How Are Panic Attacks Managed Or Treated
Psychotherapy, medications or a combination are very effective at stopping panic attacks. How long youll need treatment depends on the severity of your problem and how well you respond to treatment. Options include:
- Psychotherapy:Cognitive behavioral therapy is a type of psychotherapy, or talk therapy. You discuss your thoughts and emotions with a mental health professional, such as a licensed counselor or psychologist. This specialist helps identify panic attack triggers so you can change your thinking, behaviors and reactions. As you start to respond differently to triggers, the attacks decrease and ultimately stop.
- Antidepressants: Certain antidepressant medications can make panic attacks less frequent or less severe. Providers may prescribe serotonin selective reuptake inhibitors , serotonin-norepinephrine reuptake inhibitors or tricyclic antidepressants . SSRIs include fluoxetine and paroxetine . SNRIs include duloxetine and venlafaxine . TCAs include amitriptyline and doxepin .
- Anti-anxiety medications: Benzodiazepines are the most commonly prescribed anti-anxiety medication to treat and prevent panic attacks. They help with anxiety but have risks of addiction or dependence. These medications include alprazolam and lorazepam .
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The world is incredibly intense in so many ways right now. This stress can push us into our negative coping mechanisms and for many trauma responses. We are seeing people in mental health crises where the cumulative fatigue of emotional, physical, and financial stressors has caught up with them.
Anxiety and Depression is unbelievably common right now.
So many of us are needing new tools and support to help us to get on top of anxiety and depression.
We look at:
Try Muscle Relaxation Techniques
Another symptom of panic attacks is muscle tension. Practicing muscle relaxation techniques may help limit an attack. This is because if the mind senses that the body is relaxing, other symptoms such as rapid breathing may also diminish.
A technique called progressive muscle relaxation is a popular method for coping with anxiety and panic attacks.
This involves tensing up and then relaxing various muscles in turn. To do this:
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When Someone Is Having A Panic Attack
Below are some tips for you or your loved one to consider during a panic attack:
- Anxiety cannot increase forever and you cannot experience peak levels of anxiety forever. Physiologically there is a point at which our anxiety cannot become any higher and our bodies will not maintain that peak level of anxiety indefinitely. At that point, there is nowhere for anxiety to go but down. It is uncomfortable to reach that peak but it is important to remember this anxiety will even out and then go down with time.
- Emotions are like a wave, they will come and they will go.
- You have experienced this before, you know what to expect, and you will be able to handle it.
- Avoidance is anxiety’s best friend. Avoidance now will mean sustained anxiety in the future.
The following websites and brochures provide useful information for helping and supporting loved ones with panic disorder:
Treatment Options For Your Clients
Treatment options are suitable for clients who are experiencing panic attacks because of a clinically significant mental health condition such as panic disorder.
The first port of call for such clients should be Cognitive-Behavioral Therapy . CBT is a diverse therapy that can involve any combination of a suite of therapeutic interventions, unified by the goal of helping your client reevaluate their beliefs and âreprogramâ the habitual links between their beliefs and behaviors.
As the name suggests, the mental health interventions involved in CBT can be categorized as either cognitive or behavioral.
Cognitive therapies involve identifying and disrupting beliefs that cause the negative mood or anxiety that trigger panic attacks and educating patients to understand their panic attacks and put psychological distance between themselves and their experiences.
Behavioral therapies can involve relaxation techniques, practicing how to navigate potentially triggering situations, and exposure therapy, in which a client is safely guided through a direct or visualized experience of a potentially triggering situation.
Whatever combination of interventions works best for your client, CBT has been shown to be a successful therapy in most cases and is well suited to managing panic attacks, where controlling those triggering links between beliefs and behaviors is crucial.
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What Happens During A Panic Attack
Panic attacks are associated with physical symptoms that include:
- Shaking or trembling
- Feeling that your heart is pounding or racing
- Feeling that you are choking
- Tingling or numbness in your hands, arms, feet or legs
- Chills or hot flashes
- Sense of unreality or dreamlike sensations
A person may also have an extreme fear of losing control, going crazy, or dying during a panic attack. It is very rare for a person to have all of these symptoms at once. However, the presence of at least 4 symptoms strongly suggests that a person has panic disorder.
Many of the symptoms that occur during a panic attack are the same as the symptoms of diseases of the heart, lungs, intestines, or nervous system. The similarities between panic disorder and other diseases may add to the persons fear and anxiety during and after a panic attack. For example, you may believe that you are actually having a heart attack.
Just the fear of having a panic attack is often enough to trigger the symptoms. This is the basis for a condition called agoraphobia. A person who has agoraphobia finds it difficult to leave home because he or she is afraid of having a panic attack in public or not having an easy way to escape if the symptoms start.
