Dr. Gallan and Dove discuss about what a panic attack look like and how to get help.

Dove: Welcome to Teatime with Dove and Dr. G. I am Dove Avylla.

Dr. G: And I'm Dr. G or Dr. Gallan, PhD.

Dove: Today I wanted to ask Dr. Gallan a couple of questions about Panic Attacks. I actually have a friend who said she thought she was having a panic attack the other day for the first time in her life. What is a Panic Attack?

Dr. G: That's a great question, a lot of people think Anxiety is a Panic Attack. In fact, the American Psychological Association grouped it together, and now it's a separate diagnosis all by itself. It has so many complex possible symptoms.

A Panic attack is a phrase used to describe an immediate or sudden episode of extreme anxiety or panic. The heart beats very fast, you start sweating, you can't catch your breath. It's an extreme physical reaction that is often not relevant to anything that is obvious - when there is NO REAL DANGER or CAUSE.

In some people, like your friend ‐ I think you said it was new to her?

Dove: Yes, she's in her forties and said this is the first time she thinks she has experienced one ‐ is that possible? Can you get them at any time in your life?

Dr. G: Yes you can. In fact, women are more prone to them. They can start in late adolescent to early twenties for women. You can have 1 or 2 in your lifetime and not have any more. Or you can be walking around with a diagnosis of panic attack and it can evolve into other things.

...very frightening because the person feels like they are losing control, having a heart attack or dying. Many people have one or two in a lifetime and they go away, perhaps when the stressful situation ends.

Dove: What do they usually look like? How would I know I am having a panic attack versus something else?

Dr. G: Your biggest fear would be you are out of control, you're dying from a heart attack, you get an overbearing sense of doom. A sense that something horrible is about to happen. You feel like you're having a heart attack and think you are dying.

Dove: That sounds pretty scary. How long does that last? Minutes, seconds, hours?

Dr. G: These attacks can have many variations, but symptoms typically peak within minutes. It only takes our bodies a few minutes to react when we think something bad is going to happen. Our adrenaline and cortisol levels rise, and we have this extreme reaction. As long as we stay in that mind set it will go on for minutes. Then the hormones start to subside, and we start to come back down. And sometimes can even cause people to faint.

Dove: It sounds like you said that it starts without necessarily any cause? Is that right?

Dr. G: That is absolutely right. But let me put it a different way ‐ it's without any conscious awareness of the cause. So something is getting triggered in our memory that reminds us of something in the environment. And then the bad news is if you start having one or two you start getting worried that you are going to have them again. You start mentally planning for them to happen. And so they keep coming, like a train that keeps coming down the tracks. And you don't have control ‐ it just keeps coming.

Dove: So what do you do when you realize you are in the midst of having a panic attack?

Dr. G: In the midst of it, you really want to control your breathing. When you control your breathing, your body gets the message that "hey everything is okay". So you'll have seen people in movies that have panic attacks on airplanes and they will have a bag that they breath into. You could also breath into cupped hands. What you are trying to do is limit the amount of oxygen from coming into your body causing you to have too little carbon dioxide stay in your body. If you can slow that process down by breathing slowly, even holding your breath for a moment ‐ typically a count of 4 ‐ you will start to calm down your heartbeat and the sweating and all the symptoms you are experiencing.

Dove: You mentioned a raised heartbeat and sweating. What are some other symptoms that people might experience?

Dr. G: There is a huge list. Some of the typical symptoms can include some, but not necessarily all, of these:

  • A feeling of Doom
  • Fear of death or losing control
  • Rapid pounding heart rate
  • Chest pain
  • Sweating
  • Trembling
  • Short of breath/panting short breaths
  • Chills
  • Hot flashes
  • Nausea
  • Stomach cramps
  • Headache, dizziness or faintness
  • Numbness or tingling
  • A feeling of detachment

The fear of lose of control is one of the biggest ones. And you feel it while your body feel a loss of control. While your body is experience many of these symptoms at once.

Everyone doesn't have all of these symptoms, but any combination will qualify as you having a panic attack.

Dove: So if I am having these, what can happen to a person who does not get help with managing these?

Dr. G: The way that things unroll, the person starts to have fears that the attacks will come and they begin to have anticipatory anxiety, making it easier to have an attack. In other words, they are not talking themselves out of the attack, they are somewhat inviting it. So people try to avoid situations, typically social situations, thinking they will come on while they are doing these enjoyable things and they will be embarrassed. They feel like they won't know what to do ‐ what if I pass out or do something I can't control. Once those fears start to creep in it can cause people to start isolating. That isolating can then be linked to certain phobias like agoraphobia…avoiding places or situation that cause anxiety because of the fear of not being able to escape if an attack comes on. It's a horrible way to live.

Some other things that can happen:

1. People's bodies have to deal with the huge impact of the increase in hormones that are triggered by the fear response so they can find themselves getting lots of medical treatments
2. They can start to isolate and avoid social situations
3. They can become depressed, have other anxieties or suicidal thoughts
4. Many people try to numb themselves with ETOH or drugs
5. Financial problems can be an off shoot too.

Sometimes those fear can attach themselves to an event in the persons life. Let's take your friend let's say she was waiting for take-off on a plane and had a panic attack at that point. She will start associating panic attacks with planes and she will become afraid of planes and flying and then the fear will spread and can get out of control.

Dove: So, what would your advice be to my neighbor?

Dr. G: First of all, let's see if it happens again. If you do feel yourself get short of breath, cup your hands over your nose and mouth and breath in to your cupped hands. Then try to hold your breath to slow everything down. Not to the point of passing out, but just to regain control. If it happens again, first try the breathing techniques. Calming yourself down. I will often ask patients if they have a big black bear near them. They say "No." Okay, then I tell them they are safe. It helps us get that doom out of the picture. It helps to calm them down and get them back in control. On the flip side, let's say it continues to happen 3, 4, 5 times and she is spiraling out of control ‐ you must refer her to a psychologist or someone who specialized in anxiety disorders.

My advice

1. It is ALWAYS best to get help as soon as possible to stop them from getting worse or more frequent

2. The person needs to stick to the treatment plan as outlined by the therapist

3. Getting regular physical activity to make the body as strong as it can be to offset the impact of the release of hormones during the symptoms.

Dove: Thank you for all that great advice. I will be sure to pass it on. If you need to find a psychologist, one resource we provide is DocSourceInc.org; where we can put you in touch with a psychologist in your area. Until next time!

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