Your Secret Weapon for Managing Panic Attacks

What is a Panic Attack?

A panic attack is an episode of extreme anxiety and fear that can come on suddenly and have both physical and psychological symptoms. A panic attack can occur during specific situations that trigger a stress response, but one can also occur unexpectedly without an obvious trigger. Panic attacks are a result of the rapid release of stress hormones into the body.

People who have recurring panic attacks are often diagnosed with panic disorder, but you don’t have to have panic or an anxiety disorder to experience a panic attack. If you’ve never had a panic attack before, the symptoms can be both alarming and unnerving.

Common symptoms of panic attacks include:

• Rapid heartbeat or heart palpitations
• Sweating
• Trembling or shaking
• Shortness of breath or feeling of choking
• Chest pain or discomfort
• Nausea or abdominal distress
• Feeling dizzy, lightheaded, or faint
• Chills or hot flashes
• Numbness or tingling sensations
• A sense of impending doom or fear of losing control
  

A panic attack is usually fairly short-lived with symptoms lasting anywhere from 10 to 20 minutes, although some symptoms may linger after the panic attack has passed. It's important to note that symptoms of panic attacks vary among individuals.

Why People Have Panic Attacks

Several factors can contribute to the onset of panic attacks in an individual. In most cases, panic attacks are caused by a combination of biological, psychological, and environmental factors.

Biological Factors that Cause Panic Attacks

Scientists believe there is a genetic component to panic attacks and panic disorders. If someone in your family has had panic attacks or an anxiety disorder, you might be at higher risk of also having panic attacks.

Your individual brain chemistry can also contribute to the onset of panic attacks. Neurotransmitters, which transmit signals between nerve cells in the brain and body, regulate your mood and anxiety. Serotonin is a “feel-good” neurotransmitter that influences your mood and emotions, while norepinephrine is associated with the fight-or-flight stress response. Imbalances in these neurotransmitters can lead to a panic attack.

Psychological Factors that Cause Panic Attacks

Your nervous system is designed to respond to stressful situations to protect you from genuine threats. You want your nervous system to tell you to run if you encounter a copperhead while on a hike. But when you have an anxiety disorder or are prone to hypervigilance or catastrophic thinking, your nervous system is trained to respond to perceived threats. In these cases, your body interprets sensations or situations as more dangerous than they actually are. Your body may even interpret threats that aren't objectively dangerous as threatening.

Imagine a car alarm system. When you have an anxiety disorder, it’s as if your car alarm system is set to a more sensitive setting than usual. That means that even small disturbances such as a light breeze or distant noise, can trigger the alarm to go off. Similarly, your body’s stress response is set on high alert, and even minor stressors or worries can lead to intense feelings of anxiety.

Now, think of a panic attack like a sudden, overwhelming blaring of that car alarm. In this case, the alarm isn’t triggered by an actual threat, but by the heightened sensitivity of the system. It’s like your nervous system overreacts, sending signals of danger even when there’s no immediate danger present.

Environmental Factors that Cause Panic Attacks

Certain environmental factors can cause you to be more likely to experience a panic attack. Major stressors, such as the death of a loved one, or traumatic experiences, such as a car crash, can trigger panic attacks. These activate your body's stress response and keep your body in a heightened state of arousal. Even if you don't have a history of anxiety disorders, your nervous system is still like the overly-sensitive car alarm.

In the case of traumatic events, your body may develop a conditioned response to similar situations. If you experienced a house fire, the smell of a backyard firepit may trigger a physiological response. Another individual who experienced a house fire may not be triggered by the sight or smell of fire, but they might develop a heightened fear of its recurrence. This fear can prime the body to react more strongly to similar situations in the future. Every person’s body will react differently to traumatic events.

Caffeine, alcohol, and drug use can also trigger panic attacks or make them worse.