Things You Can Try Yourself
The next time you feel a panic attack coming on, try the following:
- don’t fight the attack and stay where you are, if possible
- breathe slowly and deeply
To reduce the chances of a further attack, it may also help to:
- read a self-help book about anxiety based on the principles of CBT
- try complementary therapies such as massage and aromatherapy
- try activities like yoga and pilates to help you relax
- learn breathing techniques to help ease symptoms
- do regular physical exercise to reduce stress and tension
- avoid sugary food and drinks, caffeine, alcohol and stop smoking, these can make attacks worse
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What Can Clients Do During An Attack
The exercises described above are essential tools for reducing the likelihood of a panic attack occurring, recovering from the aftermath, and fostering better psychological wellbeing. However, they can also be used during a panic attack to reduce its severity and duration.
As soon as your client feels the onset of a panic attack, they should begin by grounding themselves, affirming that they are experiencing a panic attack, immediately creating some psychological distance, and identifying a panic attack as something that is happening to them. Once they have done this, their focus should be on managing the intense physical pain and anxiety they will be experiencing.
This is a Herculean task, and your client should realize that success is not making the panic attack disappear, but just making it a little more controlled.
They should use their controlled breathing exercises to soothe the brain, soften the alarm signals being sent by the body, and reduce the spiraling sensation of a panic attack. They should affirm that they are safe and that the panic attack will pass, labeling their emotions as calmly as possible to increase the psychological distance they created initially.
Who Gets Panic Attacks
At least 6 million Americans suffer from panic attacks and both conditions classified as anxiety disorders. According to the Anxiety and Depression Association of America , about 2-3% of Americans experience panic disorder in a given year and it is twice as common in women as in men. Panic disorder typically affects individuals when theyre in their 20s but is also seen in young children, adolescents, and older adults.
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Panic Attack Treatment And Prevention
Cognitive behavioral therapy and selective serotonin reuptake inhibitors are the first-line, evidence-based treatments for anxiety. These treatments can be used separately or in combination.
Cognitive behavioral therapy focuses on identifying and addressing anxiety-related thoughts and behaviors. It often involves meeting with a therapist weekly and practicing hands-on strategies each day to manage anxious thoughts and behaviors.
SSRIs are taken daily and can help adjust levels of the neurotransmitter serotonin in the brain, which can affect mood and anxiety. There are many types of SSRIs. A medication provider will determine which one is best for you and will meet with you regularly to monitor benefits and side effects.
Duval doesnt recommend avoidance strategies or using substances such as drugs or alcohol to cope with or abstain from anxious feelings or panic attacks. Incorrect use of substances, including prescriptions, can interfere with relationships and work.
It is a way to mask or avoid the anxiety were not giving ourselves ways to manage it that are going to decrease it long term, Duval says.
Instead, she suggests finding strategies to manage the attacks or reduce the anxiety around having a panic attack.
The challenge is that oftentimes the more we try to prevent something, the more it will happen, Duval says. A big part of managing anxiety and panic is finding ways to face it.
What Is Panic Disorder
Panic disorder is characterized by repeated panic attacks. A panic attack is a sudden rush of strong fear or discomfort that is accompanied by a cluster of physical and cognitive symptoms, including heart palpitations, shortness of breath, dizziness, trembling, and fears of dying, going crazy, or losing control.
Panic attacks are common among all anxiety disorders but what sets panic disorder apart is that panic attacks are unexpected and occur “out of the blue” without an obvious trigger . These unexpected panic attacks must be associated with a significant change in behavior or be followed by at least one month of persistent worry about having another attack or about what will happen if you have another panic attack.
Panic disorder is a disorder that many people experience – roughly 2-3% of people per year in the United States suffer from panic disorder .
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Differential Diagnosis And Comorbidity
When evaluating a patient for a suspected anxiety disorder, it is important to exclude medical conditions with similar presentations . Other psychiatric disorders use of substances such as caffeine, albuterol, levothyroxine, or decongestants or substance withdrawal may also present with similar symptoms and should be ruled out.5
Complicating the diagnosis of GAD and PD is that many conditions in the differential diagnosis are also common comorbidities. Additionally, many patients with GAD or PD meet criteria for other psychiatric disorders, including major depressive disorder and social phobia. Evidence suggests that GAD and PD usually occur with at least one other psychiatric disorder, such as mood, anxiety, or substance use disorders.10 When anxiety disorders occur with other conditions, historic, physical, and laboratory findings may be helpful in distinguishing each diagnosis and developing appropriate treatment plans.
Treatments For Panic Disorder
Treatment aims to reduce the number of panic attacks you have and ease your symptoms.
Psychological therapy and medication are the 2 main treatments for panic disorder.
You may need one of these or both, depending on:
- your symptoms
- how long you’ve been experiencing them
- how much it’s been impacting on your day-to-to day life
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Symptoms Of Anxiety Disorders:
Anyone may experience these symptoms during stressful times. However, individuals with anxiety disorders may experience them in absence of stress, with more severe symptoms and/or with several symptoms appearing together.
