Guest post by Daniel Hochman, MD, with William Schroeder, LPC. Clinically reviewed by Teri Schroeder, LCSW.
Have you ever wondered what are panic attacks and why do people have them? Panic attack symptoms can be incredibly debilitating and embarrassing, and change the way people live. If they make you avoid grocery store and roads, it makes life pretty darn hard to navigate. You may have seen someone experience one, or even suffer from it yourself.
Let’s start with the basics. A panic attack is basically a sudden and unexpected feeling of terror that’s way out of proportion to the actual situation. Panic attacks can happen to anyone, and when they keep coming back, it may be panic disorder. According to the National Institute of Mental Health, about one in 20 U.S. adults has panic disorder at some point in their lives, and women are more than twice as likely as men to have had it in the past year. Here are the common signs and symptoms:
- Internal symptoms: Usually people sense a racing heart, sometimes with chest pain. It is not infrequent that we have a client come into therapy after they have had several emergency room visits because these symptoms can feel like a heart attack. (Chest pain should always be checked by a doctor first. Panic is one possible cause, not the only one.) As far as thoughts go, people feel a sense of doom, might even feel like they’re dying and feel totally out of control. To make it even more fun, people usually feel faint, woozy, tingly in their hands, and might sense a lump in their throat.
- External symptoms: On the outside, breaths are more rapid. You will notice the person looking quite uncomfortable, at a loss for what to do, and have a hard time making eye contact. Their skin can get sweaty and pale.
What’s the difference between anxiety and panic attacks?
As far at the timing, the major difference is that panic attacks are more intense and usually peak at around 10 minutes, and last less than an hour. Anxiety, on the other hand, can last many hours, or even years. When you ask someone to describe a panic attack, there’s usually a focus on the panic itself, with a fear of having another panic attack. And whatever fear they can describe will usually sound quite unnecessary. If you ask someone with anxiety to describe what’s going on their head, they can usually describe one or several things clearly on their mind about what’s bothering them.
The horrible positive feedback loop
With panic attacks, usually, it starts with just one small fear. Like a fear that people at the mall will be judging you. When you feel scared, your body reacts as if there’s a physical threat. And when your body reacts, it convinces your mind that there’s actually a major threat out there, which only makes the mind more scared, which only makes your body even more hyped up… and so on. What’s more, you start to notice you get scared of the mall during your drive over. And then you start to get worked up about thinking about leaving the house with your car at all. And then you get scared you’re having a heart attack or going to pass out, etc. This is the vicious positive feedback loop where now there is an entire cycle of fear, and the fear feeds itself. No longer is it the initial fear of a crowd, but it’s the drive, the road, the keys to the car, a friend’s invitation to go out, and the symptoms. They all compound. This is the idea behind how panic attacks hit so fast and hard. When I can help my patients explore their primary fear, say a fear about a crowd judging them, it helps rein in the rest. They can begin to emotionally process the underlying issue, and there’s no more fire for the rest of the feedback loop to feed.
If we can be of help, you might also want to read more about anxiety counseling or you can contact us to make a counseling appointment. We also have more information on dealing with panic attacks. If this article was of interest to you, you can also read our post on why do we get nervous.
Photo by Fernando @cferdo on Unsplash