What to Do if You Have a Panic Attack

Although a panic attack is intense and distressing, it isn’t usually life-threatening. If you find yourself having a panic attack, these steps can help you cope:

• Recognize that you’re having a panic attack. If you’ve never had a panic attack before, it can be a particularly scary experience. Naming that it’s a panic attack, especially if you’re in an already stressful situation, can help calm fears that you’re unable to breathe or that something is seriously wrong. Remember that panic attack symptoms, although they are uncomfortable, are a temporary physiological response to heightened anxiety.
• Practice calming techniques. Panic attacks are like a wave that comes on quickly, crests, and then subsides. Calming techniques can help you ride the wave. Different calming techniques will work for different people, so try to find one that may work for you. If you have a panic attack, find a space where you feel safe and remove yourself from the stressful situation if possible. Practice deep, slow breaths to reduce feelings of hyperventilation. Distract yourself by listening to music or working on a puzzle. Grounding techniques, which keep your body in the present moment, can also help.
• Get support. Support is helpful both during a panic attack and following your panic attack. If you're with someone you trust, let them know that you're having a panic attack. They can reassure you and support you if you need it. You should also consider reaching out to your primary care doctor or a mental health professional after experiencing a panic attack for further help.

Panic Attack or Medical Emergency?

Because panic attacks and heart attacks have some symptoms in common, some people confuse their panic attack for a medical emergency. How do you tell the difference between the two?

Panic attacks and heart attacks have some key differences:

• Response to relaxation techniques: While you can’t make your panic attack go away altogether, you can usually alleviate your symptoms with specific calming methods. A heart attack won’t be relieved by any of these methods.

• Onset: Panic attacks usually come on suddenly and peak within a few minutes. Heart attack symptoms may develop suddenly, but they can also develop much more gradually.
• Duration: Most panic attacks resolve within 10-20 minutes. Heart attack symptoms will usually last much longer.
• Intensity: You may feel some slight pain in your chest with a panic attack, but there are usually other symptoms. A heart attack will often feature more severe chest pain that radiates to your arms, neck, jaw, back, or stomach.

If you believe you are having a heart attack, always call 911 or go to the nearest emergency room. If you suspect a panic attack instead, it’s a good idea to follow up with a medical professional such as an urgent care doctor or your primary care doctor, but a panic attack isn’t a true medical emergency.

How Your Primary Care Doctor Can Help

Whether you've just had your first panic attack or you've had a few and you're ready to reach out for help, your primary care doctor can help – and it isn't just by prescribing medication. Your primary care doctor is the perfect ally when you need help with your mental health.

Your primary care doctor will probably start with a thorough physical exam and assessment. They'll talk with you to hear about your symptoms and possible triggers. They will also look to rule out any other medical conditions that may cause similar symptoms. For example, your doctor will listen for any irregularities in your heart rate or breathing and to consider other systemic causes.

Your doctor can also provide specific education that's tailored to your needs and answer any questions you have. The internet is a great resource, but always filter health information through your primary care doctor or a trusted medical professional.

To help you feel better, your primary care doctor will likely recommend non-pharmaceutical interventions that can help you manage anxiety and reduce the frequency of your panic attacks. Some recommendations may include dietary changes (such as eliminating alcohol or caffeine), adding exercise, practicing good sleep hygiene, and reducing stress. Your doctor can also help refer you to a mental health professional such as a psychologist or a therapist who specializes in anxiety disorders.

Medications can be helpful for some individuals. Should you need medication to manage anxiety or panic attacks, your doctor knows your medical history and can prescribe a medication that will be effective and targeted to your specific symptoms and needs.

Your doctor is your partner for better health, so you may want to have a follow-up appointment in several weeks or a few months to see how your treatment plan is going and to evaluate whether or not changes are needed.

At MedHelp, we’re committed to helping our patients be well in both their body and their spirit. Whether you visit one of our urgent care clinics in Birmingham or schedule an appointment with your primary care doctor, you’ll find compassionate, thoughtful providers.