- Inability to relax
- Rapid pulse or pounding, skipping, racing heart
- Nausea, chest pain or pressure
- Feeling a lump in the throat
- Feelings of dread, apprehension or losing control
- Trembling or shaking, sweating or chills
- Fainting or dizziness, feelings of detachment
- Thoughts of death
What Is A Phobia
A phobia is an extreme, unreasonable fear in response to something specific. There are lots of different phobias. Some of the most common phobias include fear of crowds, bridges, snakes, spiders, heights, open places, or social embarrassment.
A phobia is considered a problem only when it keeps you from living a normal life. An example is being afraid to leave home because you are afraid of one of the things listed above.
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Meditate And Practice Mindfulness
A main goal of meditation is full awareness of the present moment, which includes noticing all thoughts in a nonjudgmental way. This can lead to a sense of calm and contentment by increasing your ability to mindfully tolerate all thoughts and feelings.
Meditation is known to relieve stress and anxiety and is a primary facet of CBT.
Research from John Hopkins suggests 30 minutes of daily meditation may alleviate some anxiety symptoms and act as an antidepressant.
Always Seek Professional Advice
Always seek medical advice if you are not sure whether your symptoms, or another persons symptoms, indicate a panic attack. In an emergency, dial triple zero for an ambulance. Its important to see your doctor for a check-up to make sure that any recurring physical panic-like symptoms are not due to illnesses, including:
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Tips For Helping Someone With An Anxiety Disorder:
- Make no assumptionsask the person what they need.
- Be predictabledon’t surprise the person.
- Let the person with the disorder set the pace for recovery.
- Find something positive in every small step towards recovery.
- Don’t help the person avoid their fears.
- Maintain your own life so you don’t resent the person with the disorder.
- Don’t panic when the person with the disorder panics, but realize it’s natural to be concerned with them.
- Be patient and accepting, but don’t settle for the affected person being permanently disabled.
- Say encouraging words such as: “You can do it no matter how you feel. I am proud of you. Tell me what you need now. Breathe slow and low. Stay in the present. It’s not the place that’s bothering you, it’s the thought. I know that what you are feeling is painful, but it’s not dangerous. You are courageous.”
- Avoid saying things like: “Don’t be anxious. Let’s see if you can do this. You can fight this. What should we do next? Don’t be ridculous. You have to stay. Don’t be a coward.” These phrases tend to blame the individual for the anxiety.
What Triggers A Panic Attack
Regardless of who they happen to or how they manifest, panic attacks do not happen in a vacuum. Although panic attacks are often unpredictable and seem spontaneous, there are nevertheless risk factors that act as potential panic attack triggers.
Negative mood is a situational factor that contributes to the increased likelihood of experiencing a panic attack. In contrast, an individualâs general level of anxiety is a less specific factor that can work in the background and increase the likelihood of panic attacks regardless of situational factors.
In other words, it can be useful to think of anything that causes negative mood as a trigger , while general levels of anxiety can be thought as a magnifying lens that turn seemingly innocuous events into potential triggers.
These general triggers are useful for understanding the psychological origin of a panic attack. However, they may miss some of the spontaneity and confusion of how panic attacks manifest in day-to-day life, where triggers may be harder to identify and the timeline of a panic attack does not necessarily follow a neat beginning, middle, and end.
An individual interviewed by Woodgate, Tennent, Barriage, and Legras described the onset of their panic attack:
âI was just walking down the street and then these guys walked past me and theyâre like âWhatâs up?â and I started panicking.â
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What Do Panic Attacks Feel Like
During a panic attack, physical symptoms can build up very quickly. These can include:
- a pounding or racing heartbeat
- feeling faint, dizzy or light-headed
- feeling very hot or very cold
- sweating, trembling or shaking
- pain in your chest or abdomen
- struggling to breathe or feeling like youre choking
- feeling like your legs are shaky or are turning to jelly
- feeling disconnected from your mind, body or surroundings, which are types of dissociation.
During a panic attack you might feel very afraid that youre:
- losing control
Steer Clear Of Alcohol
Drinking alcohol may take the edge off at first, since its a natural sedative. However, suggests theres a link between anxiety and alcohol consumption, with anxiety disorders and alcohol use disorder occurring hand-in-hand.A 2017 review that looked at 63 different studies showed that decreasing alcohol intake can improve both anxiety and depression.
Heavy drinking can interfere with the balance of neurotransmitters, which can be responsible for positive mental health. This interference creates an imbalance that may lead to certain symptoms of anxiety.
Anxiety may temporarily increase in early sobriety but can improve in the long run. Alcohol has also been shown to disrupt your bodys natural ability to sleep by interfering with sleep homeostasis. And as well later point out, a good nights sleep is incredibly helpful when combating anxiety.
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Public Events Or Performances
Public speaking, talking in front of your boss, performing in a competition, or even just reading aloud is a common trigger of anxiety. If your job or hobbies require this, your doctor or therapist can work with you to learn ways to be more comfortable in these settings.
Also, positive reinforcements from friends and colleagues can help you feel more comfortable and confident.