By Diane Palmer, MSW, LCSW
This article will describe what has led many people to the emergency room thinking they are having a heart attack, and who, after being evaluated, are released and told they had an anxiety attack (also referred to as panic attacks or having a panic disorder). This article is not intended to be medical advice and is NOT advising readers that they do not need to go to the nearest emergency department if they suspect they are having a heart attack. It is meant to help identify common symptoms in anxiety attacks, and provide information about treatment options.
Fear and anxiety are normal reactions to stressful events in our lives. Panic attacks are different. Panic attacks may strike without reason or warning, causing sudden attacks of fear and nervousness, as well as physical symptoms such as sweating and a racing heart. During a panic attack, the fear response is out of proportion for the situation, which often is non-threatening. Over time, the person may develop fears of having another attack, which can affect daily functioning and general quality of life.
Symptoms of a panic attack, which often last about 10 minutes, include:
|Pounding heart or chest pain||Nausea or stomachache|
|Intense feeling of terror||Tingling or numbness in the fingers and toes|
|Sensation of choking or smothering||Chills or hot flashes|
|Dizziness or feeling faint||A fear that you are losing control or are about to die|
|Trembling or shaking|
Beyond the panic attacks themselves, a key symptom of a panic disorder is the persistent fear of having future attacks. The fear of these attacks can cause a person to avoid places and situations where an attack has occurred, or where they believe an attack may occur.
The exact cause of panic disorders is not fully understood. It is believed that a combination of factors may be involved. These factors may include: a family history of anxiety disorders, misuse of drugs and alcohol, major life stressors, and others.
Panic attacks affect about 2.4 million adult Americans. They most often begin during late adolescence and early adulthood. The disorder is twice as common in women as in men.
If symptoms are present, a doctor will begin an evaluation by performing a complete medical history and physical examination. Although there are no laboratory tests to specifically diagnose panic disorders, a doctor may use various tests to look for a physical illness as the cause of the symptoms. If no physical illness is found, you may be referred to a mental health professional who is specially trained to diagnose and treat anxiety conditions.
As with other anxiety conditions, a combination of therapies are often used to treat anxiety attacks.
- Counseling: Counseling addresses the emotional responses to anxiety. It is a process in which trained mental health professionals help people by talking through strategies for understanding and dealing with their concerns. People suffering from panic disorder often benefit from cognitive behavioral therapy, in which the person learns to recognize and change thought patterns and behaviors that lead to troublesome feelings. One of the benefits of this type of therapy is that the person learns recovery skills that are useful for a lifetime. Therapy also aims to identify possibly triggers for panic attacks.
- Medications: Anti-depressant drugs and anti-anxiety medications are used to treat panic disorders. Sometimes, heart medications are used to control irregular heartbeats.
- Relaxation Techniques: Meditation and relaxation therapy are often used to help relax the body and relieve anxiety.
Some people who respond well to treatment may have anxiety or panic attacks reoccur later on in life. If this occurs, additional treatment may be helpful to control or reduce panic attacks.
Panic disorder can be successfully treated in almost all cases, and sufferers can go on to lead full and satisfying lives. With appropriate treatment, nearly 90 percent of people with panic disorders can find relief. Unfortunately, many people with panic disorder do not seek treatment. Without treatment, panic disorder can have serious consequences and can severely impair quality of life.
- Avoidance: A person may discontinue activities that seem to trigger a panic attack. This can make a normal work and home life nearly impossible.
- Anticipatory Anxiety: This refers to anxiety that is triggered merely by thinking about the possibility of having an anxiety attack.
- Agoraphobia: This is the fear of being in places or situations in which an attack may occur, or from which escape would be difficult or highly embarrassing. This fear can drive people to avoid public places and crowds, and may even progress to the point that the person will not leave his or her home. About one-third of people with panic disorder develop agoraphobia.
You can take steps to lessen the chance of attacks and learn to manage them. It helps to recognize your symptoms as a panic attack. When you sense the first symptoms, expect that other symptoms may follow.
When you begin to experience a panic attack starting, it is often helpful to:
- Try taking slow, deep breaths. You may want to do a slow count to five as you breathe in, and again as you breathe out. Breathing in and out quickly may make symptoms worse.
- Give yourself some reassuring messages such as â€˜this is a panic attack. I am not going to die. I know what to do to stop it from getting worse.’
- Remind yourself you have survived these attacks before and can do so again.
- Stop or reduce your consumption of products that contain caffeine, such as caffeinated coffee, tea, cola and even chocolate.
- Ask your doctor or pharmacist before taking any over-the-counter medicines or herbal remedies. Many contain chemicals that can increase anxiety symptoms.
- Exercise daily and eat a healthy, balanced diet.
- Take your time. It’s important not to hope for a quick cure. Therapy takes time, and improvement comes in small steps.
- Go easy on yourself. People who feel panic tend to be overly critical of themselves.
In conclusion, anxiety or panic attacks are very common AND very treatable. Once understanding what the symptoms are, many people can learn how to reduce their frequency with only short term help.
Knowing some positive steps to take in the event of an attack helps reduce the feelings of being out of control, the fear of having another attack, and allows the individual to get back to doing what they want to in their lives.