Panic attack is an attack of severe anxiety, fear, panic, which is accompanied by certain vegetative (bodily) reactions.
The duration of attacks can vary from several minutes to several hours, averaging 15-30 minutes.
For an anxiety attack to be identified as a panic attack, it must have at least four of the following core symptoms:
- Rapid pulse;
- Sweating;
- Feeling short of air, shortness of breath, difficulty breathing;
- Chills, tremors, internal trembling;
- Pain or discomfort in the left side of the chest;
- Nausea;
- Dizziness, lightheadedness;
- Derealization, depersonalization;
- Fear of going crazy or doing something uncontrollable;
- Fear of death;
- Feeling of numbness or tingling in the extremities;
- Insomnia;
- Confusion of thoughts;
Other (additional) symptoms may be present:
- Abdominal pain,
- Elevated temperature
- Stool disorder
- Frequent urination,
- Feeling of a lump in the throat
- Gait disturbance
- Visual or hearing impairment
- Cramps in the arms or legs,
- Motor function disorder
- High blood pressure.
Patients often talk about the spontaneity (unprovoked) of attacks. However, during the conversation it often turns out that along with spontaneous manifestations of PA, there are also situational attacks that occur in places perceived by a person as potentially dangerous. Such places and situations include:
- Using public transport;
- Staying in a large crowd of people or, conversely, in a confined space;
- And sometimes even, simply, the need to leave your own home.
This list can go on for a long time, but we will stop here.
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Breathe slowly
How to get rid of panic attacks? Slow breathing helps to cope with a rapid heartbeat and shallow breathing, which are both symptoms of a panic attack and its provocateurs. By breathing slowly, you send a signal to your brain to calm down. This is one of the most effective physiological ways to stop a panic attack.
Focus on your breathing. Inhale for one-two-three-four, hold your breath for one second, exhale for one-two-three-four. Look at your stomach (even through clothes): how it inflates as you inhale and retracts as you exhale.
How to behave during the interictal period
Therapy for panic attacks during periods of calm includes several key points. The main thing is to get rid of stress, traumatic situations and internal tension.
It is very important to increase the body's ability to withstand stress. A set of measures will help with this .
- Learn to control your emotions and actions, take responsibility for them. To do this, analyze situations, your decisions, why you acted this way and not otherwise, what would have been better for you to do in this case. Write down your thoughts. If you have made wrong actions, review them and build a model of correct behavior. Now you know how to behave in a similar situation.
- Let more positive emotions into your life. Watch pleasant, funny films, do what you love more often, communicate with positive people. Try to be alone less.
- Stop making derogatory remarks about yourself. Praise yourself for your achievements, accept your shortcomings and work on them. Don't make comparisons between you and other people. Pay attention to yourself, look after yourself.
- Try not to mentally return to traumatic situations that happened to you in the past. To avoid reliving negative emotions. Try to remove all things that may remind you of this event.
- Find something you like. Direct your energy to creativity, not to dark thoughts.
Meditation will help you relax. It will relieve not only emotional tension, but also muscle tension. There are professional practices that require special training and knowledge of techniques.
At the everyday level, you can meditate by turning on relaxing music and taking a comfortable position. The best way to do this is to lie down. Close your eyes or focus on one object. Breathe deeply, evenly and mentally repeat the pre-prepared phrases: I am calm, my fear is receding, I have everything under control, and any other phrases adapted to your condition.
Admit you are having a panic attack
How to understand that you are having a panic attack and get rid of it? During a panic attack, a person catastrophizes what is happening: it seems that it is a heart attack, stroke, death, madness, that you are fainting or about to vomit.
Tell yourself mentally several times: “This is not a disaster, this is a panic attack.” The intensity of your symptoms will decrease and you will begin to regain consciousness.
Beck Scale: Test for Anxiety
Signs of the syndrome
A panic attack usually develops suddenly. And he can find the patient anywhere, at any time of the day. Its manifestations vary: from an uncontrollable, painful feeling of fear and anxiety to internal discomfort. A panic attack with mild symptoms is called “panic without panic.” In this case, physiological symptoms dominate.
The duration of the attack may be only a few minutes, in other cases it lasts several hours. But on average its duration is 20–30 minutes. PAs are repeated in one situation 1–2 times a day, in others – several times a month. Having experienced such sensations for the first time, a person retains the memory of them for the rest of his life.
There is an incredible accident when a patient experiences attacks only a couple of times in his entire life. They disappear without a trace, presumably after the stress factor ends.
