What Happens Inside Your Body
Your bodyâs âfight or flightâ response is behind these intense physical symptoms. Normally when you encounter a threat — whether itâs a grizzly bear or a swerving car — your nervous system springs into action. The hormone adrenaline floods into your bloodstream, putting your body on high alert. Your heartbeat quickens, which sends more blood to your muscles. Your breathing becomes fast and shallow, so you can take in more oxygen. Your blood sugar spikes. Your senses get sharper.
All of these changes — which happen in an instant — give you the energy you need to confront a dangerous situation or get out of harmâs way quickly.
With random panic attacks, your body goes on alert for no reason. Researchers donât know exactly what triggers them. But the physical effects are real: During a panic attack, the adrenaline levels in the body can spike by 2 1/2 times or more.
Panic attacks may not come as unexpectedly as they seem. The physical changes may start about an hour before an attack. In one study, people with panic disorder wore devices that tracked their heart activity, sweating, and breathing. The results showed lower-than-normal levels of carbon dioxide, a sign of rapid, deep breathing that can leave you breathless, as early as about 45 minutes before the panic attack.
Causes Of Panic Attacks
Anxiety disorder is the principal cause of all panic attacks. According to the National Institute of Mental Health , approximately 40 million adults in the U.S. between the ages of 18 and 51 are diagnosed as being affected by anxiety disorders. However, the total number of people who are affected by anxiety disorders â and who are therefore predisposed to experience a panic attack â is thought to be far greater.
Panic is the most acute form of anxiety. As such, a panic attack is caused by heightened anxiety, whereby the body undergoes physiological changes due to oneâs thoughts, entering into a state called fight or flight mode. A person may not be consciously aware of the thoughts that induce this state, as it can be caused by the brainâs background activity.
Fight or flight mode is an automatic response to danger, rapidly preparing the body for physical activity, such as running away from or fighting off a predator. In a panic attack, however, there is usually no immediate physical threat to escape from.
Physiological changes associated with fight or flight mode, that may contribute to a panic attack, include:
- Increased metabolic rate
- Loss of hearing and dilation of pupils
- Relaxation of the bladder and sphincters
Use Muscle Relaxation Techniques
Much like deep breathing, muscle relaxation techniques can help stop your panic attack in its tracks by controlling your bodys response as much as possible.
Consciously relax one muscle at a time, starting with something simple like the fingers in your hand, and move your way up through your body.
Muscle relaxation techniques will be most effective when youve practiced them beforehand.
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Can It Lower Your Blood Pressure
Xanax slows down essential functions such as your heart rate and breathing. It can also temporarily lower your blood pressure. In other words, if you take Xanax before getting your blood pressure tested, your reading might be lower than usual.
A 2011 randomized controlled study followed 53 participants who arrived at a hospital emergency department with elevated blood pressure. They were given either alprazolam or captopril, a high blood pressure drug, as treatment.
The researchers found that alprazolam was as effective as captopril at lowering blood pressure.
Xanax may have similar effects over the long term. A 2017 study reported that among people over the age of 60, long-term use of benzodiazepines was associated with lower blood pressure.
Similarly, a involving participants with a median age of 63.6 reported that alprazolam use was associated with a slightly reduced risk of major adverse cardiovascular events among people who had high blood pressure. These events include heart attacks and strokes.
However, taking Xanax over the long term is generally not recommended, as it can be habit-forming.
How Are Panic Attacks Diagnosed
Serious health problems, such as heart disease, thyroid disease and respiratory problems, cause symptoms similar to panic attacks. Your healthcare provider may run tests to rule out a physical problem. If theres no physical cause, your provider may make a diagnosis based on your symptoms and risk factors.
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When Might I Have Panic Attacks
Panic attacks happen at different times for everyone. Some people have one panic attack then dont ever experience another, or you might find that you have them regularly, or several in a short space of time. You might notice that particular places, situations or activities seem to trigger panic attacks. For example, they might happen before a stressful appointment.
Most panic attacks last between 5 to 20 minutes. They can come on very quickly. Your symptoms will usually be at their worst within 10 minutes. You might also experience symptoms of a panic attack over a longer period of time. This could be because youre having a second panic attack, or youre experiencing other symptoms of anxiety.
My panic attacks seem to come out of the blue now. But in fact, they seem to be triggered mainly at night when I want to go to sleep but cannot stop my mind racing, experiencing worry and panic about anything that may be on my mind.
