt be standing around admiring the clouds. It also helps to discharge the adrenaline coursing through the body, which is a stimulus for movement.

Reduce General Anxiety proper relaxation is an invaluable tool for dealing with panic attacks, since it reduces the background levels of stress that bring them on in the first place. It empties out the stress bucket in a controlled way, in other words! Heres a very quick method of deep relaxation. 1. Find somewhere to sit or lie quietly for a while. 2. Allow the eyes to close, and become aware of the breathing. 3. Breathe out, and imagine a sensation of relaxation at the top of the head this can be a feeling, or a colour, or even a sound. Page 7 of 8

4. With each out-breath, imagine that sensation of relaxation travelling down from the head, to the face, to the shoulders, to the arms and hands, and so on down the body. 5. Repeat, noticing how that sensation of relaxation deepens a little more each time it moves down the body. 6. If appropriate, spend some time experiencing in the mind a place that feels safe, relaxed and in control. This can be somewhere real or somewhere imagined. What can been seen, heard and felt there? Or mentally rehearse feeling calm in situations that have previously produced anxiety. 7. Gently reorientate to the room by counting from 1 to 5. Its also important to ensure sufficient sleep, a healthy balanced diet and regular exercise. Seeking Professional Help - there are many types of therapy which can help eliminate panic attacks for good. Two of the most effective are Hypnotherapy and Cognitive Behavioural Therapy (CBT). CBT works by addressing the thought and behavioural patterns behind panic attacks. Hypnotherapy works by dealing with the unconscious patterns which keep panic attacks in place. Both approaches can also deal with any traumatic memories that are provoking the anxiety attacks. In both cases, its vital to work with a qualified practitioner. A doctor or the professional bodies for each discipline will be happy to advise.

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