A panic attack is accompanied by the following symptoms:
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The first case of a panic attack is expressed by an extremely strong fear of dying. Its power is so powerful that it can drive the patient into a state of passion. In subsequent cases, the feeling of imminent death is transformed into a specific phobia. This could be a fear of going crazy, suffocating, etc.
There are situations when the condition is not accompanied by an anxiety-phobic complex. Emotional symptoms come to the fore: apathy, a feeling of uselessness, aggression, nervousness.
After a paroxysm, patients feel exhausted and overwhelmed.
Panic attacks most often occur between the ages of 25 and 50. Approximately 5% of humanity suffers from the pathology. And what’s interesting is that they are mostly residents of large cities. In old age, such paroxysms occur rarely, have an erased character and become remnants of attacks that occurred in youth.
Those who have experienced a similar condition at least once in their lives describe it with horror and excitement.
For example, a girl had an attack while she was driving in a car with her husband and child. There was a feeling of lack of air, an unreal horror ran through from head to toe. In an instant there was a desire to open the door and jump out of the salon. The busy highway held me back.
Another patient was seized with fear when certain sounds appeared. I felt a nasty tingling sensation in my palms. Excitement sets in, causing your thoughts to become confused and your tongue to be taken away.
A woman described her husband experiencing a panic attack while they were walking in the park and talking about a relative who had recently had a heart attack. She noticed that her husband's arms and shoulders suddenly began to shake. He was covered in sweat, it was even dripping. His face turned pale, he practically stopped breathing (he couldn’t take a breath), his gaze was wandering and unconscious. The man was sure he was dying. It took almost 2 hours to get home, whereas it usually took 20 minutes. He constantly stopped, sat down on the ground, and the attack repeated.
Train your mindfulness
Mindfulness is the ability to notice what is happening in and around you.
Panic attacks often lead to a feeling of unreality, out-of-body, detachment from one's own body and from the world. Mindfulness helps cope with a panic attack and the first signs of its approach.
How to deal with panic attacks? Focus on your body, look at it or imagine with your eyes closed: how your feet touch the floor, how your clothes touch your skin, mentally move to the tips of your fingers.
To distract yourself, you can focus your gaze on familiar objects around you - a glass with pens and pencils, a plant on the window, a pattern on the wall or on the floor, and so on.
General recommendations
Maintaining the correct daily routine is an important point in the fight against nervous tension.
You need to create your daily routine in such a way that there is enough space for both work and rest. It is also important to alternate between work and rest.
Sound and healthy sleep is something you desperately need. Moreover, it should occur precisely at night and be at least 8 hours a day.
You will have to eliminate alcohol and other stimulating drinks : coffee, strong tea. They excite the nervous system and prevent you from relaxing. Instead, drink soothing herbal infusions based on mint, lemon balm, chamomile, and linden.
Review your diet . Leave only healthy food in it. More vegetables and fruits are beneficial.
Constantly repeat to yourself that sport is your assistant in the fight against relapses of panic attacks. This is an excellent method for relieving tension and releasing negative energy. It increases the level of endorphins in the blood and reduces the amount of stress hormones. In addition, sports will allow you to abstract from your problems. Believe me, a hundred jumping ropes will bring you out of the blues and save you from gloomy thoughts.
In addition, physical exercise improves blood circulation, eliminates muscle tension, and liberates the body. It gives self-confidence, activates thinking, teaches self-control, and, of course, tightens the figure, makes it slimmer, and the image more harmonious. You will receive enormous benefits from playing sports, improve your sense of self and self-perception, and free yourself from certain complexes.
Stop the attack with medication
Drugs from the group of tranquilizers (anxiolytics or anti-anxiety drugs) help stop a panic attack if you take the pill at a time when it is still in its infancy.
Tranquilizers cannot be taken by everyone; they are sold by prescription, so they must be prescribed by a psychiatrist or psychotherapist.
Panic attacks. Why don't pills help?
Treatment
Increased self-esteem
One of the areas of treatment for panic attacks is to work on increasing self-esteem and self-confidence. And also on the ability to be critical of the personality of your parents. The ability to criticize the upbringing that was given to him by his parents will allow a person to move forward, working on his personal characteristics and developing his own individuality, rather than freezing in place, afraid to change what the adults who are significant to him have created.
In the process of psychotherapy, a person goes through the following stages:
- Understanding that parents are not perfect, since they are ordinary people;
- Protest against the methods of education that parents used and against the parents themselves;
- Separation - mental separation from parents;
- The beginning of the formation of one's own personality;
- Acceptance and gratitude to parents for doing everything they could and as best they could to raise their child.
- Accepting yourself as you are and starting to build your life in accordance with your own preferences.