Heres What Happens In Your Body During A Panic Attack
Even though psychiatrists have been investigating just what panic is since the mid-to-late 1800s, the term panic disorder didnt appear in the Diagnostic and Statistical Manual of Mental Disorders until 1980. Experts still arent sure precisely what underlies this disordered brain-body connection.
Sometimes panic might start in your body itself, and then create processes within your brain. Other times, your brain could initiate the entire onset of a panic attack, which then manifests itself in your body, says Feinstein. In some cases, genetics or changes in brain function may be at play. In others, stress is a factor.
Panic attacks begin with something that causes your heart to race it could even be caused by something as innocuous as a jolt of caffeine.
But once an attack is triggered, the cascade of physiological responses in the body is fairly universal. Typically, it begins with something that causes your heart to race. This might be a stimulus in the environment perhaps a sound or a scent that you associate with a traumatic event or even something as innocuous as a jolt of caffeine. In a panic attack, the racing heart sets off a danger alarm in your brain and sends your bodys fear response into overdrive.
Panic attacks typically peak and subside within 10 or 15 minutes, and there are a handful of solid techniques that can help you ride them out.
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Identify A Point Person
Annette said that one of the things that has helped her through attacks is having what she calls a panic attack point person. This may be your therapist, a family member or spouse, or a good friend. Whoever it is, this person should be familiar with your anxiety history, and should be someone you feel you can rely on.
It’s important to have people in your life who don’t judge you and know what works for you when you are having an episode, says Annette, a 43-year-old woman in Oregon who has been diagnosed with panic disorder. I’m so lucky to have a couple people who are always there for me and treat me with respect and dignity when I need it most.
Seeking Professional Help For An Anxiety Or Panic Disorder
Seeking professional help can help you and your child gain knowledge about the tools and techniques used to prevent and manage anxiety attacks. A trained professional may have insight on why your child is having panic attacks, however there may not be a specific reason or trigger. Additionally, a trained professional can teach certain techniques such as exposure therapy and relaxation techniques to help your son or daughter overcome panic attacks. Although there are medications known to help panic disorders, they are not recommended for children due to the side effects, therefore these disorders are best managed with therapy and knowledge.
If your child has been experiencing frequent panic attacks likely related to an anxiety disorder, Discovery Mood and Anxiety Program is here to help. Please contact Discovery to get in touch with a supportive professional today.
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How To Deal With Panic Attacks
A panic attack is a feeling of sudden and intense anxiety.
Panic attacks can also have physical symptoms, including shaking, feeling disorientated, nausea, rapid, irregular heartbeats, dry mouth, breathlessness, sweating and dizziness.
The symptoms of a panic attack are not dangerous, but can be very frightening.
They can make you feel as though you are having a heart attack, or that you are going to collapse or even die.
Most panic attacks last somewhere from five minutes to half an hour.
S For Getting Through A Panic Attack
“It feels like I’m dying.” Those are the words people use to describe what a panic attack feels like. The process of addressing and managing them is a journey there’s no immediate cure or course of action that will stop a panic attack in its tracks.
It takes time, patience and dedication to identify your unique triggers. However, there are steps that serve as preemptive measures to help shorten the duration of a panic attack when it is occurring, and reduce the frequency and severity of your anxiety in the long term.
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Some People May Develop Panic Disorders
For many people, the feelings of panic occur only occasionally during periods of stress or illness. A person who experiences recurring panic attacks is said to have panic disorder, which is a type of anxiety disorder. They generally have recurring and unexpected panic attacks and persistent fears of repeated attacks.
Supporting Others Through A Panic Attack
If someone else is the person having the panic attack, dont invalidate their feelings by telling them to calm down or just relax, Bufka said. Instead, be responsive to their concerns, and remind them of the strategies theyve been practicing.
Gallagher suggested talking to the person and trying to keep them grounded in the present. But Carbonell warned that its important to avoid taking charge of the situation: Be a source of support rather than a rescue.
Keep in mind that its not up to you or the person experiencing the attack to make it end, he said. If someone is having a panic attack, their goal should be to try to feel a little better while waiting for the symptoms to subside.
Panics not a disease, Carbonell said. Panics an overblown version of something very normal and ordinary and essential to life our capacity to feel fear. So we dont want a cure for that.
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Panic Attack Or Heart Attack
The symptoms of a panic attack can be similar to those of a heart attack. The Ada app can help you check your symptoms. or find out more about how it works.
It is common for people experiencing a panic attack to become convinced that they are having a heart attack during the episode. Although this may be related to the distressing thoughts that accompany a panic attack, emergency medical services should be called if a heart attack is suspected, as â unlike a panic attack â a heart attack requires prompt medical attention and can be life-threatening.
