A panic attack is a discrete period of intense fear or discomfort that is accompanied by one or more of the following symptoms.
Symptoms may include:
- trembling or shaking
- shortness of breath or smothering
- feelings of choking
- chest pain or discomfort
- nausea or abdominal distress
- dizziness or light-headedness
- pins and needles
- dry mouth
- derealisation or depersonalisation
- and chills or hot flushes
Panic Attack Symptoms
There are two types of panic attack:
- Spontaneous (Uncued) Panic Attacks These are not associated with a situational trigger and appears to come ‘out of the blue’. These panic attacks can occur during periods of relaxation or when sleeping.
- Situational (Cued) Panic Attacks Occur either in anticipation of a situation or in a situation where an attack has previously been experienced. Usually the symptoms become apparent as one enters the situation.
I will outline some of the typical fears people have resulting from the panic attack symptoms. The most common fears created by the panic symptoms are:
- Losing Control: Will I Pass Out in Public? Am I Having A Heart Attack? Feeling Out of Touch or a Sense of Unreality
- “Am I going crazy?”
It is understandable for anyone to fear they may be going crazy when they suffer from the panic attack symptoms. There is so little real public awareness of mental disease, so people often jump to extreme conclusions. These conclusions are usually based on misinformation and an overactive imagination.
The most commonly known mental health issue is schizophrenia—even the word itself strikes terror within the average person. Schizophrenia is a major disorder characterized by such severe symptoms as disjointed thoughts and speech, babbling, having delusions or strange beliefs (for example, sufferers often claim they are receiving messages from an inner voice), and hallucinations.
Furthermore, schizophrenia appears to be largely a genetic disorder and run strongly in families.
Schizophrenia generally begins very gradually, and not suddenly (such as during a panic attack). Additionally, because it runs in families, only a certain proportion of people can become schizophrenic, and in other people, no amount of stress will cause the disorder. A third important point is that people who become schizophrenic will usually show some mild symptoms for most of their lives (such as unusual thoughts, flowery speech, etc.). Thus, if this has not been noticed in you yet, then chances are you will not become schizophrenic. This is especially true if you are over 25, since schizophrenia generally first appears in the late teens to early 20’s.
During a panic attack, because of the symptoms the people are feeling, they are prone to believe they are going to “lose control.” This loss of control can be bodily, i.e., that all your vital organs will completely lose the run of themselves and descend into chaos, or that the individual will mentally lose a grip on reality. Often, it is those who hate being socially embarrassed suffer from this fear the most.
Losing control could range from steering your car into an innocent passerby, or picking up a knife and killing the nearest and dearest person to you (not that we all don’t think of this from time to time!).
Put your mind at rest! As scary as those thoughts may be, you are not going to commit any of these acts. Relax. The reason you are experiencing them is because your body feels out of control with the panic attack symptoms. Your mind feels that if your body is out of control, it is next on the list.
You are not going to lose it. In fact, I am sure that with all the panic attacks you may have experienced in public places, nobody even noticed you looked uncomfortable. We are, by nature, social animals and dread to be seen in some kind of an embarrassing situation. Jumping up from your chair in a business meeting and screaming for an ambulance may go through your mind, but it is unlikely to happen. In the end, even if we do embarrass ourselves socially, does it really matter? We have to learn to be kind to ourselves. So what if we were to cause a scene and great embarrassment? Life is too short to keep up with appearances all the time. In fact, the more honest you are with your fears, the less pressure you are subjecting yourself under, and the more your panic attack symptoms will dissipate.
Passing Out in Public
Panic attack symptoms often include light-headiness, which induces fears of passing out or fainting in public. The core fear of passing out in public is that we suddenly become so vulnerable, especially if we are alone. Who will look after us as we lie strewn across the sidewalk? We also dread the thought of passing out for fear that we may never wake but fall into a coma. Passing out is caused by a lack of blood to the brain. When we faint, the body falls to the ground and allows blood to be easily supplied to the brain?which is, again, another of the clever safety mechanisms of the body. Quite simply, fainting during a panic attack is highly uncommon due to the amount of blood that is being circulated. Your heart is usually beating fast and there is little worry that the brain would be short of fresh supply. The symptoms of dizziness often felt during a panic attack is caused by increased respiration, and while it may be confusing for the individual, it is harmless and does not lead to fainting.
This fear really is a minefield and almost anyone who has suffered from panic attack symptoms at some point will fear for the health of their heart. Let us look at the facts of heart disease and see how this differs from panic attacks.
The major symptoms of heart disease are breathlessness and chest pain, as well as occasional palpitations and fainting. Such symptoms are generally related to the amount of physical effort exerted. That is, the harder you exercise, the worse the symptoms, and the less you exercise, the better.
The symptoms will usually go away quickly if the individual rests. This is very different to panic attack symptoms. Certainly, panic symptoms can occur during exercise, but they are different to the symptoms of a heart attack as they occur frequently at rest. Of most importance, heart disease will almost always produce major electrical changes in the heart, which are picked up very obviously by an EKG. In panic attacks, the only change that shows up on the EKG is a slight increase in heartbeat rate.
Sometimes, individuals go through a similar worry about their heart as they do with their breathing. People convince themselves that if they worry enough about their heart, or concentrate too much upon its actions, that it may somehow get confused and forget how to beat correctly. It is quite common for people who suffer from panic attacks to regularly check in on their heart at intervals, to make sure it is still beating away.
It is true that, mentally, we can all affect the pattern of our heartbeats. When you concentrate hard you may notice an irregular beat or two. This is nothing to get upset about. Remember that our bodies have an incredible internal intelligence and simply telling your heart out of panic that it might stop does not mean that it takes any heed of our fears. Learn to become more comfortable with your heart, let it do its job. Listen to it when relaxed and also when exercising. The more comfortable you are with the diversity and range of your heartbeats, the more confidence you will have in it when it is exerting itself.
If you are worried about heart problems, treat yourself to an EKG, and put your mind to rest. If you have had an EKG and the doctor has cleared you, you can safely assume you do not have heart problems.
Also, if your symptoms occur at any time and not solely upon exertion, this is additional evidence against a heart disorder.
Of all the panic attack symptoms, this is perhaps the least mentioned one in the literature (induced by excessive anxiety). It is the sensation of unreality. Many people become distressed by this sensation and feel they may be losing their mind.
People who experience panic attack symptoms report feeling disconnected from their world, or having a sensation of unreality. The sensation is described as if the world has become nothing more than a projection of a film. This sensation is quite distressing as it often leads to the individual believing that some permanent damage has been done to their brain, causing these sensations. A typical manifestation of this is when the individual may be having a conversation with someone and suddenly feels alarmingly isolated and removed from the situation. Once the sensation arises it can be so impactful that it takes days to leave the eerie feeling behind and stop thinking abou it.
I mention this because the condition is not often spoken about, and to reassure those of you who may have experienced this sensation, that it is only a side-effect of excessive anxiety and will pass as soon as the body learns to relax. Once the body returns to normal and has the opportunity to dispel some excess chemicals produced by the adrenal glands, then this unusual sensation will dissipate. Give it time, and these feelings will subside as you move from a life of anxiety to a more tranquil one.