Disclaimer
It is worth noting that all the procedures described in this section are best carried out under the supervision of a psychotherapist or psychologist. Or at least visit him periodically and tell him about the work done in order to receive the necessary recommendations and make adjustments to your wellness actions.
Self-treatment
Simultaneously with working on self-esteem, it is necessary to carry out procedures that help reduce anxiety.
Helps reduce anxiety:
- Breathing exercises;
- Sports activities;
- Autogenic training;
- Relaxation exercises.
Medicines
Also, if a psychiatrist or neurologist prescribes medications, then you should not neglect them, just as you should not get carried away.
Medicines should be treated as an auxiliary tool that facilitates psychotherapy and the dosage of which should be constantly reduced as psychotherapeutic treatment progresses.
Psychotherapy
Psychotherapeutic treatment can be carried out in various directions:
- Cognitive behavioral therapy. It will help you develop the habit of not being afraid of panic attacks.
- Body-oriented therapy. Will teach you to understand the body signals that precede panic attacks, as well as manage bodily reactions to reduce symptoms.
- Hypnotherapy. It will help create new internal attitudes that promote mental immunity, helping to predict and prevent panic attacks.
In addition to all of the above, a psychotherapist will help you understand the causes of PA. During psychotherapeutic sessions, it will become clear what underlies this disorder and what events or series of events led to it.
Complex treatment
In order for the treatment of panic attacks to be successful, a certain number of vectors must converge:
- A doctor prescribing medications must respect psychotherapeutic methods of treatment and understand that medications do not fully treat a mental disorder, but only relieve certain bodily symptoms and adjust the chemical and hormonal background of the body. As soon as a person stops taking them, his body stops producing the chemical elements necessary to maintain health. Therefore, in the long term, medications lead to addiction.
- The psychotherapist should also not sabotage drug treatment, but should enter into collaboration with the doctor to discuss the results of drug-psychotherapeutic treatment, as well as determine and adjust the dosage of medications.
- The third condition is the cooperation of the patient himself with the specialists treating him. He should try to be honest with them and follow all their instructions. In other words, the patient must feel responsible for what happens to him and not shift it to the people treating him.
Treatment results
If client-doctor-psychotherapist cooperation is established, then a decrease in the number of panic attacks will gradually be observed, as a result of which they will stop completely.
As treatment progresses, the dosage of medications should be reduced until they are completely discontinued. All this should happen against the background of psychotherapeutic treatment.
As general anxiety decreases, both phobias and panic attacks will go away, that is, complete physical and mental recovery will occur.
Author: Dmitry Malin - clinical psychologist
Diagnostics
If signs characteristic of panic attacks appear, you should contact a neurologist, psychologist or psychiatrist. Diagnosis begins with establishing the number of episodes of panic fear. A person is said to be susceptible to panic attacks if there are several such cases that arise spontaneously without the presence of a real threat to life and health, as well as outside the use of drugs or medications.
To develop the most effective treatment tactics, it is also important to establish the type of panic attacks. There are:
- expected (situationally related and situationally predisposed) – when anxiety attacks are associated with the presence of a specific fear, for example, heights;
- unexpected – when there is no obvious reason for the occurrence of fear and a clearly traceable trigger, so it is impossible to predict in advance the possibility of its occurrence.
In the first case, panic attacks are largely a consequence of the presence of one or another phobia, obsessive-compulsive disorder, post-traumatic disorder, or depression. Therefore, in these cases they are secondary, and therefore treatment will be aimed primarily at eliminating the cause of their occurrence.
Sometimes an additional consultation with a cardiologist, gastroenterologist, endocrinologist or pulmonologist may be required to detect disorders in the cardiovascular, endocrine, respiratory or digestive systems. In such situations, a fairly wide range of studies may be required to exclude underlying diseases, including:
- ECG;
- daily monitoring of ECG and blood pressure;
- Ultrasound of the heart, abdominal organs;
- X-rays of light;
- determination of the level of basic hormones;
- EEG;
- X-ray or MRI of the cervical spine;
- Doppler ultrasound of cerebral vessels.
Therefore, panic disorders, as the main diagnosis, are spoken of only in cases of sudden onset of severe anxiety with the development of physical symptoms to a greater or lesser extent. It is important that there is no anxiety during the period between attacks.
It is also necessary to establish the severity of the patient’s condition at the time of the attack using tests aimed at detecting fears and a special scale. The Spielberg scale is often used for this purpose. To do this, he is asked to fill out a special questionnaire or orally answer the doctor’s questions. In addition, it is important for the doctor to observe the patient over a certain period of time, and also to obtain information about when and what diseases he suffered, how often he is exposed to stress and how much he is exposed to it, what changes have occurred in his life, etc.