Key differences between a heart attack and a panic attack include:
Despite being able to identify these differences, it is advisable to always seek medical attention if the affected person:
- Has a history of heart attacks
- Meets the risk criteria for a heart attack, such as high blood pressure, being overweight, getting limited physical exercise
- Has never had a panic attack before
If one is not deemed to be at risk of a heart attack, psychotherapeutic techniques such as cognitive behavioral therapy may be recommended in order to help the affected person overcome any long-term anxiety about having a heart attack. This will help prevent a fear of having a heart attack from manifesting in, or forming the basis of, future panic attacks.
Remember That It Will Pass
During a panic attack, it can help to remember that these feelings will pass and cause no physical harm, however scary it feels at the time.
Try acknowledging that this is a brief period of concentrated anxiety, and that it will be over soon.
Panic attacks tend to reach their most intense point within 10 minutes of their onset, and then the symptoms will begin to subside.
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Go Home If You Need To
Some panic attacks are more intense than others. If you feel it is difficult to continue working, take the rest of the day off. It is better for you to go home and take extra care of yourself rather than try to tough it out. Panic attacks are exhausting, and staying at work afterward rarely results in any work getting done. If you are protected by the Americans with Disabilities Act , you cannot be fired or demoted for needing to take time off due to having panic disorder, with some exceptions. To learn more about the ADA, continue reading.
Symptoms Of Panic Attacks
The symptoms of Panic Disorder are clearly defined in the 5th edition of The Diagnostic and Statistical Manual of Mental Disorders.
- Recurrent unexpected panic attacks
- A panic attack is a sudden increase in severe fear or discomfort. This discomfort generally reaches its worst peak within a few minutes. During this time four of the following symptoms are experienced:
- Following at least one of these panic attacks, must experience either:
- Continued concern about future panic attacks or the consequences
- Significant change in behavior associated with the attack
- Symptoms cannot be caused by a substance or medication or be due to a medical disorder
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Take Charge With The Venue
A guy once asked me to go bowling on a first date. Yeah, no thanks! I was nervous enough as it was without having to worry about being terrible at bowling. If a particular setting puts you on edge, you can always laugh the request off and say something like, Maybe on the second date! Then, suggest somewhere youd feel more comfortable going.
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:
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What Questions Should I Ask My Doctor
If you have panic attacks, you may want to ask your healthcare provider:
- Why am I having panic attacks?
- What is the best treatment for panic attacks?
- How long will I need therapy?
- How long do I need to take medications?
- Should I look out for medication side effects?
A note from Cleveland Clinic
Panic attacks can be extremely uncomfortable. Although theyre not physically harmful, they can take a toll on your mental health and stop you from doing the things you love. Dont be embarrassed to tell your healthcare provider that you have panic attacks. Your provider can help you overcome fears and anxieties that trigger attacks. You can get better with treatments like psychotherapy and medications.
Last reviewed by a Cleveland Clinic medical professional on 08/12/2020.
How Is Panic Disorder Diagnosed
Medical or mental health providers can diagnose panic disorder. Your provider may diagnose panic disorder when you have repeated panic attacks and you:
- Persistently worry about having more panic attacks or their consequences.
- Obsess about losing control during a panic attack.
- Change your behaviors to avoid situations that may trigger a panic attack.
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What To Do In A Panic Attack
Panic attacks are terrifying and confusing.
I heard this brilliant metaphor on the Armchair Expert Podcast from Dax Shepard, you shouldnt visit your first AA meeting when you go to Vegas. Aint that the truth. Hes saying be prepared. In case it happens, itll help to know what to do in a panic attack, whenever it happens to you, and wherever it strikes.
Dont wait until youre in the middle of it to come up with a plan or support ideas for what to do in a panic attack. When you feel a couple of the first signs, its signature move time.
Firstly. Tell yourself that youre having a panic attack. It might be a little one where you feel short of breath and youre having trouble thinking clearly. Thats OK, youre just having a panic attack and it will pass. It might be a huge one and your whole world is crashing down around you. Thats OK, youre just having a panic attack and it will pass.
See the pattern here. Calling it out is really important. It helps to lower the flight or flight response, because youre telling yourself you know what this is. Instead of adding more panic by saying to yourself, Whats going on? Am I having a panic attack? Whats wrong with me!?! Have a deep breath and just own it. Yep. A panic attack is happening.
Secondly, you need a little signature move. Kinda like a signature pick up line, or a party trick thats your go-to.