The body is transformed into its own corset. There is a single force that exists in the past, present, and future. A swing that defies gravity soars to dizzying heights. The contours of people and objects vanish.
Countless poets and authors have attempted to put words to the intense feeling of a panic attack, which many people confuse for a heart attack, stroke, or other life-threatening crisis.
Despite the fact that panic attacks do not cause long-term physical harm, the fear of another attack can restrict one’s everyday activities— and lead to more panic attacks.
According to studies, about a third of us will have at least one panic attack in our lives. And no one wants to go through another one, whether it’s their first, their hundredth, or they’re watching someone else go through one.
Even learning about them can be unsettling, but it’s important because knowing panic attacks is the first step toward avoiding them. A panic attack is, at its heart, an overreaction to the body’s natural physiological response to perceived threat.
The amygdala, a brain region involved in fear processing, initiates this response. As the amygdala detects risk, it activates the sympathetic nervous system, causing adrenaline to be released.
Adrenaline causes the heart and breathing rates to speed up in order to bring blood and oxygen to the muscles in the arms and legs. This also increases the amount of oxygen in the brain, which makes it more alert and receptive.
This reaction is exaggerated well beyond what would be helpful in a dangerous situation during a panic attack, resulting in a pounding heart, rapid breathing, or hyperventilation.
Lightheadedness and numbness in the hands and feet are caused by changes in blood flow. Within 10 minutes, a panic attack normally reaches its height. The prefrontal cortex then takes over and activates the parasympathetic nervous system, taking over from the amygdala.
This causes the release of acetylcholine, a hormone that slows the heart rate and brings the panic attack to a close. The body’s sense of danger in a panic attack is enough to cause the same reaction we would have in the face of a real threat—and then some.
We don’t know why this occurs, but environmental stimuli that remind us of a traumatic experience can often cause a panic attack.
Panic attacks may occur as a result of anxiety disorders such as post-traumatic stress disorder (PTSD), social anxiety disorder (SAD), obsessive-compulsive disorder (OCD), and generalised anxiety disorder (GAD). A panic disorder diagnosis is based on recurrent panic attacks, frequent anxiety about new attacks, and behavioural improvements to prevent panic attacks.
Antidepressant medication and cognitive behavioural therapy, or CBT, are the two most common therapies for panic disorder. Both have a response rate of about 40%, while people who respond to one may not respond to the other.
Antidepressant drugs, on the other hand, have certain adverse effects, and 50% of people who quit taking them relapse. CBT, on the other hand, is more long-lasting, with just a 20% relapse rate. The aim of CBT for panic disorder recovery is to help people develop and practise concrete techniques for exerting physical, and thus emotional, control over the feelings and thoughts that accompany a panic attack.
CBT starts with an overview of the physiological causes of a panic attack, and moves on to breathing and muscle exercises to help people consciously regulate their breathing patterns.
The next step is cognitive restructuring, which entails recognising and replacing typical attack-related thoughts with more accurate ones, such as thinking you’ll stop breathing, have a heart attack, or die.
Exposure to the bodily stimuli and circumstances that usually cause a panic attack is the next step of treatment. The aim is to shift the perception that these sensations and circumstances are harmful through experience.
Taking these measures in the midst of an assault, even after CBT, is difficult. However, with practise, these tools can be used to both deter and de-escalate attacks, thus reducing panic’s grip on a person’s life.
Many panickers derive comfort outside of structured therapy from the same values that CBT seeks to instil: that anxiety can’t harm you, but holding on to it will make panic worse.
Even if you’ve never had a panic attack, knowing what to look for will help you recognise one in yourself or someone else, which is the first step toward avoiding one.