How to cope with a panic attack

Panic attacks are considered a severe disorder. During an attack, a person experiences sudden bouts of unreasonable fear and helplessness. These attacks trigger intense physical and emotional reactions, including rapid heartbeat, trembling, dizziness, rapid breathing, and a sense of impending doom. Such pathology restricts everyday activities and negatively impacts a person’s quality of life.

It's important to seek medical advice at the first signs of this disorder to conduct a comprehensive assessment, make a diagnosis, and receive effective treatment. A specialist can help manage symptoms and develop anxiety-management strategies, preventing potential complications.

What is a Panic Attack?

A panic attack is a pathological condition classified under anxiety disorders. It involves sudden, intense episodes of unrestrained fear or anxiety. These episodes arise abruptly and last for a period of time. During an attack, a person may experience physical discomfort, such as a rapid heartbeat, shaking, sweating, difficulty breathing, dizziness, choking sensations, nausea, and a strong urge to escape.

Emotionally, panic attacks are accompanied by overwhelming anxiety, fear of dying, and fear of losing one’s mind or control. These experiences are frightening and exhausting. The unpredictable nature of these symptoms negatively impacts daily life, work, and relationships.

Frequent panic attacks may indicate panic disorder or another mental health condition, so it is important to consult a doctor for a precise diagnosis and appropriate treatment. Symptoms are usually most intense for a few minutes up to half an hour, rarely lasting up to an hour. Panic attacks are not life-threatening.

Causes of Panic Attacks

Panic attacks can have various causes, often due to a combination of genetic, biological, psychological, and environmental factors. Major causes include:

• Genetic predisposition: The risk of panic attacks is higher if other family members have had similar episodes.
• Neurochemical imbalance: An imbalance of brain chemicals, such as serotonin, can trigger panic attacks.
• Anxiety from stress disorder: High stress levels and anxiety contribute to panic episodes.
• Traumatic events: Past psychological trauma, especially from childhood, may lead to panic reactions.
• Somatic illnesses: Certain conditions like heart disorders, hyperthyroidism, or respiratory pathologies can provoke attacks.
• Personality traits: People prone to perfectionism, dependence on others’ approval, or fear of losing control may be more susceptible to panic attacks.

Most cases are considered multifactorial, requiring individualized approaches to diagnosis and treatment.

Symptoms of Panic Attacks

Panic attacks are characterized by sudden episodes with both physical and emotional symptoms. Common symptoms include:

• Physical symptoms:
  • Rapid heartbeat or pulsating veins
  • Difficulty breathing, feeling of suffocation
  • Dizziness or unsteadiness
  • Sweating and body tremors
  • Nausea and abdominal discomfort
  • General discomfort or pain
• Emotional symptoms:
  • Overwhelming fear and anxiety
  • Feeling of losing one’s mind or control
  • A sense that something terrible is about to happen, or fear of imminent death
  • Panic thoughts with a feeling of helplessness
• Behavioral symptoms:
  • Avoiding situations where attacks occur
  • Seeking shelter or support from others
  • Developing instinctual reactions like crying or hysterics

After a panic attack, a person often feels fatigued and disoriented. It’s important to note that panic episodes vary between individuals, and symptom intensity and duration can differ.

When to See a Doctor for Panic Attacks

If you or someone close to you experiences psychological symptoms with panic, it’s essential to seek medical help, especially if attacks recur.

In cases of panic attacks, one should consult a psychiatrist or psychotherapist, specialists in diagnosing and treating various mental disorders, including panic attacks. The doctor will conduct a thorough examination, make a diagnosis, and suggest effective treatments, such as psychotherapy, medication, or other medical interventions. Timely intervention is crucial to prevent the condition from worsening.

Diagnosis of Panic Attacks

Diagnosis begins with a detailed history and symptom assessment. The doctor will ask about attack frequency, intensity, and triggers, as well as the duration of symptoms and their impact on daily life.

Next, psychological testing is conducted using structured questionnaires and tests to identify panic attacks and other mental disorders. Occasionally, diagnosis includes additional tests, such as neurophysiological assessments or an MRI, to rule out organic causes. After a thorough examination, the psychiatrist establishes a diagnosis and develops an individualized treatment and support plan for the patient.

Methods of Treating Panic Attacks

Treatment must be comprehensive, involving both medication and psychotherapy. It’s crucial to seek professional help because mental health is essential for a person's well-being and quality of life.

Medication Treatment

Medication is prescribed for recurrent attacks and may include:

• Antidepressants, like selective serotonin reuptake inhibitors (SSRIs) or tricyclic antidepressants, to reduce the frequency and intensity of attacks and relieve fear of recurrence.
• Anxiolytics (benzodiazepines), used to manage acute attacks and suitable for short-term use.
• Beta-blockers to reduce physiological symptoms like increased heart rate and body tremors.

A tailored approach is essential, combining medication with psychotherapy to achieve the best outcomes.

Psychotherapy

Cognitive-behavioral therapy (CBT) is the most effective method for managing panic attacks. During sessions, the therapist helps patients learn to control thoughts and behaviors during an episode. Psychotherapy develops strategies to help individuals manage panic and relax the body. Psychodynamic therapy addresses the deep psychological causes and resolves internal conflicts, while mindfulness and meditation practices teach stress control.

Self-Help for Panic Attacks

If panic attacks occur, consider these recommendations:

• Deep breathing: Focus on breathing and take slow, deep breaths to reduce stress.
• Muscle relaxation: Try relaxing body muscles from head to toe, using progressive muscle relaxation.
• Positive thoughts: Shift attention to positive thoughts or memories to divert from panic sensations.
• Meditation and yoga: These practices calm the mind and body, helping to manage chronic stress and intense fear.
• Seeking help: If attacks are frequent, consult a psychotherapist or psychiatrist.

What to Do During a Panic Attack

When an attack begins, these steps may help:

• Deep breathing: Stop and focus on breathing. Try slow, deep breaths to calm yourself.
• Positive affirmations: Repeat supportive thoughts like "I can handle this," "Everything will be okay," or "This is temporary."
• Change your environment: Move to another room or outside to distract from the attack.
• Find support: Reach out to a close person and share your feelings, asking for support.
• Relaxation: Use relaxation methods like meditation or yoga.

How to Calm Someone Else During a Panic Attack

If someone is experiencing an attack, offer support and stay calm. Here’s how to help:

• Be present: Your presence and support mean a lot.
• Remain calm: Project confidence to help the person feel secure. Speak in a soft, reassuring voice.
• Guide their breathing: Help them focus on breathing with slow, deep breaths.
• Give them time: Let the person go through the attack without rushing them.
• Massage gently: Rub their back or shoulders to relax muscles.
• Practice relaxation exercises together: Simple muscle relaxation exercises can be beneficial.
• Discuss their feelings: Encourage them to talk about what they’re experiencing, which can help them control emotions.

Encourage them to see a doctor if attacks become frequent or interfere with daily life. Supporting them on the path to recovery is invaluable.

How to Calm Down Before Bed

For those with panic attacks, a calm pre-sleep routine is essential, as stress and anxiety can heighten at night. Create a relaxing atmosphere in the bedroom, use soft lighting, read a book, or listen to calming music. Drinking herbal tea before bed can also help.

Practice deep breathing and progressively relax each body part. Avoid watching news before sleep. Imagine a mental picture of a favorite, peaceful place and immerse yourself in it mentally.

How to Get Rid of Panic Attacks

Remember, each case is unique, and effective treatment varies. Consultation with a qualified psychiatrist is crucial for identifying the best individual approach. Additionally, avoid situations that provoke panic when possible.