A Panic Attack is an adrenaline rush: Your body believes it has seen a grizzly bear and reacts accordingly.
Years ago, when I worked directly in physicians’ offices, I was asked to see five or six new clients each week that presented with Panic Attacks. At least 10 percent of people experience Panic Attacks during their lifetimes, so this number was not surprising.
I have written a series of four blog posts that explain Panic Attacks so that you can take the fear and worry out of them, and so that you can stop having them. This post is the first in the series. The entire series of posts explore:
You will derive the most benefit if you read through the posts in the order they are presented. However, each has been written to be a stand-alone document, so you can skip directly to the last post to learn how to stop a Panic Attack, if you choose.
Many people require only two therapy sessions to stop experiencing Panic Attacks.
Most people that consult a psychologist because they are experiencing Panic Attacks require only two sessions to resolve the problem. In the first session, the psychologist explains what Panic Attacks are, what triggers them, why we have them, and how to dismantle any future attacks. During the second session, the psychologist checks in with the client to determine whether they have experiencing any additional attacks and if so, whether they have been able to stop subsequent attacks.
In my experience, the majority of my clients either never have another Panic Attack, or are able to prevent subsequent attacks from gaining any steam, once they understand what is happening.
There are 13 Symptoms of Panic Attacks: You need to have experienced four to receive a diagnosis of Panic Disorder.
In situations where a client has been unable to stop subsequent attacks, further counselling is required. In these cases, the client usually has had long-standing problems with anxiety and has benefited from remaining in therapy for a longer period to learn how to better manage their anxiety.
In my private practice as a psychologist, when a new client presents with Panic Attacks, I ask them to endorse the symptoms they experienced during their most recent attack to ensure we are dealing with Panic Attacks.
The DSM (Diagnostic and Statistical Manual, which is a diagnostic manual used by mental health professionals), lists 13 symptoms for Panic Attacks. You must endorse four of the 13 to receive a diagnosis. In addition, the symptoms must develop abruptly and peak within 10 minutes.
The symptoms of Panic Attacks, as listed in the DSM, include:
1. palpitations, pounding heart, or accelerated heart rate
3. trembling or shaking
4. sensations of shortness of breath or smothering
5. feeling of choking
6. chest pain or discomfort
7. nausea or abdominal distress
8. feeling dizzy, unsteady, lightheaded or faint
9. derealization (feelings of unreality) or depersonalization (being detached from oneself)
10. fear of losing control or going crazy
11. fear of dying
12. paresthesias (numbness or tingling sensations)
13. chills or hot flushes
For more detailed information, you can search Panic Attack criteria and DSM on the internet.
Panic Attacks drive people to the Emergency Room.
A large number of people visit the emergency room because they believe they are having a heart attack when they experience their first major Panic Attack. Emergency room doctors take these complaints seriously because a heart attack is not something to fool around with.
But after you’ve been put through a series of tests, a physician will sit down with you briefly and explain that your heart is fine. One telling sign that there is not a problem with your heart is that they will keep you waiting in Emergency while they deal with urgent cases, like people having real heart attacks.
Medications help manage the symptoms of Panic Attacks or prevent Panic Attacks from happening only until they are removed.
You may be given a benzodiazepine like Xanax or Ativan to get you through the next couple of days, until you can see your family physician.
If you visit your physician because you are having Panic Attacks, you may be put on a medication because some medications (for example: benzodiazepines, beta-blockers, and SSRIs) can help manage the symptoms of Panic Attacks or prevent Panic Attacks from happening.
A limitation of this approach, however, is that Panic Attacks can resume once the medication is removed. And who wants to remain on a medication over the longer-term when you don’t have to be on one?
Psychoeducation, combined with therapy, can help you eliminate Panic Attacks altogether.
Some physicians bypass the medication route and tell their patients to see a psychologist for help with the problem. Physicians don’t have enough time available in a 15 minute or 30 minute appointment to dismantle Panic Attacks with their patients, and the majority have not been trained in how to do so.
It is often through this route that people experiencing Panic Attacks find their way to my office. Either that, or people Google how to stop Panic Attacks from happening when they get home from the Emergency Room and find my website.
Psychologists are trained to treat Panic Attacks successfully.
Psychologists approach the problem of treating Panic Attacks quite differently than physicians. We explain that a Panic Attack is simply an adrenaline rush. If you re-read the 13 symptoms of Panic Attacks listed earlier in this post, you will notice that they are also the symptoms you experience when you are badly frightened.
Think about what happened the last time you were badly frightened. Your heart raced, you started sweat heavily, and you likely trembled. You likely had chest pain and trouble breathing, too.
So, what’s going on? Your body believes it has seen a grizzly bear. Your primitive brain, with no conscious control from your thinking brain, moves you into hyperarousal, which you are likely more familiar with as Fight or Flight.
I treat clients with Panic Attacks today in my Calgary office.
Once a diagnosis is confirmed, I tell each client a series of stories to explain why Panic Attacks occur and what triggers them, and then I teach my clients physical strategies and thinking strategies that they can use to dismantle future attacks if they arise.
In my experience, once clients understand what Panic Attacks are, they seldom have another. Cognitively knowing what is going on is often enough.
The next post in this series of four discusses why Panic Attacks occur.
— Dr. Patricia Turner, Registered Psychologist, Calgary, Alberta