What are panic attacks?

What Are Panic Attacks?

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By Daniel Hochman, MD and William Schroeder, LPC

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. About one in 20 U.S. adults has one at some point in their lives, with women being twice as likely to experience them.  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 (in fact, most chest pain seen in the ER is due to anxiety and not heart attacks). 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 reign 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 this article was of interest to you, also check out our blog post on why do we get nervous. 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.

Daniel Hochman, MD is the founder of Self Recovery, a private online addiction recovery program. It is ideal for those in therapy or post-discharge from rehab and need ongoing programming. The program will help to continue developing prior skills and teach new ones to create a more complete approach.

Photo by Fernando @cferdo on Unsplash