Panic attack

Nowadays, hardly there is a person who hasn’t heard the term “panic attack”. It is being used so often that you may have started worrying – what kind of malady is this? It seems that half the people are affected by it.  

A panic attack (PA) is an unexplainable and very disturbing bout of acute anxiety. It is accompanied by general fear in conjunction with different bodily reactions. 

You could say that PA is a plague of the 21st century. But it doesn’t mean that panic attacks didn’t exist before. They surely did! But there was no such diagnosis. 

The person would come to a doctor with a dozen of different symptoms that could not be explained by any physiological reasons. The apparently healthy organs were malfunctioning. Such a mystery, right? 

By the way, the doctors were ready to help. They would prescribe herbal sedatives and baths, they would ask the person to worry less, to go out for a walk, or to take a contrast shower. Etc., etc. 

But the patient would not get better. 

The reactions of the autonomic nervous system could bring a huge discomfort. For example, if a person has weak capillaries, then even if they worry about something a little bit, they may get symptoms like PA. 

The state of panic feeds on itself – when a person breathes fast, the brain gets the signals of nervousness. For example, like this: “Oh, fast breathing! That means something scary is going on, I should get ready!”. This, in turn, causes fear (sometimes even the fear of death), and the state of panic intensifies even more. It is a positive feedback loop.  

Nancy has asthma; therefore, she can have trouble breathing. The physiological basis of her breathing problems is clear – it is asthma. But she has asthmatic episodes extremely rarely, mostly when she has some allergic reaction. The last time she experienced it was when she was hiking in a field full of blooming flowers. She easily dealt with it with the help of the inhaler that she always takes with her. In the winter, Nancy had to travel for work. Only on the plane, she noticed that she had forgotten her “magic wand”. Over a span of 10 minutes, she had a full-blown asthma attack, that started with one simple thought: “I don’t have my inhaler! If an asthma attack starts – I will die, and nobody will be able to help me!” She experienced strong fear and voila – she started suffocating. 

Fortunately, one of the passengers had an inhaler and she helped Nancy. But panic attacks (that’s what Nancy really experienced) started to occur regularly. 

Panic attacks may hide behind the sudden onset of different bodily illnesses.

So, what kind of symptoms can this mysterious syndrome be comprised of? 

• heart palpitations, the heart is beating so fast, as if it is about to jump out from the chest  

• feeling as if the heart is about to stop, as if it is skipping beats  

• unexplainable and often sudden fear  

• lack of air, difficulties breathing: “I can’t breathe”, “No air”, “I am suffocating”  

• high blood pressure, the sensation of blood rushing to the head  

• dizziness, blurred vision, “fog in front of my eyes”  

• derealization and depersonalization (“this is not happening to me”, “this is not real”)  

• sweating, nausea  

• numbness, inability to speak, to move, to control arms and legs  

• pain in the stomach and in the chest  

• tremor – shaking hands  

•  confused thoughts  

Yes… This is not a pleasant picture. It really can feel that this is the end, and you are not going to survive this turmoil…  

But as a matter of fact, these are just the tricks of your autonomic nervous system. It is a malfunction in its work.  

Angela was taking subway. Everything was as usual: 7:30 in the morning, rush hour, crowds of people… Suddenly, she felt wobbly and it seemed to her that she was about to fall on the train tracks. Scared, she stepped away from the platform, but the uncomfortable feeling wouldn’t leave her. Angela tried to inhale more air but couldn’t. She felt even more dizziness. Fear consumed her, she felt paralyzed – “Out, out, I need to get out of here!” She tried to run, but she couldn’t. Her arms and legs felt awkward as if they didn’t belong to her. Angela thought that this was the end, that she was experiencing a heart attack or a stroke, that she would suffocate right here, beneath the ground. She got covered in sweat. Her hands became cold and started shaking. She tried to force her way against the stream of people rushing towards her and tried to walk up the escalator that was moving down. Later, Angela said that she was not able to think at that moment. It was terrible. Some man helped her: he took her by the hand, pulled her away from the escalator, and walked her to a bench. He sat next to her helping her breathe steadily and repeating “You are not dying; it is just a panic attack. Soon it will go away.” Gradually, after 10 minutes that seemed like an eternity, Angela calmed down.  

As we can see, the symptoms of PA can be grouped into two main categories: emotional and physiological. These two elements (emotions + physiology) literally form a closed loop and amplify each other in such a way that it is impossible to separate them. Everything is merged into one single horrific experience: the faster the panicking person breathes, the more intense their fear becomes. The more scared they are, the faster and rougher their breathing gets. Now, add thoughts to this mixture! Oh, those thoughts… Everyone who has ever experienced a PA can tell you about a whirlwind of frustrating thoughts that ultimately plunges the poor person into despair: “I am dying”, “This will never end”, “I will not survive this”, “Something is wrong with me”, “I am losing my mind”. 

Symptoms may come not all at once. And there is no “one size fits all” pattern. Some people can have stronger physiological components, while others – emotional. But in the end, the main point is – it is a very rough experience. 

Jason wanted to do sky diving for a long time. He took a course and started studying the theory part with great enthusiasm. Before the group could skydive, they all climbed a tower and had to go down on a cable. And here Jason realized that he couldn’t do it. He climbed the stairs with great difficulties, trying not to look down. At the top, he got a panic attack: he couldn’t breathe, he felt dizzy. Suddenly, he got scared that he would jump down right now, without any cables and parachutes. He felt that he could not control himself. It was very scary. Jason sat down on the floor and covered his face with his hands, trying to take control of himself. His instructor was saying something, and his classmates were trying to help him to come down the stairs. But he could barely hear them.  

During a PA, the person’s brain evaluates the situation as catastrophic since the person doesn’t understand what is going on with them. This completely throws them off, scares them, and forces them to seek urgent help – from a doctor, cardiologist, physician. The symptoms are obvious: breathing, head, heart! They urgently need to get diagnosed and treated! And this how a sad medical saga begins. Meanwhile, it is not the body that needs treatment… 

In the next article, we will discuss where does all of this come from and why.