What is a Panic Attack?

It is about 3:00 in the morning. You’ve just been jolted awake and spring upright in your bed very suddenly. Your heart is racing, you’re sweating, your breathing has become very rapid and you have an overwhelming sense of fear. You are in fact, virtually terrified! The idea that you may be having a heart attack flashes through your mind. You don’t know what to do, so you get out of bed and walk around, feeling very agitated (maybe you go to the bathroom and splash some water on your face), as you try to make sense of the terror you are experiencing. After about 10 minutes or so, things get a little better. The intensity of the feeling seems to diminish somewhat. Another 30 minutes passes and you now know the worst is over but you still have no idea what has just happened to you or why. You are scared, confused, very emotionally distressed, and don’t feel at all normal. You may even begin to wonder whether you “really” did have a heart attack.

Or, maybe you weren’t in bed when this happened. Perhaps you were driving in your car on a familiar road or expressway. Without warning, you begin to experience the intensely uncomfortable symptoms just mentioned. Instantly you realize something is terribly wrong. You look for a place to pull off the road in order to calm yourself down and feel safer. But safe from what? You’ve driven on this road many times before; logically you know there’s nothing to fear. But at this moment you cannot apply logic because your sense of fear is simply overwhelming. You search your mind desperately trying to figure out “what’s going on” and to understand the inexplicable terror that has suddenly overcome you!

Does this sound familiar? Has anything like this ever happened to you before? If it has then you should know that you’re not alone. You might even have guessed that the above descriptions are not fictional. Rather, they reflect the actual experiences of two former female patients (names withheld for reasons of confidentiality). These were two ordinary young women, one in her late twenties, the other in her early thirties who suffered episodes of panic, otherwise known as panic attacks, in the very situations described above. In the case of the former, her panic attacks were so severe that she could manage her life’s responsibilities only with the utmost difficulty. Also, she would avoid going to supermarkets, church or other public places where she might not feel safe. In the latter case, this young woman hadn’t been able to drive a car for nearly three years, unless accompanied by a relative, seated next to her. She was also very reluctant to venture out from home or go places where she felt unsafe, knowing that escape to a safe haven would be difficult.

What these examples illustrate is that episodes of panic can be frightening. They often cause serious psychological distress and sometimes dramatically affect one’s quality of life. But that’s not the whole story. Fortunately, there is some GOOD NEWS about panic attacks!

Fact #1: Panic attacks don’t kill people. No matter how frightening they may be, not one person has ever died from a panic attack. (This fact is supported by the research literature, which to my knowledge does not report a single case of death due to an episode of panic.) This is certainly good news to those who have suffered panic attacks. Henceforth, you will be armed with the knowledge and understanding that episodes of panic are not fatal; Uncomfortable and unpleasant, to be sure, but you can now say to yourself, “I will definitely survive this episode!”

Fact #2: Panic attacks have a temporal course that is relatively short in duration. In most instances they reach their peak (i.e., point of maximum intensity) in approximately 10 minutes. Their intensity usually diminishes within the next 30 to 60 minutes but on some occasions, residual unpleasant sensations can last for a number of hours. Here again there’s good news: For even though the experience of a panic attack can be extremely unpleasant, the unpleasantness generally doesn’t endure for too long. So, in the future if you do have a panic attack you can remind yourself, “this certainly feels very uncomfortable, but in 10 minutes or so I’ll feel better!”

Fact #3: Panic attacks respond very well to effective psychotherapeutic treatment. In most cases, significant improvement occurs within a period of 12 weeks. Psychotherapeutic treatment generally consists of a combination of cognitive-behavioral therapy, psycho-education and instruction in abdominal breathing and relaxation techniques. In cases where symptoms are severe, causing significant impairment in one’s ability to function, certain medications can be very helpful. (Please click on the heading “medications” for detailed information). These medications are highly efficacious in their ability to greatly reduce the unpleasant symptoms associated with panic attacks. So, if you suffer from panic attacks, even serious ones, take heart and remind yourself of the good news that, “help is available and the prognosis is favorable!”

Cautionary note: It is strongly recommended that medications should be prescribed only by a psychiatrist or other qualified medical practitioner with expertise in treating panic attacks.

DEFINITION OF A PANIC ATTACK: A panic attack (sometimes referred to as panic anxiety) is characterized by the abrupt onset of an episode of intense fear or discomfort that usually peaks within ten minutes. Panic attacks generally include at least four of the following symptoms:

• A feeling of imminent danger
• The need to escape
• Dizziness or lightheadedness
• Palpitations, pounding heart, accelerated heart rate
• Shortness of breath
• A fear of dying
• A fear of losing control
• Sweating
• Trembling
• Tingling sensations
• Chills or hot flashes
• A feeling of choking
• Chest pain or discomfort
• Nausea or abdominal discomfort

A final note about panic attacks: Earlier (under the heading “what is anxiety”), I stated that anxiety does not occur without some reference to the future. This becomes evident when we consider the fact that social phobia, generalized anxiety and other anxiety-based problems are invariably linked to an undetermined outcome (i.e., associated with a context of the future.) The case of panic attacks, however, does present an exception. The reason is that panic attacks can occur “out of the blue.” In these instances the attacks are said to occur spontaneously, in the absence of any identifiable cue or trigger (e.g., a restaurant or expressway.) Being awakened suddenly in the middle of the night would be one such example. Why this happens is not currently understood. However, I would imagine that unconscious mental activity is somehow involved. And if this notion is true, it is also likely that the content of the activity in question is somehow linked to………………………….the future!

After reading the material above, should you still have questions or concerns about panic attacks, please feel free to click on the section entitled TREATMENT. The information presented in this section will give you a more comprehensive idea of how I treat panic disorder and other anxiety-based problems. Or, you can always email me directly if you have questions about your particular problem. My email address is lpulver@cfl.rr.com I look forward to hearing from you!